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Rotator Cuff Tear Arthropathy

Dr. Ecklund is Chief Resident, Department of Orthopaedic Surgery, University of California, Irvine, Orange, CA. Dr. Lee is Professor and Vice Chair, Research, Department of Orthopaedic Surgery, University of California, Irvine. Dr. Tibone is Professor, Department of Orthopaedic Surgery, University of Southern California School of Medicine, Los Angeles, CA. Dr. Gupta is Professor and Chair, Department of Orthopaedic Surgery, University of California, Irvine.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Ecklund, Dr. Lee, Dr. Tibone, and Dr. Gupta.

Reprint requests: Dr. Gupta, Department of Orthopaedic Surgery, University of California, Irvine, 101 The City Drive South, Orange, CA 92868.

Rotator cuff tear arthropathy represents a spectrum of shoulder pathology characterized by rotator cuff insufficiency, diminished acromiohumeral distance with impingement syndromes, and arthritic changes of the glenohumeral joint. Additional features may include subdeltoid effusion, humeral head erosion, and acetabularization of the acromion. Although the progression of rotator cuff tears seems to play a role in the development of cuff tear arthropathy, information is lacking regarding the natural progression of rotator cuff tears to cuff tear arthropathy. Controversy remains about the role of basic calcium phosphate crystals in the development of cuff tear arthropathy. Nonsurgical management is the first line of treatment in most patients. Traditionally, surgical management of rotator cuff tear arthropathy has been disappointing because of the development of complications long-term and poor patient satisfaction with functional outcomes. Recent studies, however, report promising experience with reverse ball-and-socket arthroplasty.