Thursday, December 8, 2011

The spectrum of rotator cuff disease

Here is a view of the rotator cuff from inside the joint, showing the humeral head in the center of the healthy shoulder, the biceps tendon upper left, and the tendons of the cuff surrounding the head. If you imagine that you are looking at this anatomy from the glenoid socket, you can see how the cuff pulls the humeral head toward the socket providing stability by concavity compression.

The term 'rotator cuff tear' can refer to anything from a small gap in the tendon from use and wear

to a larger tear involving the supraspinatus tendon from an old injury with what appears to be sufficient quality and quantity of tissue for a robust repair

to a long-standing large tear without enough tissue for a repair

to a massive tear of the entire rotator cuff

to tears with deterioration of the joint surface of the humeral head

to full on rotator cuff tear arthropathy without or with collapse of the humeral head and essentially no rotator cuff remaining.