Challenge of the Week / Shoulder & Elbow / 05.06.2022

A 72-year-old male patient cannot actively raise his arm above 90° and has evidence of pseudoparalysis but full passive range of motion. There are no clinical signs of neurological impairment. He has had 2 previous rotator cuff repairs performed on the same shoulder. Which of the following is the most appropriate operative treatment option at this time?

    • Biceps tenodesis
    • Biceps tenodesis will likely not improve clinical function but can provide pain relief.
    • Partial rotator cuff repair
    • A partial rotator cuff repair can improve pain but has not been shown to improve function in the setting of pseudoparalysis.
    • Superior capsular reconstruction
    • While there is some anecdotal evidence of improvement in patients undergoing superior capsular reconstruction, it has not been reported to reliably improve outcomes in the setting of pseudoparalysis.
    • Reverse shoulder arthroplasty
    • Reverse shoulder arthroplasty has been shown to be the most reliable treatment option for this patient.


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