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Replacement arthroplasty of the rotator cuff deficient shoulder.

Ecklund KJ, Lee TQ, Tibone J, Gupta R. "Rotator Cuff Tear Arthropathy" J Am Acad Orthop Surg. 2007 Jun;15(6):340-9.

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Hemiarthroplasty in rotator cuff-deficient shoulders.

This condition is sometimes called arthropathy and the term cuff tear arthropathy is used to describe this type of arthritis of the shoulder that develops when the rotator cuff is damaged.

Glenoid loosening in total shoulder arthroplasty: association with rotator cuff deficiency.

N2 - Rotator cuff tear arthropathy is characterized by massive and irreparable rotator cuff tears associated with shoulder arthritis. Symptoms include varying degrees of pain, loss of motion, and loss of function, or "pseudo-paralysis" alone. Nonoperative modalities are the treatment mainstay for mildly symptomatic patients, and there are viable medical and surgical treatment options for those whose symptoms are not severe enough to warrant shoulder arthroplasty. The trend toward using reverse total shoulder arthroplasty as the only treatment for this highly variable patient group does not allow a cautious approach to this disease nor recognize the high potential complication rate of the reverse prosthesis.

But, sometimes a rotator cuff tear cannot be repaired.

Roentgenographic findings in massive rotator cuff tears: a long-term observation.

The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum two-year follow-up study of sixty patients.

Shoulder replacement surgery for cuff tear arthropathy is an elective procedure that can be scheduled when circumstances are optimal for the patient. It is not an urgent procedure. The patient has plenty of time to become informed about the process of surgery and recovery.

A pinched nerve in the neck can mimic a rotator cuff tear.

Charles Neer actually described rotator cuff tear arthropathy (RCTA) in 1977.

N2 - Reverse total shoulder arthroplasty was developed in the late 1980s for elderly patients with rotator cuff arthropathy. Several biomechanical advantages of the reverse shoulder arthroplasty result in improved deltoid function, which improves shoulder motion and function compared to other types of shoulder arthroplasty. The main indication for the reverse prosthesis is painful rotator cuff tear arthropathy. The indications for reverse shoulder arthroplasty have continued to expand since it was first performed in the United States in 2004. Although the results of reverse total shoulder arthroplasty have been generally favorable, the complication rate is higher than that of conventional total shoulder arthroplasty. Complications include those common to other shoulder procedures (infection, instability, and nerve injury) and those unique to reverse total shoulder arthroplasty (scapular notching, glenoid baseplate failure, component disassociation, and scapular stress fractures). It is helpful for orthopaedic surgeons to understand ways to avoid these complications and methods with which to treat them.

A rotator cuff tear arthropathy can create a challenging treatment problem. While are effective treatment for shoulder arthritis, the standard implants rely on the rotator cuff to function properly. Just as the normal shoulder relies on proper functioning of the rotator cuff, a standard shoulder replacement also relies on this function of the rotator cuff. When the rotator cuff is not working, and a standard shoulder replacement is performed, the joint is abnormally aligned, and the socket portion of the replacement tends to loosen and wear out quickly.

Today, doctors generally refer to this as simply cuff tear arthropathy.
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  • Reverse shoulder arthroplasty in cuff tear arthropathy ..

    Shoulder hemiarthroplasty for glenohumeral arthritis associated with severe rotator cuff deficiency.

  • initially proposed by Grammont for cuff tear arthropathy ..

    Grammont’s reverse shoulder prosthesis for rotator cuff arthropathy: a retrospective study of 32 cases.

  • Painful cuff tear arthropathy ..

    Trauma, such as falls, lifting, and pulling forcefully can also cause a rotator cuff tear.

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Cuff (Rotator) Tear Arthropathy - Houston Methodist

This operation is intended for patients who have developed instability from cuff tear arthropathy where attempts to elevate the arm results in dislocation of the ball from the socket. These patients have generally undergone resection of part of the acromion bone as part of a previous rotator cuff tear. The reverse prosthesis is also a possibility for patients with pseudoparalysis of the shoulder who have poorly compensated function.

Treatment for Rotator Cuff Tear Arthropathy | SOS Med

Surgery for debridement and lysis of adhesions generally takes about one and a half hours. Replacement surgery for cuff tear arthropathy takes approximately three hours. In both cases, the preoperative preparation and the postoperative recovery may add several hours to this time. Patients often spend an hour in the recovery room prior to returning to the inpatient ward.

Treatment for Rotator Cuff Tear Arthropathy

This operation is geared toward patients with an irreparable rotator cuff who have disabling pain from abrasion of the humeral head against the arthritic socket and acromion bone. Unlike the Smooth and Move Operation, this surgery address the arthritis that has developed between the ball and upper socket Through an incision on the front of the shoulder, an artificial ball with a smooth round metal head is inserted onto a metal stem that fits in the canal of the humerus bone. This ball reduces the friction and abrasion against the arthritic socket and acromion from bone-on-bone contact. Unlike a total shoulder replacement, the socket is not replaced in cuff tear arthropathy because of a high risk of socket loosening.

acromion bone as part of a previous rotator cuff tear

Shoulder arthroscopy can be used to repair tears in the rotator cuff. During the procedure, tendon fragments and debris are removed (debridement), the acromion is smoothed (subacromial decompression), and anchors are placed in the humerus, or upper arm bone. The rotator cuff tendon is then reattached to the humerus with sutures.

Rotator Cuff Arthropathy - Shoulder & Elbow - …

Over time this pinching can lead to damage and weakening of the rotator cuff tendons.

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Related Document:

What causes this condition?


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