THE PROGRESSIVE COMPLEX NATURE OF ROTATOR CUFF TEAR ARTHROPATHY

Authors

  • DOUGLAS W KELLY Capstone Instructor, University of Arizona College of Medicine-Phoenix, Arizona, United States of America.

DOI:

https://doi.org/10.22159/ijms.2021.v9i4.41785

Keywords:

Rotator cuff tear arthropathy, Ecchymoses, Instability, Hemarthrosis, Vascular erosion, Acromial artery

Abstract

A small number of patients with a chronic rotator cuff tear appear to progress to the clinical entity known as rotator cuff tear arthropathy (RCTA). There are various theories concerning the etiology and progression to account for the findings associated with this clinical condition. A broad spectrum of pathology may be present. Progressive destruction of soft tissues, cartilage, and bone leading to increasing shoulder disability has been documented. Significant complications such as instability or bleeding are rarely associated with RCTA. We present an extreme case of RCTA with extensive destruction and unusual shoulder pathology that has not been previously reported. Of even more concern was the finding of acute and subacute hemorrhage from major vascular erosion requiring emergency treatment. There appears to be little or no limits to the extent of pathology in some individuals with this condition.

References

Neer CS 2nd, Craig EV, Fukuda H. Cuff-tear arthropathy. J Bone Joint Am 1983;5:1232-44.

Jensen KL, Williams GR Jr., Russell IJ, Rockwood CA Jr. Rotator cuff tear arthropathy. J Bone Joint Surg Am 1999;81:1312-24.

Codman EA. The shoulder. In: Rupture of the Supraspinatus Tendon and Other Lesions in or about the Shoulder. Boston, MA: Thomas Todd Company; 1934. p. 478-80.

McCarty DJ, Halverson PB, Carrera GF, Brewer BJ, Kozin F. Milwaukee shoulder-association of microspheroids containing hydroxyapatite crystals, active collagenase, and neutral protease with rotator cuff defects: I. Clinical aspects. Arthritis Rheum 1981;24:464-73.

Halverson PB, Cheung HS, McCarty DJ, Garancis J, Mandel N. Milwaukee shoulder-association of microspheroids containing hydroxyapatite crystals, active collangenase, and neutral protease with rotator cuff defects: II. Synovial fluid studies. Arthritis Rheum 1981;24:474-83.

McCarty DJ, Swanson AB, Ehrhart RH. Hemorrhagic rupture of the shoulder. J Rheumatol 1994;21:1134-7.

Sjoden GO, Movin T, Sperber A, Guntner P, Wikstrom B. Cuff tear arthropathy with hemarthrosis. A report on 3 elderly patients. Acta Orthop Scand 1996;67:571-4.

Woolf AD, CawstonTE, Dieppe PA. Idiopathic haemorrhagic rupture of the shoulder in destructive disease of the elderly. Ann Rheum Dis 1986;45:498-501.

Yaron RE, Robinson D. Recurrent hemorrhagic shoulder treated with hemiarthroplasty-a case report. Iowa Orthop J 2007;27:112-4.

Sano H, Nakajo S. Repeated hemarthrosis with massive rotator cuff tear. Arthroscopy 2004;20:196-200.

Fukata S, Miyatake K, Matsuura T, Sairvo K. Two cases of spontaneous recurrent hemarthrosis of the shoulder with acromial erosion associated with impingement syndrome. Case Rep Orthop 2019;2019:3042475.

Kang H, Baron M, Glikstein R. Shoulder hemarthrosis due to a bleeding pseudoaneurysm. Clin Rheumatol 2005;24:305-7.

Visotsky JL, Bassamania C, Seebauer L, Rockwood CA, Jensen KL. Cuff tear arthropathy pathogenesis, classification, and algorithm for treatment. J Bone Joint Surg Am 2004;86 Suppl 2:35-40.

Seebauer L. Reverse shoulder arthroplasty in the management of glenohumeral arthritis and irreparable cuff insufficiency. In: Iannotti JP, Miniaci A, Williams GR, Zuckerman JD, editors. Disorders of the Shoulder: Reconstruction. 3rd ed. Philadelphia, PA: Lippincott Williams &Wilkens; 2014. p. 407.

Published

01-07-2021

How to Cite

KELLY, D. W. (2021). THE PROGRESSIVE COMPLEX NATURE OF ROTATOR CUFF TEAR ARTHROPATHY. Innovare Journal of Medical Sciences, 9(4), 1–3. https://doi.org/10.22159/ijms.2021.v9i4.41785

Issue

Section

Case Study(s) / Case Report (s)