Cuff tear arthropathy - CTA - prosthesis for shoulder arthritis: Surgery with a cementless CTA prosthesis can lessen pain and improve function in shoulders with the combination of arthritis and rotator cuff tears.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Monday, October 09, 2006
Review of the conditionWhat are some general characteristics of rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear)? What are its usual manifestations? Rotator cuff tear arthropathy
(or shoulder arthritis with a large rotator cuff tear) is a severe and
complex form of shoulder arthritis in which the shoulder has lost not
only the cartilage that normally covers its joint surface, but also the
tendons of the rotator cuff tear which help position and power the
joint.
Normally, the tendons of the rotator cuff (large arrows) allow
smooth motion of the upper end of the arm bone (humerus) beneath the
overlying bones and muscles. [Figure 10]
When the rotator cuff is degenerated, chronically torn or otherwise
deficient, the normally smooth upper surface of the upper end of the
arm bone (humeral head) is unprotected from rubbing with the
undersurface of the bone and ligaments above as shown by the large
arrow.[Figure 11]
In cuff tear arthropathy, the upper surface of the ball of the upper
arm bone (humeral head) becomes roughened as it rubs against the
overlying bone (the acromion) as shown by the arrow. [Figure 12].
This condition results in shoulder pain, weakness, stiffness and grinding on movement. What are the different types of rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear)? Rotator cuff tear arthropathy appears to be a condition with a
succession of stages, depending on the stability of the humeral head
(ball of the shoulder joint) in respect to the glenoid (socket of the
shoulder joint). These stages have been described at the beginning of this article.What else might be confused with or similar to rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear)? How can these be distinguished from the condition? Shoulder arthritis with a massive cuff defect must be distinguished
from arthritis without substantial rotator cuff involvement, from
isolated rotator cuff disease, from frozen shoulder, and from neck
arthritis, each of which may produce somewhat similar symptoms.
Arthritis usually gives rise to stiffness without weakness. Rotator
cuff tears usually cause pain and weakness, but stiffness is less
common. Frozen shoulder is characterized by shoulder stiffness, but the
X-rays are usually normal. Neck arthritis may cause shoulder pain and
weakness that is worse when the head is held in certain positions.How common is rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear) (statistics, demographics, risk factors)? Rotator cuff tear arthropathy (or shoulder arthritis with a large
rotator cuff tear) most commonly occurs in individuals over the age of
65 and is more common in women than men.How is rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear) diagnosed? What tests or exams may be used? Rotator cuff tear arthropathy (or shoulder arthritis with a large
rotator cuff tear) is diagnosed by a history of progressive loss of
shoulder function, usually without an injury along with a physical
examination showing weakness and grinding on movement and a typical
appearance on X-ray. In these films the humeral head can be seen
contacting the undersurface of the coracoacromial arch as indicated by
the arrows. [Figure 13] The most important test for cuff tear
arthropathy is the x-ray, characteristically showing rounding off of
the humeral head as it contacts with the undersurface of the
coracoacromial arch. [Figure 14]
Rotator cuff tear arthropathy (arthritis of the shoulder associated
with a massive cuff tear) is best diagnosed by an orthopaedic surgeon
with experience in shoulder disorders. Certain surgeons specialize in
rotator cuff tear arthropathy (arthritis of the shoulder associated
with a massive cuff tear). Such individuals may be found in the
shoulder services of major schools of medicine.
Can medications help rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear)? Mild analgesic medications may relieve some of the symptoms of cuff tear arthropathy.Can exercises help rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear)? If the symptoms of rotator cuff tear arthropathy (shoulder arthritis
with a massive rotator cuff tear) are mild, the condition may be
treated with gentle motion exercises and exercises to strengthen the deltoid and other muscles around the shoulder that remain intact.
Specifically, how is rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear) improved by shoulder joint replacement surgery with a rotator cuff tear arthropathy (cta) prosthesis? When combined with a good rehabilitation effort, shoulder joint
replacement arthroplasty with a cuff tear arthropathy (CTA) head
prosthesis allows arthritic shoulders to regain some of their lost
comfort and function. In experienced hands, this procedure can address
the restricting scar tissue that frequently accompanies rotator cuff
tear arthropathy. It can also restore smooth, stabilizing joint
surfaces when these surfaces have been damaged by rotator cuff tear
arthropathy.
Joint replacement surgery can improve the mechanics of the shoulder,
but cannot make the joint as good as it was before the onset of rotator
cuff tear arthropathy. In cuff tear arthropathy, the tendons and
muscles around the shoulder have deteriorated before the shoulder
replacement. After the surgery, it may take months of gentle exercises
before the shoulder achieves maximum improvement.
The effectiveness of the procedure depends on the health and
motivation of the individual, the condition of the shoulder, and the
expertise of the surgeon. When performed by an experienced surgeon,
experience has shown that shoulder replacement arthroplasty with a cuff
tear arthropathy head can provide improved shoulder comfort and
function. The greatest improvements are in the ability of the
individual to sleep and to perform some of the simple activities of
daily living. In that the tendons of the rotator cuff are not
repairable in this condition, normal strength and function of the
shoulder cannot be regained. Surgery for Rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear) at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-BONE (2663) to make an appointment.
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