SPORTS MEDICINE  ·  SURGERY OF THE KNEE  ·  SURGERY OF THE SHOULDER  

Rotator Cuff Tear Arthropathy Print

In normal X-rays the ball idoes not touch the top bone (acromium). X-rays of patients with cuff tear arthropothy reveal that the ball of the shoulder has arisen out of the socket and now hits the undersurface of the acromion.

Often, a new socket will form on the undersurface of the acromion. Since the space which is normally occupied by the rotator cuff is no longer present, it is obvious on X-ray that the rotator cuff has been torn for some time. 

Surgical repair of the rotator cuff on these patients is impossible. The only treatment options are attempts to relive the patient's symptoms. These may involve repeated injections. Since there is little risk of further damage to the shoulder with these injections, they may be given every three months. Another option for pain relief may be to simply try to clean the shoulder out with arthroscopic surgery. This seems to provide at least temporary relief in some patients. The last resort for patients with this type of pain is to replace the ball of the shoulder with a metal prosthesis or a "reverse" total shoulder replacement. The reverse shoulder replacement may improve function and reduce pain although there is a high complication rate with the procedure. The results of reverse shoulder replacement may be unpredictable with some patients having significant pain relief and other patients continuing to experience pain despite the procedure.

As a result of the poor results of surgical treatment of cuff tear arthropathy, we tend to be quite aggressive in treating early rotator cuff disease in the hope that very few of our patients with reach the point where only palliative measures are available.

Fig. 1

This X-rays shows a normal shoulder.

Rotator Cuff Tear Anthropathy, Dr. Allen F. Anderson, Nashville, Orthopaedic Sports Medicine, Figure 16B
Figure 2 Shows Rotator  Cuff Arthropathy
 
© Allen F. Anderson, M.D. 2017