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Rotator Cuff Tear Arthropathy: Evaluation, Diagnosis, and Treatment

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Nam, Denis, MD1; Maak, Travis G., MD1; Raphael, Bradley S., MD1; Kepler, Christopher K., MD1; Cross, Michael B., MD1; Warren, Russell F., MD1

doi: 10.2106/JBJS.K.00746
Scientific Articles

Abstract: Rotator cuff tear arthropathy encompasses a broad spectrum of pathology, but it involves at least three critical features: rotator cuff insufficiency, degenerative changes of the glenohumeral joint, and superior migration of the humeral head. Although many patients possess altered biomechanics of the glenohumeral joint secondary to rotator cuff pathology, not all patients develop rotator cuff tear arthropathy, and thus the exact etiology of rotator cuff tear arthropathy remains unclear. The objectives of this manuscript are to (1) review the biomechanical properties of the rotator cuff and the glenohumeral joint, (2) discuss the proposed causes of rotator cuff tear arthropathy, (3) provide a brief review of the historically used surgical options to treat rotator cuff tear arthropathy, and (4) present a treatment algorithm for rotator cuff tear arthropathy based on a patient’s clinical presentation, functional goals, and anatomic integrity.

1Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for D. Nam:

Copyright © 2012 by The Journal of Bone and Joint Surgery, Incorporated
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