Shoulder: reverse shoulder arthroplasty: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Shoulder: reverse shoulder arthroplasty

Sample item

A 74-year-old woman has pseudoparalysis of active elevation from an irreparable massive rotator cuff tear with glenohumeral arthritis. Her deltoid function is good. Which operation is most suitable?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Reverse total shoulder arthroplasty

In cuff tear arthropathy the humeral head migrates upward because the cuff cannot centre it. A reverse prosthesis places the centre of rotation medially and lowers the humerus, so a working deltoid can elevate the arm without the cuff. Anatomical replacement fails because it relies on the cuff.

Option by option

  • A. Shoulder arthrodesis

    Arthrodesis is a salvage option with poor function.

  • B. Reverse total shoulder arthroplasty (correct)

    Correct. The reverse design lets the deltoid substitute for the cuff.

  • C. Subacromial decompression alone

    Decompression alone does not restore elevation in pseudoparalysis.

  • D. Anatomical total shoulder replacement

    Anatomical replacement depends on an intact cuff and loosens.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Reverse total shoulder arthroplasty. In cuff tear arthropathy the humeral head migrates upward because the cuff cannot centre it.

Why is "Shoulder arthrodesis" not the answer?

Arthrodesis is a salvage option with poor function.

Why is "Subacromial decompression alone" not the answer?

Decompression alone does not restore elevation in pseudoparalysis.

Why is "Anatomical total shoulder replacement" not the answer?

Anatomical replacement depends on an intact cuff and loosens.

What concept does this question test?

It tests Shoulder: reverse shoulder arthroplasty in Orthopaedics. A reverse prosthesis places the centre of rotation medially and lowers the humerus, so a working deltoid can elevate the arm without the cuff. Anatomical replacement fails because it relies on the cuff.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Shoulder: reverse shoulder arthroplasty?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.