by AceMedEd

Teach card · keep it in your scrub pocket

Reverse total shoulder arthroplasty

Ask during the case

  1. During the deltopectoral exposure: "Show me the cephalic vein. Which way do I retract the conjoined tendon, and which nerve am I stretching if I pull too hard?"
  2. Before the inferior capsular release: "Put your finger along the lower border of subscapularis. What's down there, how do you feel for it, and why does losing it ruin a reverse?"
  3. At trial reduction: "Where is the center of rotation now compared with the native head, what did that do to the deltoid's lever arm, and what does lengthening the arm risk?"

Point at: the axillary nerve on the finger sweep below subscapularis, or the conjoined tendon under the retractor, while they name it.

End of day: "Draw me the AP of a reverse: the ball, the socket, the old and new centers of rotation, the deltoid's line, and where notching shows up." Two minutes, no notes.

Where this kit and your technique differ, yours wins.

Send this to your students

The night before. They prep alone, redraw at turnover, and get a cold check tomorrow morning. They won't see these questions.

Open the student page

Reviewed by Mehdi “AC” Talle, D.O., November 2026. Sources: Netter, Gray's Anatomy and Hoppenfeld's surgical exposures. Teaching schematic, not to scale; anatomy and technique vary. Management and indications are left to you on purpose.