painful dislocated rt shoulder in a 76 year old lady

Mri showed chronic cuff tear grade 3 gautilier

 with subscap tear 

 The issue  of  reverse shoulder was easy as she has pain and was unstable due to cuff tear arthropathy with thrice weekly dislocation during sleep. Before the arrival of Grammonts prosthesis,  fusion could have been the only option

superior capsular reconstruction  have come recently from Dr. Mihata, however as there is already cuff arthropathy, pain at rest may not relieved.  Capsular reconstruction would improve movement but not increase strength and in this case the instability sealed  the solution.

The next problem whether a constrained liner was needed  or a subscap repair was mandatory or desirable. In this case as subs cap was retracted  further to try repair a constrained liner was use  and the result  is below