Clin Orthop Surg.  2010 Dec;2(4):196-202. 10.4055/cios.2010.2.4.196.

Rotator Cuff Deficient Arthritis of the Glenohumeral Joint

• Macaulay A
• Greiwe RM
• Bigliani L

• KMID: 1719318
• DOI: http://doi.org/10.4055/cios.2010.2.4.196

Abstract

Rotator cuff deficient arthritis of the glenohumeral joint, especially cuff tear arthropathy, has proved a challenging clinical entity for orthopaedic surgeons ever since Charles Neer originally detailed the problem in 1983. Understanding has improved regarding the pathophysiology and pathomechanics underlying cuff tear arthropathy. Surgical reconstruction options can lead to excellent outcomes for patients afflicted with these painful and functionally limited shoulders. Humeral hemiarthroplasty and reverse total shoulder arthroplasty have jumped to the forefront in the treatment of cuff tear arthropathy. As studies continue to look at the results of these procedures in cuff tear arthropathy, existing indications and treatment algorithms will be further refined. In this article the history and pathophysiology of cuff tear arthropathy are reviewed. Additionally, the clinical findings and results of surgical reconstruction are discussed.

Keyword

Cuff tear arthropathy; Glenohumeral arthritis; Rotator cuff tear; Reverse total shoulder arthroplasty

MeSH Terms

Arthritis/diagnosis/etiology/*surgery
Arthroplasty, Replacement/adverse effects/methods
Humans
Magnetic Resonance Imaging
Rotator Cuff/*injuries
Shoulder Joint/radiography/*surgery
Tomography, X-Ray Computed

Figure

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  Fig. 1 The fluid sign.

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  Fig. 2 (A) Coronal oblique MRI showing a massive rotator cuff tear. (B) Sagittal MRI showing fatty infiltration and atrophy of the supraspinatus muscle.

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  Fig. 3 Sirveaux classification for scapular notching (reproduced from Sirveaux F, et al. J Bone Joint Surg Br. 2004;86(3):388-95, with permission from British Society of Bone and Joint Surgery).27)

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  Fig. 4 (A) 155 degree prosthesis with no center of rotation offset. (B) 143 degree prosthesis with 2.5 mm center of rotation offset.

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