Rise in rotator cuff tear arthropathy
is significantly contributing to the increase in demand for reverse total shoulder arthroplasty (RTSA).
Reverse total shoulder replacement works well for people with rotator cuff tear arthropathy
because it relies on different muscles to move the arm.
Gupta, "Rotator cuff tear arthropathy
," Journal of the American Academy of Orthopaedic Surgeons, vol.
Rotator cuff tear arthropathy, as it was termed by Neer, was characterized by a massive rotator cuff tear with superior humeral head migration and diminished acromiohumeral distance with "femoralization" of the tuberosities and "acetabularization" of the acromion.
Early attempts of hemiarthroplasty or bipolar arthroplasty to treat cases of rotator cuff tear arthropathy were unable to consistently alleviate pain and restore function.
Rotator cuff tear arthropathy is currently the primary indication for a reverse TSA, as this group has demonstrated predictable outcomes.
Neer classification system for shoulder impingement syndrome Stage Description Treatment 1 * reversible inflammation, edema rest, conservative and hemorrhage of the bursa, treatment subacromial space and rotator cuff 2 * irreversible rotator cuff rest, conservative fibrosis and tendinitis treatment, surgery * partial-thickness rotator cuff tear * recurrent pain with activity 3 * partial- or full-thickness surgery rotator cuff tear * bone spurs and excrescences * tendon tear/rupture 4 * rotator cuff tear arthropathy
surgery * progressive disability From: Neer (40,41) Table 2.
This type of surgery, however, is not as beneficial for patients with large rotator cuff tears who have developed a complex type of shoulder arthritis called rotator cuff tear arthropathy.
Rotator cuff tear arthropathy is a devastating condition that seriously compromises the comfort and function of the shoulder.
For patients with rotator cuff tear arthropathy, conventional total shoulder replacement may result in pain and limited motion.
Shoulder radiographs revealed bilateral loss of joint space, proximal migration of the humeral head, and sourcil sign (erosion of the inferior acromial surface), consistent with rotator cuff tear arthropathy