Abstract

» Secondary rotator cuff insufficiency is a challenging complication after anatomic total shoulder arthroplasty. » Acute tears may be amenable to open or arthroscopic repair in some instances. » Chronic attritional tears are best managed with revision to reverse shoulder arthroplasty, especially in the elderly. » Increased glenoid inclination, larger critical shoulder angle, oversized humeral components, thicker glenoid components, and rotator cuff muscle fatty infiltration have all shown to contribute to tear risk.