Clifford Alexis L, Hurley Eoghan, Anakwenze Oke, Klifto Christopher S
University of Florida, College of Medicine, Gainesville, FL.
Department of Orthopaedic Surgery, Duke University, Durham, NC.
J Hand Surg Glob Online. 2024 Feb 29;6(4):458-462. doi: 10.1016/j.jhsg.2023.12.014. eCollection 2024 Jul.
Rotator cuff arthropathy is a spectrum of disease states secondary to full-thickness cuff tears classified by rotator cuff insufficiency and degenerative disease within the shoulder joint. Diagnosis can be made through standard physical exam and radiographic films demonstrating varying levels of weakness, along with acetabularization, femoralization, and superior migration of the humeral head. Severity of disease is classified through both the Hamada and Seebauer grading systems, which are used clinically to determine the appropriate treatment algorithm. Treatment exists along the spectrum from conservative therapy with physical therapy to a definitive treatment with total joint replacement. Depending on a patient's progression and other comorbidities, arthroscopic treatments may additionally be used in specific circumstances as joint-sparing techniques. In recent years, reverse total shoulder arthroplasty has produced increasingly favorable outcomes with improvements in pain and function while simultaneously diminishing complication rates, making it generally accepted as standard of care. This disease limits quality of life for a large population of patients and efforts toward optimization of the treatment regimen is critical. This review provides an overview on the diagnostic criteria, classification, pathoanatomic changes, biomechanics, treatment options, outcomes, and complications of rotator cuff arthropathy.
肩袖关节病是一系列继发于全层肩袖撕裂的疾病状态，根据肩袖功能不全和肩关节内的退行性疾病进行分类。诊断可通过标准体格检查和X线片进行，这些检查可显示不同程度的肌力减弱，以及肱骨头的髋臼化、股骨化和向上移位。疾病的严重程度通过滨田（Hamada）和西伯尔（Seebauer）分级系统进行分类，这两个系统在临床上用于确定合适的治疗方案。治疗方法涵盖从物理治疗的保守疗法到全关节置换的确定性治疗。根据患者的病情进展和其他合并症，关节镜治疗在特定情况下也可作为保留关节的技术使用。近年来，反式全肩关节置换术在缓解疼痛和改善功能方面取得了越来越理想的效果，同时降低了并发症发生率，因此被普遍接受为标准治疗方法。这种疾病限制了大量患者的生活质量，优化治疗方案的努力至关重要。本文综述了肩袖关节病的诊断标准、分类、病理解剖变化、生物力学、治疗选择、疗效及并发症。
