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The association between massive tears of rotator cuff tendons and severe glenohumeral degenerative arthritis is complex and poorly understood. The theories that have been proposed to account for rotator cuff tear arthropathy of the shoulder joint include severe, localized rheumatoid arthritis1,2; hemorrhagic arthritis27; microcrystalline-induced arthritis67; and arthritis due to chronic attrition, leading to a massive tear of the rotator cuff tendons19,75. The confusion concerning the etiology of rotator cuff tear arthropathy is in part due to the fact that different authors have described its clinical characteristics in general terms and have given it various names, such as l'arthropathie destructrice rapide de l'epaule58, apatite-associated destructive arthritis30, Milwaukee shoulder40,45,67, and cuff tear arthropathy75. Adams1,2 and Smith90,91 provided the earliest description of the pathoanatomical features of rotator cuff tear arthropathy, in the nineteenth century. Adams, who was the Regius Professor of Surgery at the University of Dublin, described two types of chronic rheumatoid arthritis: a generalized form resembling rheumatoid arthritis and a localized form involving the shoulder, which had the morphological characteristics of what is now known as rotator cuff tear arthropathy2. In his 1934 monograph, Codman19 reported the case of a fifty-one-year-old woman who had what he termed a subacromial space hygroma. He described recurrent swelling of the shoulder, absence of the rotator cuff, cartilaginous bodies attached to the synovial tissue, and severe destructive glenohumeral arthritis. These clinical descriptions of the entity now known as rotator cuff tear arthropathy were made without the benefit of modern diagnostic tests, such as serological analysis or synovial crystal analysis. L'epaule senile hemorragique (the hemorrhagic shoulder of the elderly) was described by DeSeze … |
