What is Rotator Cuff Arthropathy?
Rotator Cuff Arthropathy is a condition of the shoulder in which there is a large rotator cuff tear that has been present for a long time. A large rotator cuff will eventually cause the ball and socket joint to no longer be lined up and the ball migrates higher in relation to the socket. The rotator cuff is a group of four muscles that function in shoulder strength but also help keep the ball lined up with the socket. This chronic condition usually results in the development of arthritis.
Mechanism of Injury
Rotator Cuff Arthropathy occurs after many years of having a torn rotator cuff. A rotator cuff tear can be caused by a traumatic injury, overuse injury, or just develops overtime as we grow older.
Diagnosis and Symptoms
The shoulder usually becomes painful after a number of years as this condition develops. Stiffness and weakness are also hallmarks of rotator cuff arthropathy. A physical exam and radiographic evaluation with x-rays are important in establishing a diagnosis. Advanced imaging (CT, MRI) can be performed to determine the chronicity of an injury but commonly are done in preparation for surgery.
Treatment of Rotator Cuff Arthropathy
Rotator cuff arthropathy can be treated with and without surgery. Initial treatments aim at decreasing the discomfort through non-operative therapies. These modalities can include ice/heat, anti-inflammatories, cortisone injections, and physical therapy. If the pain is not relieved by simple treatments, then different surgical options exist, depending on age, medical status and activity level. The younger patients with this condition and without arthritis, can consider an arthroscopic procedure (minimally invasive) called a superior capsular reconstruction (SCR). This uses a graft or tissue to connect between the ball and socket to help with mobility of the shoulder. The SCR does not recreate the strength of the shoulder. The most definitive or reliable surgical treatment for people with arthritis and arthropathy is to perform a specialized shoulder replacement called a reverse shoulder replacement. This is where the ball and socket are replaced and the anatomy is reversed to allow different muscles to move the shoulder. The surgery usually results in great pain relief and improved function. The replacement does not recreate a normal shoulder nor does it allow for heavy lifting.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.aaos.org/en/treatment/reverse-total-shoulder-replacement
https://orthoinfo.aaos.org/en/treatment/reverse-total-shoulder-replacement-surgical-video