Which condition is cuff tear arthropathy typically indicated for treatment with reverse total shoulder arthroplasty?

• A. Calcific tendonitis.
• B. Cuff tear arthropathy.
• C. Osteoarthritis with intact rotator cuff.
• D. Acute fracture of humeral head.

Answer: (B)

The main idea is that a reverse total shoulder arthroplasty is used when the rotator cuff tear is massive and irreparable, causing cuff tear arthropathy where the normal rotator cuff mechanism is lost and the deltoid becomes the primary elevator. In this situation, the reverse design changes the shoulder’s mechanics by medializing and distalizing the center of rotation, which allows the deltoid to elevate the arm effectively even without a functional rotator cuff. This restores function and relieves pain where anatomic repair or the natural mechanics have failed.

Calcific tendonitis is a painful calcification within the rotator cuff tendons and is typically managed with conservative therapy or targeted procedures, not a shoulder arthroplasty. Osteoarthritis with an intact rotator cuff still relies on the native cuff function, so an anatomic total shoulder arthroplasty is preferred rather than a reverse. An acute fracture of the humeral head is treated based on fracture patterns and bone quality, often with fixation or hemiarthroplasty, unless a cuff tear arthropathy is also present.