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Natural History

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Reverse Shoulder Arthroplasty
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Abstract

The severe degenerative alterations of the glenohumeral joint resulting from the inveterate rupture of the rotator cuff associated with marked functional limitations and intense patient pain had already been described in the nineteenth century. However, it was only in 1983 that the term rotator cuff tear arthropathy of the glenohumeral joint was coined by Charles S. Neer.

While other authors in the same years proposed a crystal-mediated theory with the term “Milwaukee shoulder syndrome”—which is still a similar pathology—he explained etiopathogenesis as a combination of mechanical and nutritional factors.

Several authors have later on supported mechanical theory with the concepts of “force coupling” and “concavity compression” acting on the shoulder joint.

An imbalance of these myotendinal forces following the rotator cuff tear would lead to progressive articular degeneration characterized by the proximal migration of the humeral head with wear of the top of the glena and the humeral head and the lower part of acromion with recurrent joint effusions and subacromial space.

Since only a small part of rotator cuff tear cases, especially older women and the dominant side shoulders, into joint articular degeneration, it was attempted to understand what risk factors could be involved in the progressive evolution of this severe pathology.

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Siuni, E. (2019). Natural History. In: Gumina, S., Grassi, F., Paladini, P. (eds) Reverse Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-97743-0_7

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  • DOI: https://doi.org/10.1007/978-3-319-97743-0_7

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