The term arthritis is generally used to describe inflammation of a joint or joints that causes pain, swelling, stiffness and a limited range of motion. Osteoarthritis of the acromioclavicular joint, where the clavicle and the acromion meet, as well as osteoarthritis of the glenohumeral joint, between the humerus and scapula, are the result of joint cartilage damage. On the other side, in the case of rotator cuff tear arthropathy, cartilage damage is a symptom.
This condition is caused by massive rotator cuff tears or progressive degeneration of the rotator cuff tendon and leads to the inability of the rotator cuff to centralize the humeral head within the glenoid cavity. The humeral head, which is normally lined by articular cartilage, shifts upwards, and in most cases, rubs against the acromion, therefore becoming ‘‘strained’’, and slowly causing cartilage damage.  

The progression from rotator cuff tear to rotator cuff tear arthropathy, constitutes an area of interest in the medical research field– the condition has been fully described since 1983. Women are considered to be more vulnerable than men, as well as individuals that are around the age of 70, whereas the hand that is predominantly used is also affected more. The combination of rotator cuff tears and arthritis results in intense shoulder pain and weakness, along with the patient being unable to lift the arm sideways.

The suggested option for rotator cuff tear arthropathy is surgical treatment. In early stages, debridement (arthroscopy) is recommended, whereas in late stages the appropriate treatment is reverse total shoulder arthroplasty. This distinctive arthroscopic technique involves the reversed replacement of the natural position of the joint surfaces. A metal ball (glenosphere) is attached to the glenoid cavity and an artificial hollow surface (humeral socket) is fixed to the upper end of the humerus bone, supported by a peg (cylindrical piece) inserted in the humerus groove.
A specialized surgeon, capable of distinguishing anatomical alterations of the joint, is vital to this particular surgical procedure. The anatomy of the deformed shoulder is restored as much as possible, and the torn rotator cuff, which no longer contributes in shoulder movement, is bypassed. By adding pressure to lift the upper extremity, the shoulder relies on the deltoid muscle for movement.
Postoperatively, a customized rehabilitation program must be followed during which the patient is ‘‘trained’’ to use the surgically repaired joint. 

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