A Review of Preoperative Planning and Technical Considerations for Anatomic Total Shoulder Arthroplasty

Anatomic total shoulder arthroplasty (aTSA) is best performed in the setting of glenohumeral joint osteoarthritis with an intact rotator cuff tear in patients with symptoms refractory to appropriate nonoperative treatment. Mid- to long-term follow-up supports overall high patient satisfaction with low complications rates. As reverse total shoulder arthroplasty (rTSA) allows the surgeon to manage a broader range of shoulder problems with greater technical ease and fewer complications, it has become the more commonly used option over aTSA. Specifically, glenoid deformity, joint incongruity, and rotator cuff deficiency pose challenging technical considerations for aTSA. The purpose of this article is to review the appropriate patient selection, preoperative planning, perioperative and intraoperative technical considerations required to achieve a successful outcome if aTSA is chosen.