Shoulder Arthroplasty & Arthritis MCQs

A 72-year-old man with a chronic massive rotator cuff tear presents with pseudoparalysis. Radiographs show severe superior migration of the humeral head and acetabularization of the acromion. If a reverse total shoulder arthroplasty is performed, the center of rotation is altered in which direction compared to the native anatomy?

A 72-year-old woman with severe osteoporosis presents with a closed, displaced 3-part proximal humerus fracture involving the surgical neck and greater tuberosity. The humeral head is varus and severely retroverted. What is the most appropriate surgical treatment?

A 78-year-old woman with a history of severe osteoporosis sustains a displaced 4-part proximal humerus fracture. She lives independently and is active. What surgical option provides the most predictable return of forward elevation and is least dependent on tuberosity healing?

A 65-year-old woman is scheduled to undergo a reverse total shoulder arthroplasty for cuff tear arthropathy. To minimize the risk of scapular notching, how should the glenosphere baseplate optimally be positioned?

A 72-year-old man is 3 years post-operative from a reverse total shoulder arthroplasty (rTSA) for massive cuff tear arthropathy. Radiographs demonstrate a large radiolucent area at the inferior aspect of the glenoid neck. Which surgical technique during the index procedure most effectively minimizes this complication?

A 78-year-old woman with severe osteoporosis presents with a 4-part proximal humerus fracture after a mechanical fall. The humeral head is entirely devoid of soft tissue attachments, and the tuberosities are comminuted. What is the preferred surgical treatment to maximize functional outcome and pain relief in this patient?

A 72-year-old woman with rotator cuff tear arthropathy and pseudoparalysis undergoes a reverse total shoulder arthroplasty (RTSA). Which of the following muscles provides the primary motive force for active elevation postoperatively?

A 78-year-old woman with severe osteoporosis sustains a comminuted 4-part proximal humerus fracture. The humeral head is split, and the tuberosities are widely displaced. She is treated with a reverse total shoulder arthroplasty (RTSA). Healing of which structure is most critical to restore active external rotation?

A 75-year-old osteoporotic woman sustains a displaced 4-part proximal humerus fracture. The articular surface is subluxated, and the tuberosities are widely displaced. Which treatment modality is associated with the most reliable return of forward elevation?

A 75-year-old woman with severe osteoporosis sustains a displaced, 4-part proximal humerus fracture. Examination of preoperative imaging suggests severe valgus impaction and poor tuberosity bone stock. Which of the following surgical interventions will provide the most predictable outcome for postoperative functional elevation and pain relief?

A 72-year-old woman with pseudoparalysis and severe rotator cuff arthropathy is scheduled for a reverse total shoulder arthroplasty (RTSA). The biomechanical advantage of RTSA relies on shifting the center of rotation in which directions compared to the native shoulder?

A 58-year-old woman sustains a severely displaced 4-part proximal humerus fracture. The humeral head is noted to be entirely devascularized on advanced imaging. When comparing hemiarthroplasty to reverse total shoulder arthroplasty (RTSA) for this patient, RTSA has been shown in the literature to provide which of the following advantages?

A patient is evaluated 2 years after receiving a reverse total shoulder arthroplasty (RTSA). Radiographs reveal a progressive lucency and bone loss on the inferior scapular neck. What is the primary mechanical cause of this scapular notching?

A 78-year-old woman presents with a 4-part proximal humerus fracture. She has severe osteoporosis and a sedentary lifestyle. The fracture involves significant displacement of the tuberosities and valgus impaction of the humeral head. Which of the following is the primary advantage of reverse total shoulder arthroplasty (RTSA) over hemiarthroplasty for this patient?

A 72-year-old male presents with long-standing shoulder pain and an inability to actively elevate his arm above 45 degrees. Radiographs demonstrate an acromiohumeral distance of 3 mm.

MRI reveals massive, retracted supraspinatus and infraspinatus tears with grade 4 fatty infiltration. What is the most appropriate surgical treatment?

Which of the following best describes the fundamental biomechanical alteration achieved by a classic Grammont-style reverse total shoulder arthroplasty in a patient with advanced rotator cuff arthropathy?

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

Which of the following glenoid morphologies (Walch classification) in the setting of primary osteoarthritis is characterized by a biconcave surface and posterior subluxation of the humeral head, and carries the highest risk of early glenoid component loosening in anatomic total shoulder arthroplasty?

A 78-year-old female with osteoporosis sustains a highly comminuted 4-part proximal humerus fracture with a split humeral head.

What is the most appropriate surgical management to maximize her functional outcome?

A 75-year-old man presents with chronic right shoulder pain and an inability to actively elevate his arm above 45 degrees. Radiographs demonstrate an acromiohumeral distance of 3 mm. MRI reveals massive, retracted tears of the supraspinatus and infraspinatus with grade 4 fatty infiltration, while the subscapularis and deltoid are intact. What is the most appropriate surgical treatment?