A 72-year-old male patient cannot actively raise his arm above 90° and has evidence of pseudoparalysis but full passive range of motion. There are no clinical signs of neurological impairment. He has had 2 previous rotator cuff repairs performed on the same shoulder. Which of the following is the most appropriate operative treatment option at this time?
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- Biceps tenodesis Biceps tenodesis will likely not improve clinical function but can provide pain relief.
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- Partial rotator cuff repair A partial rotator cuff repair can improve pain but has not been shown to improve function in the setting of pseudoparalysis.
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- Superior capsular reconstruction While there is some anecdotal evidence of improvement in patients undergoing superior capsular reconstruction, it has not been reported to reliably improve outcomes in the setting of pseudoparalysis.
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- Reverse shoulder arthroplasty Reverse shoulder arthroplasty has been shown to be the most reliable treatment option for this patient.