Rotator Cuff Arthropathy

Question 1

Rotator Cuff Arthropathy characters

Answer 1

• rotator cuff insufficiency
• glenohumeral cartilage destruction
• superior migration of the humeral head
• subchondral osteoporosis
• humeral head collapse

Question 2

risk factors

Answer 2

• rotator cuff tear
• rheumatoid arthritis
• crystalline-induced arthropathy
• hemorrhagic shoulder (hemophiliacs and elderly on anticoagulants)

Question 3

Radiographic Findings

Answer 3

• acromial acetabularization (true AP)
• femoralization of humeral head (true AP)
• asymmetric superior glenoid wear
• lack of osteophytes
• osteopenia
• “snowcap sign” due to subchondral sclerosis
• anterosuperior escape

Question 4

Seebauer Classification of Rotator Cuff Arthropathy

Answer 4

Question 5

Nonoperative

Answer 5

• activity modification, subacromial steroid injection, physical therapy
  
  • indications
    
    • first line of treatment
  • technique
    
    • physical therapy with a scapular and rotator cuff strengthening program
    • non-steroidal anti-inflammatories
    • subacromial steroid injection

Question 6

Operative

Answer 6

1. arthroscopic debridement
2. hemiarthroplasty
3. reverse shoulder arthroplasty
4. latissimus dorsi transfer
5. pectoralis transfer
6. resection arthroplasty

• indications
  
  • salvage only (chronic osteomyelitis, infections, poor soft tissue coverage)