Rotator Cuff Arthropathy
What is rotator cuff arthropathy?
If the rotator cuff is torn and is not repaired, a type of wear and tear arthritis of the shoulder can develop over time. This condition is sometimes called arthropathy and the term cuff tear arthropathy is used to describe this type of arthritis of the shoulder that develops when the rotator cuff is damaged.
Rotator cuff arthropathy treatment options?
Treatment options for rotator cuff arthropathy depend on the severity of the condition, age, activity level, and overall health. The goal is to improve pain, range of motion and function. It is a devastating condition characterized by the permanent loss of the rotator cuff tendons and damage to the joint surfaces.
What is non-surgical treatment?
Nonsurgical treatment is available to low demand patients in pain and those who are medically unfit for surgery. It involves:
- activity modification
- corticosteroid injections to reduce pain and inflammation associated with arthritis, and
- physical therapy to strengthen the muscles around the shoulder joint and improve range of motion.
What are the surgical treatment options?
When non-surgical treatment fails to improve pain and function, surgery may be recommended. There are an array of surgical options both established and emerging techniques. Each patient is different. Dr. Godin will choose the surgical procedure that is appropriate in each case.
Surgical options may include:
- debridement
- cuff repair with patch augmentation
- muscle and tendon transfers
- capsular reconstruction
- balloon arthroplasty
However, the gold standard procedure to treat massive cuff injuries with arthritis that cannot be repaired is a reverse shoulder replacement. It is the preferred option for older patients with symptomatic rotator cuff arthropathy who are somewhat inactive because it offers reliable improvements in pain and function.
Reverse shoulder replacement
This procedure is called “reverse” total shoulder replacement because it reverses the normal anatomy of the shoulder joint, by placing the ball portion of the joint onto the shoulder blade and the socket portion onto the upper end of the humerus bone.
During the procedure, the damaged or diseased parts of the shoulder joint are removed, and the prosthetic components are implanted into the joint. The ball portion of the joint is placed on the glenoid cavity, which is a shallow socket on the shoulder blade, and the socket portion is attached to the upper end of the humerus bone. This allows the deltoid muscle, instead of the rotator cuff, to provide the power to lift the arm, improving shoulder function.
Reverse total shoulder replacement is often recommended for patients who have significant rotator cuff tears and arthritis, or for those who have had a previous shoulder replacement surgery that was unsuccessful. The procedure can be performed using an open or minimally invasive technique.
Rehabilitation after a reverse total shoulder replacement is an important part of the recovery process. Rehabilitation usually begins within a few days after surgery and can last several months, depending on the individual’s progress. The goals of rehabilitation after a reverse total shoulder replacement are to reduce pain and swelling, restore range of motion, and strengthen the shoulder joint.
Schedule a shoulder consultation
Dr. Jonathan Godin is a renowned board-certified orthopedic surgeon and a leader in sports medicine. He received fellowship training in advanced arthroscopic and reconstructive surgical techniques for the treatment of complex orthopedic and sports related injuries at the distinguished Steadman Clinic in Vail Colorado. Contact Dr. Godin at his Vail, Frisco, or Edwards, Colorado office to schedule a consultation to receive the correct diagnosis and all your treatment options.
