Elsevier

The Journal of Arthroplasty

Volume 6, Issue 4, December 1991, Pages 363-370
The Journal of Arthroplasty

Surgical management of complex irreparable rotator cuff deficiency

https://doi.org/10.1016/S0883-5403(06)80189-0Get rights and content

Abstract

The authors surgically treated 23 shoulders in 23 patients with disabling pain associated with irreparable tears of the musculotendinous cuff. In a total of 12 shoulders with preserved passive motion, normal deltoid function, loss of glenohumeral joint surfaces, and sculpturing of the coracoacromial arch, a standard or oversized Neer II humeral prosthesis without glenoid replacement was selected. A total of 11 shoulders that failed to meet these prerequisites or demanded heavy use after operation underwent arthrodesis. Twenty-two patients (12 from the hemiarthroplasty group and 10 from the arthrodesis group) were available for evaluation at an average follow-up period of 37.5 months. Comfort level and overall function were improved in both groups. Active for-ward elevation improved an average of 44° in the hemiarthroplasty group and an average of 15° in the arthrodesis group. The success of hemiarthroplasty and the problems of glenoid loosening in the presence of cuff deficiency with upward head displacement have led to the conclusion that humeral hemiarthroplasty is the preferred method for managing complex irreparable tears of the rotator cuff in which the articular surface is destroyed, yet the deltoid muscle is functional. Shoulder arthrodesis is reserved for those patients who have both irreparable tears of the rotator cuff and irreparable deficiencies of the deltoid muscle, or the younger patient with demands for substantial strength at low angles of flexion.

References (16)

  • FranklinJL et al.

    Glenoid loosening in total shoulder arthroplasty: association with rotator cuff deficiency

    J Arthroplasty

    (1988)
  • NixonJE et al.

    Ruptures of the rotator cuff

    Orthop Clin North Am

    (1975)
  • BrownleeC et al.

    Shoulder replacement in cuff tear arthropathy

  • CodmanEA

    Complete rupture of the supraspinatus tendon: operative treatment with report of two successful cases

    Boston Med Surg J

    (1911)
  • CofieldRH

    Tears of rotator cuff

  • CofieldRH

    Current concepts review: rotator cuff disease of the shoulder

    J Bone Joint Surg

    (1985)
  • CofieldRH et al.

    Glenohumeral arthrodesis

    J Bone Joint Surg

    (1979)
  • DebeyreJ et al.

    Repair of ruptures of the rotator cuff with a note on advancement of the supraspinatus muscle

    J Bone Joint Surg

    (1965)
There are more references available in the full text version of this article.

Cited by (0)

View full text