Abstract
In the elderly patient population, concerns of patient selection secondary to medical comorbidities, bone quality, bone loss, patient compliance, and soft tissue balancing come to a head, and anatomic total shoulder arthroplasty (aTSA) presents unique challenges that distinguish this surgical intervention as one of the most challenging surgeries confronted by upper extremity specialists. Yet, aTSA is established as the benchmark treatment for patients with primary shoulder osteoarthritis with an intact rotator cuff. Accordingly, aTSA offers the potential advantage of increased ROM and PROs but carries risks of glenoid loosening and need for conversion to rTSA in the setting of symptomatic RCT. © ISAKOS 2023. All rights reserved.