Treatment options for rotator cuff tear arthropathy

Rotator cuff tear arthropathy is characterized by massive and irreparable rotator cuff tears associated with shoulder arthritis. Symptoms include varying degrees of pain, loss of motion, and loss of function, or "pseudo-paralysis" alone. Nonoperative modalities are the treatment mainstay for mildly symptomatic patients, and there are viable medical and surgical treatment options for those whose symptoms are not severe enough to warrant shoulder arthroplasty. The trend toward using reverse total shoulder arthroplasty as the only treatment for this highly variable patient group does not allow a cautious approach to this disease nor recognize the high potential complication rate of the reverse prosthesis.