How do patient biomechanics influence the choice between an anatomic and reverse TSA?

Patient biomechanics play a crucial role in determining the appropriate surgical intervention, whether that be an anatomic or reverse total shoulder arthroplasty (TSA). By evaluating shoulder anatomy, rotator cuff integrity, and joint stability, surgeons can tailor their approach to the unique needs of each patient.

Understanding shoulder anatomy is vital since anatomic TSA is most suitable for patients with good rotator cuff function and a normally structured joint. In cases where the rotator cuff is compromised or when there are significant anatomical deformities, the reverse TSA can provide better outcomes. This is due to its design, which shifts the center of rotation and improves stability by allowing the deltoid muscle to compensate for the deficient rotator cuff.

Joint stability is another essential factor. In patients with significant instability or severe degenerative changes, a reverse TSA is often preferred as it inherently provides more stability compared to an anatomic repair.

Other options do not accurately reflect the complexity of the decision-making process in shoulder surgeries. Factors such as age alone are inadequate for determining the best surgical intervention, as the individual's overall shoulder mechanics and function play more significant roles than age by itself. Relying solely on patient preference without considering biomechanical factors would likely lead to suboptimal results, hence not providing