DOS 2017

DOS Kongressen 2017 ·

Cuff-Tear Arthropathy: An Historical Review of 19th

Century Sources

Stig Brorson

Ortopædkirurgisk Afdeling, Herlev/Gentofte Hospital

Background:

The term cuff-tear arthropathy was first introduced by Charles

Neer in 1977. It is a widely held belief that the condition was unknown prior

to the description in the classical paper by Neer, Craig, and Fukuda in 1983.

Cuff-tear arthropathy designates the end stage of a process characterized by

massive rotator cuff tear, glenohumeral instability with upward migration of the

humeral head, and painful arthritis.

Purpose / Aim of Study:

In this historical review it is hypothesized that the

pathogenesis and the pathoanatomical changes seen in cuff-tear arthropathy

were well described and understood in the pre-radiographical era.

Materials and Methods:

19th century clinical case series, autopsy reports,

monographs, dissertations, reviews, articles, editorials, letters, and illustrations

were systematically searched from historical bibliographical databases and re-

trieved for relevance. Historical descriptions, discussions and illustrations were

identified, presented and interpreted.

Findings / Results:

The typical progressive pathoanatomical changes in bone,

cartilage, capsule, muscles, tendons, joint fluid, and bursa were described in de-

tails and the pathogenesis was understood within a biomechanical framework.

In particular, the consequences of the degeneration, displacement or rupture of

the tendon of the long head of the biceps and the superior migration of the hu-

meral head were well understood. Relevant historical nosological terms include

‘chronic rheumatic arthritis of the shoulder’ and ‘partial luxation upwards of the

humeral head’.

Conclusions:

A thorough pathoanatomical and biomechanical understanding of

the condition later termed cuff-tear arthropathy can be found in 19th century

sources.

No conflicts of interest reported

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