PMC8282145_01
A, An anteroposterior radiograph in external rotation. B, A
trans-scapular Y-view of the left shoulder demonstrating arthropathy of
the acromioclavicular and glenohumeral joints with bony hypertrophy at
the greater tuberosity.
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Preoperative x-rays demonstrated cuff tear arthropathy with superior humeral migration and narrowing of the acromiohumeral interval consistent with Hamada stage II (Figure 1(A) and (B)).
An MRI of the left shoulder (A-C) A T2 coronal series demonstrating
complete tearing of the supraspinatus tendon with medial retraction to
the glenoid (D-F) A T2 axial series demonstrating partial tearing and
medial dislocation of the biceps tendon. G and H, A T1 coronal series
demonstrating good deltoid bulk without atrophy. I, A T1 sagittal image
demonstrating marked fatty atrophy of the supraspinatus and
infraspinatus muscles.
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An MRI was performed which further demonstrated moderate arthritic changes in the glenohumeral joint, and full width, full thickness tearing of the supraspinatus, infraspinatus, and subscapularis tendons with medial retraction and advanced fatty atrophy (Figure 2(A) to (I)).
A and B, Axial CT images. C, A coronal CT image calibrated to a bone
window demonstrating superior and anterior migration of the humeral head
with arthritic changes of the glenohumeral and acromioclavicular joints
including a large osteophyte in the glenohumeral joint and subchondral
cystic changes with intraarticular loose body (B).
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A preoperative CT was performed which also demonstrated degenerative changes, mild anterior subluxation of the humeral head, 4.3 cm of bone stock at the center of the glenoid, and normal glenoid retroversion (Figure 3(A) to (C)).
This figure shows the case of a patient with cuff tear arthropathy who
underwent RSA for rotator cuff arthropathy. X-rays from same-day post-op
(A-C), 6-month follow-up films (D-F), and 1-year follow-up films (G and
H). This progression demonstrates incomplete seating of the glenosphere
with cephalad tilting on immediate post-operative films, followed by
spontaneous seating of the glenosphere between 6 and 12 months. I and J,
18-month follow-up demonstrating maintenance of complete seating of the
glenosphere.
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Postoperative x-rays revealed incomplete seating of the glenosphere on the baseplate with cephalad tilt of the glenosphere without associated fracture or dislocation (Figures 4(A) to (C) and 5). AROM to 140  of flexion and 40  of external rotation with unchanged x-rays. At the 6-month visit, the patient had completed her course of PT and was doing well with home exercises despite unchanged x-rays (Figure 4(D) to (F)). Significantly, at the 1-year follow-up visit the glenosphere had fully radiographically seated on the baseplate without surgical intervention or mechanical events (Figure 4(G) and (H)).