CTA: Instrumental Evaluation

  • Domiziano Coppacchioli
  • Giacomo Ponte
  • Tony Mangano


The first cases of glenohumeral arthritis occurring with tears of the rotator cuff were described by Adams and Smith in the 1850s [1]. In 1983 Neer described a massive rotator cuff tear as the initial event in the development of degenerative arthritis, with a final spectrum of this condition ranging from superior migration of the humeral head with only regional chondromalacia to collapse of the humeral head with full-thickness cartilage defects. Neer defined this condition “cuff tear arthropathy” (CTA) and identified the diagnostic hallmarks in the superior humeral migration and diminished acromiohumeral distance, erosion of the great tuberosity (“femoralization”) and of the inferior aspect of the acromion (“acetabularization”), joint space narrowing, and other arthritic changes at the glenohumeral joint [2]. All of these features have been variably considered by the historical works upon CTA, especially those dealing with the radiographic classifications, and have been widely accepted as the hallmarks not only of the diagnosis but also of the natural evolution itself of this pathology.


Massive Rotator Cuff Tears Cuff Tear Arthropathy Critical Shoulder Angle (CSA) Acromion Index (AI) Reverse Total Shoulder Arthroplasty 
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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Domiziano Coppacchioli
    • 1
  • Giacomo Ponte
    • 2
  • Tony Mangano
    • 3
    • 4
  1. 1.Department of Orthopaedics and TraumatologyOspedale San GiuseppeEmpoliItaly
  2. 2.Unit of RadiodiagnosticGruppoMedGenoaItaly
  3. 3.Department of Orthopaedics and TraumatologyCasa di Cura Villa IgeaAcqui TermeItaly
  4. 4.Unit of Shoulder and Elbow SurgeryOspedale Humanitas—San Pio XMilanItaly

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