Rotator Cuff Arthropathy

Rotator Cuff Tear Arthropathy (RCTA) represents a spectrum of signs and symptoms associated with the presence of a rotator cuff insufficiency, which leads to a cascade characterized by imbalanced forces of the rotator cuff, followed by anterior superior migration of the humeral head, and mechanical impact of the head onto the acromion. In addition, cartilage fragmentation and particulate debris lead to the development of an enzymatic inflammatory cascade and cartilage degradation. In regard to the status of the glenohumeral joint, RCTA can be stratified radiographically according to Hamada, taking into account the degree of arthropathy and according to Favard, to define glenoid defects. RMI delivers more details about the integrity of the articular cartilage and the presence of the fatty infiltration of the muscles as a result of the disuse secondary to the rotator cuff tear. Conservative treatment, on the one hand, should include lifestyle and activity modifications, physical therapy, painkillers, and intra-articular injections. On the other hand, surgical treatments encompass a wide range of possibilities, such as in scope debridement, tendon transfer, hemiarthroplasty, and reverse shoulder arthroplasty (RSA). Being RSA, the most used treatments currently. Finally, several complications have been described. Among the most important, should be mentioned: neurologic injury, periprosthetic fracture, infection, scapular notching, and instability.