Shoulder Arthroplasty & Arthritis MCQs

A 76-year-old woman sustains a displaced 4-part proximal humerus fracture. She has a history of severe osteoporosis. A decision is made to proceed with reverse total shoulder arthroplasty (rTSA). Healing of the tuberosities to the humeral shaft in rTSA is primarily associated with:

Which of the following best describes the biomechanical alteration achieved by a Grammont-style reverse total shoulder arthroplasty?

Which of the following modifications in reverse total shoulder arthroplasty component positioning has been shown to decrease the incidence of scapular notching?

According to the Walch classification of glenoid morphology in primary osteoarthritis, a B2 glenoid is best described by which of the following?

In a patient undergoing anatomic total shoulder arthroplasty (TSA), failure to correct excessive posterior glenoid retroversion (B2 glenoid) is most likely to result in which of the following mechanisms of failure?

A 72-year-old female undergoes a reverse total shoulder arthroplasty (rTSA) utilizing a standard Grammont-style prosthesis for the treatment of severe rotator cuff tear arthropathy. Postoperatively, she demonstrates excellent active forward elevation to 150 degrees but complains of profound weakness and inability to actively externally rotate her arm. Which biomechanical alteration inherent to this specific rTSA design primarily explains her functional deficit?

A 72-year-old female presents with progressive shoulder pain three years after undergoing a reverse total shoulder arthroplasty (rTSA) for rotator cuff tear arthropathy. Radiographs reveal Grade 3 scapular notching. Which of the following intraoperative technical errors during the initial surgery most likely contributed to this complication?

A 72-year-old male undergoes a reverse total shoulder arthroplasty (rTSA) for severe rotator cuff tear arthropathy. To minimize the risk of scapular notching—a complication specific to the altered biomechanics of this implant—the surgeon plans the glenosphere positioning carefully. In addition to placing the glenosphere with 10 to 20 degrees of inferior tilt, which of the following biomechanical alterations is most effective in reducing the incidence of this complication?

A 72-year-old female presents with progressive shoulder pain two years after undergoing a reverse total shoulder arthroplasty (rTSA) for rotator cuff tear arthropathy. Radiographs reveal significant erosion of the inferior scapular neck, consistent with severe scapular notching. Which of the following intraoperative technical errors during the initial placement of the glenosphere most likely contributed to this complication?

A 68-year-old female undergoes an anatomic total shoulder arthroplasty. Six weeks postoperatively, she presents with increased passive external rotation compared to her intraoperative assessment, profound weakness in active internal rotation, and a positive abdominal press test. Which of the following is the most likely cause of her clinical presentation?

In the design of a reverse total shoulder arthroplasty (rTSA), moving from a traditional Grammont-style medialized glenosphere to a lateralized glenosphere primarily aims to mitigate which of the following complications?

A 72-year-old female undergoes a reverse total shoulder arthroplasty (rTSA) for severe rotator cuff tear arthropathy. Compared to the native anatomic shoulder, which of the following best describes the biomechanical alteration of the center of rotation following a standard Grammont-style rTSA?

Scapular notching is a well-recognized complication following Reverse Total Shoulder Arthroplasty (RTSA). Based on modern biomechanical principles and implant design modifications, which of the following component positioning strategies is most effective in minimizing the risk of inferior scapular notching?

In planning a reverse total shoulder arthroplasty (rTSA), the surgeon decides to use a lateralized glenosphere rather than a standard medialized Grammont design. What is the primary biomechanical advantage of lateralizing the center of rotation on the glenoid side?

A 78-year-old female sustains a comminuted 4-part proximal humerus fracture. The surgeon elects to perform a reverse total shoulder arthroplasty (RTSA). To minimize the risk of post-operative external rotation weakness and optimize functional outcome, the surgeon must prioritize the healing of which specific bony fragment?

A 78-year-old right-hand-dominant female with osteoporosis falls and sustains a complex 4-part proximal humerus fracture. There is a valgus impacted head, significant tuberosity displacement, and a compromised medial calcar hinge. What is the most reliable surgical option for pain relief and functional restoration in this patient?

A 72-year-old male with severe rotator cuff arthropathy and pseudoparalysis undergoes a reverse total shoulder arthroplasty (RTSA). Biomechanically, how does RTSA restore active forward elevation?

Which of the following best describes the biomechanical alterations achieved by a Grammont-style reverse total shoulder arthroplasty compared to native shoulder anatomy?

An 68-year-old male with primary osteoarthritis of the shoulder is planned for an anatomic total shoulder arthroplasty. A preoperative CT scan reveals a biconcave glenoid with severe posterior wear and a retroversion of 20 degrees.

According to the Walch classification, what type of glenoid is this?

A 72-year-old female presents with pain and crepitus 3 years after a reverse total shoulder arthroplasty for cuff tear arthropathy. Radiographs demonstrate a radiolucent area on the scapular neck extending beyond the inferior screw of the glenoid baseplate.

According to the Sirveaux classification of scapular notching, what grade is this?