by Jeffrey L. Visotsky, Carl Basamania, Ludwig Seebauer, Charles A

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Presentation transcript:

Cuff Tear Arthropathy: Pathogenesis, Classification, and Algorithm for Treatment by Jeffrey L. Visotsky, Carl Basamania, Ludwig Seebauer, Charles A. Rockwood, and Kirk L. Jensen J Bone Joint Surg Am Volume 86(suppl 2):35-40 December 1, 2004 ©2004 by The Journal of Bone and Joint Surgery, Inc.

The pathological changes associated with a massive rotator cuff tear at the precollapse stage include atrophy of the articular surface, rupture of the long head of the biceps, and superior migration of the humeral head. The pathological changes associated with a massive rotator cuff tear at the precollapse stage include atrophy of the articular surface, rupture of the long head of the biceps, and superior migration of the humeral head. (Adapted from: Neer CS, Craig EV, Fukuda H. Cuff-tear arthropathy. J Bone Joint Surg Am. 1983;65:1236.)‏ Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.

The progressive pathological changes associated with cuff tear arthropathy include superomedial erosion of the joint, glenohumeral incongruity, and an unstable humeral head. The progressive pathological changes associated with cuff tear arthropathy include superomedial erosion of the joint, glenohumeral incongruity, and an unstable humeral head. A-C = acromioclavicular. (Adapted from: Neer CS, Craig EV, Fukuda H: Cuff-tear arthropathy. J Bone Joint Surg Am. 1983;65:1237.)‏ Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Pathomechanics: the mechanical factors. Pathomechanics: the mechanical factors. Upward migration and instability are the primary factors leading to cuff tear arthropathy. (Adapted from: Neer CS, Craig EV, Fukuda H: Cuff-tear arthropathy. J Bone Joint Surg Am. 1983;65:1243.)‏ Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Pathomechanics: the nutritional factors. Pathomechanics: the nutritional factors. Massive rotator cuff tears and reduced motion contribute to disruption of perfusion of nutrients to the articular cartilage leading to cuff tear arthropathy. (Adapted from: Neer CS 2nd, Craig EV, Fukuda H: Cuff-tear arthropathy. J Bone Joint Surg Am. 65:1243.)‏ Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Transverse and coronal force couples. Transverse and coronal force couples. The loss of stable fulcrum of motion leads to cuff tear arthropathy. (Adapted, with permission, from: Burkhart SS. Fluroscopic comparision of kinematics patterns in massive rotator cuff tears. A suspension bridge model. Clin Orthop. 1992;284:146.)‏ Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Seebauer Classification of Cuff Tear Arthopathy*. Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Results*. Results* Jeffrey L. Visotsky et al. J Bone Joint Surg Am 2004;86:35-40 ©2004 by The Journal of Bone and Joint Surgery, Inc.