Shoulder arthritis and rotator cuff tears: The combination of arthritis and rotator cuff tears is called rotator cuff tear arthropathy. The management of this condition requires thought and experience.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Thursday, January 13, 2005
Management and treatmentTreatment An orthopaedic surgeon with experience with many similar cases can
provide a balanced perspective to individuals with rotator cuff tear
arthropathy.
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.
If exercises do not improve the comfort and function of the
shoulder, surgery may be necessary to create a smooth gliding surface
on the humeral head (ball of the arm bone). This surgery may consist of
rounding off any rough edges on the joint surface and removing
interfering soft tissue as was performed for the individual whose
shoulder is shown in the x-ray. [Figure 8].
Alternatively, the situation may require replacing the joint surface
with a smooth metal prosthesis with a stem that is fixed by a press fit
in the shaft of the bone as is shown in the diagram. [Figure 9].
In cases where rotator cuff tear arthropathy (shoulder arthritis
associated with massive rotator cuff defects) is associated with
instability of the joint, a reversed or “reverse Delta” prosthesis, may be needed to fix the fulcrum of shoulder movement. [Figure 10]
Self-management The individual with cuff tear arthropathy may self-manage the condition with gentle range of motion exercises, to enhance the smoothness of the joint and its flexibility, followed by strengthening exercise, once the shoulder is comfortable to enhance its function.Health care team Rotator cuff tear arthropathy (shoulder arthritis associated with
massive rotator cuff defects) can best be managed by a shoulder
specialist who sees many such cases per year. Such surgeons may be
found in the Shoulder Section in major schools of medicine.
Consultation by the Shoulder and Elbow Service at the University of
Washington regarding the diagnosis and treatment of cuff tear
arthropathy may be requested by using our online referrals website.
You can also call 206-598-0312 to make an appointment. Pain and fatigue The pain and fatigue caused by rotator cuff tear arthropathy shoulder
arthritis associated with massive rotator cuff defects) may be managed
by first range of motion exercises and then by strengthening exercises.Diet Diet has not proven to be a useful method for managing rotator cuff
tear arthropathy (shoulder arthritis associated with massive rotator
cuff defects).Exercise and therapy Exercises can help the range of motion and the strength in some cases of rotator cuff tear arthropathy (shoulder arthritis associated with massive rotator cuff defects).Medications Medications, other than mild analgesics and anti-inflammatory
medications , have not been shown to be helpful in the management of
rotator cuff tear arthropathy (shoulder arthritis associated with
massive rotator cuff defects).Surgery Surgery can be helpful in the management of rotator cuff tear
arthropathy (shoulder arthritis associated with massive rotator cuff
defects). The surgical procedures can range from a simple smoothing of
the roughened bone [Figure 11] to a resurfacing of the humeral head
with a smooth prosthesis , such as a CTA head, fixed to the shaft of the arm bone (humerus) [Figure 12]. If the joint is unstable, a reversed prosthesis, such as the reverse Delta
[Figure 13] may be needed. Consultation by the Shoulder and Elbow
Service at the University of Washington regarding the diagnosis and
treatment of cuff tear arthropathy may be requested by using our online referrals website.
You can also call 206-598-0312 to make an appointment. Joint aspiration Joint aspiration (removing fluid from the joint) can be helpful for
relieving the fluid that tends to collect in shoulders afflicted with
rotator cuff tear arthropathy (shoulder arthritis with a massive cuff
tear). However the fluid tends to recollect rapidly and repeated
injections may risk infection. Joint aspiration may be needed to
examine the joint fluid for the possibility of infection.
Splints or braces Splints or braces have not proven useful for shoulders afflicted with
rotator cuff tear arthropathy (shoulder arthritis with a massive cuff
tear).Alternative remedies Alternative remedies have not proven useful for shoulders afflicted
with rotator cuff tear arthropathy (shoulder arthritis with a massive
cuff tear).Social impacts Adverse social impacts have not been noted from the treatment of
shoulders afflicted with rotator cuff tear arthropathy (shoulder
arthritis with a massive cuff tear).
Long-term management Long term management with annual examination and x-rays is recommended
for patients with shoulders afflicted with rotator cuff tear
arthropathy (shoulder arthritis with a massive cuff tear). This is to
assure that bone erosion does not take place to the extent that
reconstructive surgery becomes impossible.Surgery for rotator cuff tear arthropathy (shoulder 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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