Cuff tear arthropathy in the nineteenth century: ‘chronic rheumatic arthritis’ with ‘partial luxation upwards’ of the humeral head

Abstract

Introduction

Cuff tear arthropathy of the shoulder is a common indication for insertion of an increasing number of reverse shoulder arthroplasties. It is widely believed that this condition was unknown to medical practitioners and writers prior to the introduction of the term cuff tear arthropathy by Charles Neer in 1977.

Purpose

To search nineteenth-century written sources for pathoanatomical and biomechanical descriptions of the typical changes found in cuff tear arthropathy.

Methods

A historical review. Nineteenth-century medical textbooks, reviews, case series, autopsy reports and illustrations were systematically searched and retrieved for relevance. References were hand-searched. Illustrations were reproduced and interpreted.

Results

A richly illustrated nineteenth-century literature was identified. The typical changes in cuff tear arthropathy were termed ‘chronic rheumatic arthritis’ of the shoulder with ‘partial luxation upwards’ of the humeral head and interpreted within a pathoanatomical and biomechanical framework. Detailed descriptions and illustrations of massive rotator cuff tears, biceps pathology and the osseous changes were identified and presented.

Conclusion

The pathoanatomical and biomechanical changes later termed cuff tear arthropathy were well understood and nicely described in nineteenth-century medical literature.