Shoulder

The shoulder is one of the largest and most complex joints in the body, where many muscles act to provide the widest range of motion of any part of the body. This flexibility is also what makes the shoulder prone to instability and injury.

The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket. The clavicle (collarbone) extends across the front of the shoulder from the sternum to the scapula and helps stabilize the shoulder’s movements.

Rotator Cuff Arthropathy

WHAT IS ROTATOR CUFF ARTHROPATHY?

Rotator cuff tear arthropathy, also known as shoulder arthritis with a large rotator cuff tear, is a severe and complex form of shoulder arthritis in which the shoulder has lost both the cartilage (normally covering its joint surface) and the tendons of the rotator cuff tear (help position and power the joint).

The tendons of the rotator cuff usually allow for smooth motion of the upper end of the arm bone beneath the overlying bones and muscles. When the rotator cuff is degenerated, the normally smooth upper surface of the upper end of the arm bone is unprotected from rubbing with the undersurface of the bone and ligaments above.

In a rotator cuff tear arthropathy, the upper surface of the ball of the upper arm bone becomes roughened as it rubs against the overlying bone (the acromion). This condition results in shoulder pain, weakness, stiffness and grinding on movement.

 

WHAT ARE THE SYMPTOMS OF ROTATOR CUFF ARTHROPATHY?

Patients typically complain of shoulder pain, weakness, stiffness and grinding movement of the shoulder. They will also experience:

  • An inability to raise their arm above chest level with ease
  • Swelling around the shoulder
  • Significant strength differences between the two shoulders.

WHAT ARE THE CAUSES AND RISK FACTORS OF ROTATOR CUFF ARTHROPATHY?

Rotator cuff arthropathy is a result of shoulder arthritis developing on top of an untreated rotator cuff tear.

WHAT IS THE DIAGNOSIS OF ROTATOR CUFF ARTHROPATHY?

An x-ray is used to determine the diagnosis.

WHAT ARE THE TREATMENT OPTIONS FOR ROTATOR CUFF ARTHROPATHY?

At Cove Orthopaedic Clinic, nonsurgical treatments are always the first line of treatment. This includes:

  • Medications

Over-the-counter or prescription non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be prescribed by your doctor to relieve pain and inflammation.

  • Steroid injections

A corticosteroid such as cortisone can be injected directly into your shoulder joint to relieve severe pain and swelling.

 

Should nonsurgical treatments prove ineffective, surgery is recommended. The reverse total shoulder arthroplasty (aka reverse shoulder replacement) involves a ball-and-socket joint as well, but the ball is placed on the shoulder blade and the socket is placed on top of the arm bone.

By reversing the ball and the socket, the deltoid muscle (the large shoulder muscle) is able to lift the arm up overhead and compensate for the torn rotator cuff, allowing the shoulder to function even without a working rotator cuff.

 

RECOVERY AFTER SURGERY

After surgery, you will be given several doses of antibiotics to reduce your risk for infection, and pain medication to keep you comfortable. Most patients are able to eat solid food and get out of bed the next day, and you will most likely be able to go home on the second or third day after surgery. For short-term pain relief, NSAIDs and local anaesthetics will be given as well.

Your arm will be placed in a sling to minimise movement. Physiotherapy may be recommend, where you will be doing gentle range of motion exercise to help you regain your strength and mobility.

 

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