Rotator Cuff Tear Arthropathy

Ecklund, Kier J.; Lee, Thay Q.; Tibone, James E.; Gupta, Ranjan

doi:10.5435/00124635-200706000-00003

Cited by 136 publications

(108 citation statements)

References 37 publications

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“…Grammont's RTSA was originally designed to treat a massive rotator cuff combined with superior migration of the humeral head and glenohumeral arthritis, a condition termed cuff tear arthropathy by Neer [5,15,18,21,40]. The indications for RTSA have expanded considerably since its introduction, but its most common use remains conditions involving severe rotator cuff disease [57].…”

Section: Discussionmentioning

confidence: 99%

“…The indications for RTSA have expanded over the last few years and include CTA [15,18,26,50,57,61], inflammatory arthropathy with massive rotator cuff tear [26,45], proximal humeral nonunion or malunion [6,34,57], acute fractures [34,57,58], fixed glenohumeral dislocation [57], posttraumatic arthritis [26,57], tumor [4,13,35,57], revision arthroplasty [6,27,33,57], and chronic pseudoparalysis without arthritis [41,57,60,61]. We will limit our discussion to problems dealing with the rotator cuff.…”

Section: Indications For Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

“…This entity is characterized by rotator cuff dysfunction and end stage glenohumeral arthritis [15,18,40]. Physical exam will elicit pain and imaging studies confirm the presence of an irreparable rotator cuff tear and associated arthritis.…”

Section: Cuff Tear Arthropathymentioning

confidence: 99%

“…The current iteration reverse total shoulder arthroplasty (RTSA) has been in use in Europe since the late 1980s [24,25], and was approved by the FDA for use in the United States in 2004 [7]. The RTSA was originally designed to treat a massive irreparable rotator cuff with superior migration of the humeral head combined with glenohumeral arthritis (cuff tear arthropathy [CTA]) [5,15,18,21,40]. The indications have expanded however, and currently it is being used for multiple diagnoses including fracture sequelae [6,31,32,34,58], revision arthroplasty [6,27,33,57], instability [57], and tumors [4,13,35,57].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical findings are variable and depend largely on the degree of arthritis and the specific rotator cuff tendons torn. Patients may complain of severe shoulder pain, weakness of the shoulder or arm, and progressive disability, including the inability to raise their arm [15,18,40]. These symptoms are reported to worsen over several years' time, although there may also be recent trauma that precipitated or accelerated the symptoms [18,40].…”

Section: Introductionmentioning

confidence: 99%

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Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

220

129

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Background Reverse total shoulder arthroplasty (RTSA) was introduced to treat rotator cuff tear arthropathy but is now used to treat a variety of problems. Although its use has expanded substantially since the FDA's approval in 2004, the appropriateness in patients with rotator cuff disease is unclear. Questions/purposes We review the use of RTSA in patients with rotator cuff disease to (1) describe classification of rotator cuff tear reparability and the concept of a balanced shoulder; (2) explore the theory behind RTSA design relative to rotator cuff arthropathy; (3) discuss the indications and contraindications for RTSA; and (4) review published outcomes of RTSA for rotator cuff arthropathy.Methods We performed a selective review of the literature on the use of RTSA in the treatment of rotator cuff disease.Results Modern RTSA designs restore deltoid tension and a functional fulcrum to the rotator cuff deficient shoulder, which allows recovery of active shoulder elevation and effectively restores function in short-and mediumterm followup studies. Conclusions In short-term followup the RTSA relieves symptoms and restores function for patients with cuff tear arthropathy and irreparable rotator cuff tears with pseudoparalysis (preserved deltoid contraction but loss of active elevation). Severely impaired deltoid function, an isolated supraspinatus tear, and the presence of full active shoulder elevation with a massive rotator cuff tear and arthritis are contraindications to RTSA. Clinical Relevance For properly selected patients who have symptomatic and disabling rotator cuff deficiency, RTSA can result in life-changing improvements in pain, motion, function, and patient satisfaction. Level of Evidence Level V therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Indications For Reverse Total Shoulder Arthroplastymentioning

confidence: 99%

Section: Cuff Tear Arthropathymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Drake¹,

O’Connor

Edwards

2010

Clinical Orthopaedics &Amp; Related Research

220

129

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Influence of rotator cuff tears on glenohumeral stability during abduction tasks

Hölscher

Weber

Lazarev

et al. 2016

Journal Orthopaedic Research

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One of the main goals in reconstructing rotator cuff tears is the restoration of glenohumeral joint stability, which is subsequently of utmost importance in order to prevent degenerative damage such as superior labral anterior posterior (SLAP) lesion, arthrosis, and malfunction. The goal of the current study was to facilitate musculoskeletal models in order to estimate glenohumeral instability introduced by muscle weakness due to cuff lesions. Inverse dynamics simulations were used to compute joint reaction forces for several static abduction tasks with different muscle weakness. Results were compared with the existing literature in order to ensure the model validity. Further arm positions taken from activities of daily living, requiring the rotator cuff muscles were modeled and their contribution to joint kinetics computed. Weakness of the superior rotator cuff muscles (supraspinatus; infraspinatus) leads to a deviation of the joint reaction force to the cranial dorsal rim of the glenoid. Massive rotator cuff defects showed higher potential for glenohumeral instability in contrast to single muscle ruptures. The teres minor muscle seems to substitute lost joint torque during several simulated muscle tears to maintain joint stability. Joint instability increases with cuff tear size. Weakness of the upper part of the rotator cuff leads to a joint reaction force closer to the upper glenoid rim. This indicates the comorbidity of cuff tears with SLAP lesions. The teres minor is crucial for maintaining joint stability in case of massive cuff defects and should be uprated in clinical decision-making. ß

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Shoulder arthritis secondary to rotator cuff tear: A reproducible murine model and histopathologic scoring system

Zingman

Sundem

et al. 2016

Journal Orthopaedic Research

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Untreated rotator cuff tears can progress to a distinct form of shoulder arthritis, and the mechanism of this progression is poorly understood. Biomechanical, molecular and genetic factors may be at play, and a reliable animal model is needed to enable further research. The purpose of this study was to create a reproducible model of posttraumatic shoulder arthritis in the mouse, and to develop a scoring system for this model to enable future research on interventions, the role of various gene products, and the development of therapies to alter the natural course of the disease. Forty-five mice underwent operative ligation of the rotator cuff tendons and were followed for 45 weeks following surgery, with free cage activity post-operatively. Mice were sacrificed at various intervals from 2–45 weeks post-injury and histopathologic scoring was developed and tested by blinded reviewers using both quantitative computational analysis of coronal sections of the shoulder joint and semi-quantitative grading. The scoring system revealed a progressive, time-dependent set of tissue changes in the shoulder joint with features similar to human cuff tear arthropathy including acetabularization of the acromion and femoralization of the humeral head. This model establishes that osteoarthritis of the shoulder is distinct from osteoarthritis of the knee or hip, with different stages of degeneration and unique histopathologic features. Using the novel grading procedure and quantitative assessments presented here, future research using this model will enable investigators to test established and novel therapies and evaluate the role of inflammatory factors and gene products in shoulder arthritis.

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Rotator Cuff Tear Arthropathy

Cited by 136 publications

References 37 publications

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Indications for Reverse Total Shoulder Arthroplasty in Rotator Cuff Disease

Influence of rotator cuff tears on glenohumeral stability during abduction tasks

Shoulder arthritis secondary to rotator cuff tear: A reproducible murine model and histopathologic scoring system

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