What is Cuff Tear Arthropathy?

Cuff tear arthropathy is a diagnostic term applied to a problem of the shoulder that consists of a torn rotator cuff tendon along with arthritis of the glenohumeral joint. The glenohumeral joint is the ball and socket joint of the shoulder. When one has cuff tear arthropathy, it is associated with a rotator cuff tear that cannot be surgically repaired.

The diagnosis of cuff tear arthropathy is made by a combination of careful history, physical examination, and x-ray findings.

The clinical presentation of cuff tear arthropathy covers a very broad spectrum of pain and impairment of function. Most patients present to an orthopedist with a complaint of weakness or pain in the shoulder.

Clarification of the diagnosis of cuff tear arthropathy sometimes involves MRI scanning of the shoulder. In most cases the diagnosis of cuff tear arthropathy can be made based on regular x-ray examination. An MRI scan is often not necessary.

Treatment

Cuff tear arthropathy is often treated with:

  • Home exercises
  • Supervised physical therapy
  • Activity modifications
  • Medication
  • Surgery

A home exercise regimen for the treatment of cuff tear arthropathy can often be communicated to the patient with one or two visits to a physical therapist. After that, the patient exercises his or her shoulder at home using simple assistive devices such as an overhead pulley and elastic bands. It generally takes a couple of months of diligent exercise for the patient to notice a dramatic improvement in their weakness or pain from cuff tear arthropathy.

Supervised physical therapy may be warranted for treatment of cuff tear arthropathy if the patient is having difficulty doing exercises on their own. Some patients have such dramatic weakness from cuff tear arthropathy that they will benefit more from supervised physical therapy along with home exercises.

Some patients will find satisfactory resolution of their symptoms with simple activity modifications. These might include getting some help at home, so that they don’t spend as much time reaching high over their shoulders during a typical day. Rearranging cabinets and closets to avoid reaching high may help.

The medications used for cuff tear arthropathy are the same medications sometimes used for treatment of osteoarthritis. One may try an oral medication designed to lessen the inflammation. I find the most effective medication for treatment of cuff tear arthropathy to be injection of cortisone into the shoulder joint.

Cortisone Injection FAQs

Surgery for cuff tear arthropathy might include:

An arthroscopic procedure for cuff tear arthropathy is rarely indicated. On a few occasions, I’ve encountered patients that still have a connected and functioning biceps tendon along with cuff tear arthropathy. In that rare scenario, relief may be afforded with an outpatient arthroscopic procedure designed to cut the biceps tendon.

Learn about arthroscopic biceps tenotomy

Arthroscopic surgery to “clean out the joint” (this is often called a debridement) is almost certain to fail in providing long-term relief of the symptoms of cuff tear arthropathy.

Shoulder hemiarthroplasty is an excellent way to lessen the pain of cuff tear arthropathy. Hemiarthroplasty also improves function. The shoulder hemiarthroplasty will improve a person’s shoulder, but it will not make their shoulder function as well as a complete shoulder replacement. Shoulder hemiarthroplasty will not give as good of relief of pain when compared to shoulder replacement.

Learn about shoulder hemiarthroplasty

Shoulder replacement to treat rotator cuff arthropathy is known as reverse shoulder arthroplasty. It is designed to function in the shoulder that does not have a functioning rotator cuff tendon.

Learn about reverse shoulder arthroplasty