Shoulder Arthroplasty & Arthritis MCQs

Scapular notching is a recognized complication of reverse total shoulder arthroplasty (rTSA). Which technical modification of the glenosphere most effectively reduces the incidence of this complication?

In reverse total shoulder arthroplasty (RSA), moving the center of rotation medially and distally compared to the native joint achieves which of the following biomechanical advantages?

A 70-year-old female is 2 years status-post reverse total shoulder arthroplasty for cuff tear arthropathy. Radiographs reveal erosive changes on the inferior scapular neck extending beyond the inferior screw of the baseplate, but not reaching the central peg. According to the Sirveaux classification, what grade of scapular notching is present?

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 achieved by the classic Grammont-style reverse shoulder implant?

A 75-year-old male is evaluated 3 years after a reverse total shoulder arthroplasty. He is asymptomatic, but a standard AP radiograph shows bone resorption at the inferior scapular neck that extends medially, progressing just past the inferior screw of the glenoid baseplate. According to the Sirveaux classification, what grade of scapular notching does this represent?

A 75-year-old female with osteoporosis presents with a severely displaced 4-part proximal humerus fracture. The decision is made to proceed with a reverse total shoulder arthroplasty (RTSA) rather than a hemiarthroplasty. Which of the following is the primary biomechanical advantage of RTSA over hemiarthroplasty in this specific clinical scenario?

In an active 78-year-old female with a highly comminuted 4-part proximal humerus fracture and poor bone quality, what is the primary advantage of a reverse total shoulder arthroplasty (RTSA) compared to a hemiarthroplasty?

A 78-year-old female sustains a 4-part proximal humerus fracture with severe tuberosity comminution. Which of the following is the primary biomechanical advantage of choosing a reverse total shoulder arthroplasty (RTSA) over a hemiarthroplasty in this patient?

A 65-year-old male is scheduled for an anatomic total shoulder arthroplasty. Preoperative CT scanning classifies the glenoid morphology as a Walch B2 type. Which of the following best describes a Walch B2 glenoid?

By what primary biomechanical mechanism does a reverse total shoulder arthroplasty (RTSA) restore active forward elevation in patients with rotator cuff tear arthropathy?

When performing a reverse total shoulder arthroplasty (RTSA), optimal positioning of the glenoid baseplate is critical to prevent scapular notching. Which of the following baseplate configurations is most effective in minimizing this complication?

A 78-year-old active female presents with a complex, comminuted four-part proximal humerus fracture with significant displacement and severe osteopenia. She has a pre-existing rotator cuff tear that was symptomatic prior to her fall. She is physiologically fit for surgery and desires the best possible functional outcome. Considering the patient's age, fracture pattern, bone quality, and pre-existing rotator cuff pathology, which surgical option is most likely to provide predictable pain relief and functional improvement?

An 82-year-old female sustains a displaced 4-part proximal humerus fracture. She lives independently and is medically optimized for surgery. When comparing hemiarthroplasty to reverse total shoulder arthroplasty (RTSA) for this patient, which of the following is the most significant advantage of RTSA?

A 75-year-old female undergoes reverse total shoulder arthroplasty (rTSA) for an unreconstructible 4-part proximal humerus fracture. Regarding the management of the tuberosities in this setting, which of the following statements is true?

Which of the following is considered an absolute indication for Reverse Total Shoulder Arthroplasty (RTSA) over Open Reduction Internal Fixation (ORIF) in the management of an acute proximal humerus fracture?

A 75-year-old female with severe osteoporosis sustains a comminuted 4-part proximal humerus fracture with widely displaced tuberosities. Which surgical option is associated with the most predictable restoration of forward elevation and the lowest rate of functional failure in this specific demographic?

A 75-year-old female with osteoporosis sustains a severe 4-part proximal humerus fracture. A reverse total shoulder arthroplasty (RTSA) is chosen over a hemiarthroplasty. What is the primary functional advantage of RTSA in this specific clinical scenario?

A 78-year-old female with osteoporosis presents with a highly comminuted, 4-part proximal humerus fracture. There is significant disruption of the medial hinge and tuberosity osteopenia. Which surgical intervention offers the most reliable functional outcome for this patient?

A 72-year-old female with massive, irreparable rotator cuff tear and pseudoparalysis is undergoing a reverse total shoulder arthroplasty (RTSA). During component positioning, which of the following modifications is most effective at decreasing the risk of postoperative scapular notching?