The shoulder is a “ball and socket” joint that can become severely arthritic. A total shoulder arthroplasty (TSA) replaces arthritic bones, but some patients also have torn shoulder muscles so a standard TSA does not work. When this happens, surgeons must switch or “reverse” the natural position of the ball and socket to compensate for the torn muscles. This technique is called a reverse TSA (RTSA).

An additional procedure is sometimes done with a RTSA called a subscapularis repair.  Some surgeons feel this reduces the risk of shoulder dislocation while others feel it may restrict movement too much. There has never been a study to compare these approaches. The main goal of this study is to compare a RTSA with and without subscapularis repair.

Eighty-four patients with shoulder arthritis and severe rotator cuff injury will be randomly assigned to have a subscapularis repair or no repair. The main outcome is a patient-reported questionnaire that asks patients to rate their pain and ability to perform daily activities. Range of movement and rates of shoulder dislocation will also be compared.

The surgeons involved in this study perform all RTSA procedures done in Manitoba. Therefore, we have an incredible opportunity to potentially involve all patients that require this surgery from our population to evaluate their outcomes and to improve care for patients like them across the world. This study is critical in guiding surgeons to make the best choice for their patients and maximizing the outcome of this major shoulder procedure.