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Even though some cytokines have been related to the pathogenesis of synovitis in hemophilic arthropathy with some similarities to RA, few studies have clearly demonstrated their functional role in the pathogenic cascade of the disease . In fact, hemophilic arthropathy has been firstly described as a degenerative rather than an inflammatory joint disease . However, recent studies indicate that hemophilic arthropathy has similarities either with the degenerative joint damage occuring in OA or with the chronic inflammatory process associated with RA, even if specific pathogenetic mechanisms have not yet been fully elucidated .
Multicentric osteolysis, nodulosis, and arthropathy (MONA) describes a rare inherited disease characterized by a loss of bone tissue (osteolysis), particularly in the hands and feet. MONA includes a condition formerly called nodulosis-arthropathy-osteolysis (NAO) syndrome. It may also include a similar disorder called Torg syndrome, although it is unknown whether Torg syndrome is actually part of MONA or a separate disorder caused by a mutation in a different gene.
In most cases of MONA, bone loss begins in the hands and feet, causing pain and limiting movement. Bone abnormalities can later spread to other areas of the body, with joint problems (arthropathy) occurring in the elbows, shoulders, knees, hips, and spine. Most people with MONA develop low bone mineral density (osteopenia) and thinning of the bones (osteoporosis) throughout the skeleton. These abnormalities make bones brittle and more prone to fracture. The bone abnormalities also lead to short stature.
Facet arthropathy is a degenerative condition that affects the spine. The spine is made up of segments of vertebrae running along the spinal column. Between each vertebra are two facet joints. The facet joints along the posterior of the spine help align the vertebrae and limit motion. Facet joints are made up of two bony surfaces cushioned by cartilage and lubricated by synovial fluid. Facet arthropathy occurs when the facet joints begin to wear down and put pressure on the spinal cord, resulting in pain.
While there is no cure for facet arthropathy, there are ways to effectively manage the pain. Your orthopaedic specialist will work with you to find the least invasive treatment plan to manage your pain. Nonsurgical treatment options include:
While facet arthropathy is a degenerative symptom, with preventative measures, non-surgical and surgical treatment, relief and effective pain management is possible. At MidAmerica Orthopaedics, our dedicated team of spine experts can help get you on the path to comfort and healing.
Joining our pain management team is Robert Metzler, MD. Dr. Metzler is a Physical Medicine and Rehabilitation (Pain Management) specialist with an emphasis in the diagnosis and treatment of facet arthropathy. Dr. Metzler works alongside physical and occupational therapists to identify patients' goals and help them achieve them.
Overview Rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear) is a devastating condition that seriously compromises the comfort and function of the shoulder. This condition is characterized by the permanent loss of the rotator cuff tendons and the normal surface of the shoulder joint. These tissues cannot be restored to their normal condition and the lost comfort and function of the shoulder cannot be totally regained. However in the hands of an experienced surgeon and in a well-motivated individual shoulder replacement surgery with a cuff tear arthropathy (CTA) head prosthesis along with post-surgical rehabilitation can help restore substantial comfort and function to shoulders damaged by cuff tear arthropathy. When the rotator cuff is essentially intact shoulder arthritis is often best treated by total shoulder replacement. If you have questions regarding this procedures please feel free to email Dr Matsen at email@example.com.
In rotator cuff tear arthropathy the rotator cuff tendons that normally are interposed between the humeral head and the overlying coracoacromial arch become progressively thinned until the humeral head moves upwards and rubs against the bone of the arch. [Figure 2].
In stage 1A of rotator cuff tear arthropathy the humeral head remains centered in the socket (glenoid) in spite of a large rotator cuff tear [Figure 3]. In stage 1B of rotator cuff tear arthropathy the humeral head migrates medially into the socket (glenoid) [Figure 4]. In stage 2A of rotator cuff tear arthropathy the humeral head migrates upwards but is stabilized by the overlying coracoacromial arch in spite of the lack of rotator cuff. [Figures 5 and 6]. In stage 2B of rotator cuff tear arthropathy the humeral head migrates upwards and forwards because it is no longer stabilized by the coracoacromial arch. This condition often arises after previous procedures such as an acromioplasty when it is performed in the presence of a large cuff tear. [Figure 7]
After performing a clinical exam a shoulder surgeon experienced with rotator cuff tear arthropathy can suggest what type of surgery is most likely to be helpful to the individual with the condition. Individuals are most likely to benefit from this surgery if they are well motivated and in good health.
Shoulders demonstrating changes of Stages 1A 1B and 2A with substantial loss of comfort and function are considered for shoulder arthroplasty using a cuff tear arthropathy (CTA) prosthesis as described in this article.
Shoulders with stage 2B cuff tear arthropathy with substantial loss of comfort and function are considered for the reversed (reverse Delta) prosthesis because the cuff tear arthropathy (CTA) prosthesis may not provide sufficient stability for the humeral head (ball of the shoulder joint). The reversed (reverse Delta) prosthesis is designed with a socket where the ball (head of the humerus) is normally located and a ball where the socket (glenoid) is usually located.
The goal of shoulder replacement arthroplasty with a cuff tear arthropathy (CTA) prosthesis is to restore the best possible function to the joint by removing scar tissue balancing muscles and replacing the destroyed joint surface of the humerus (arm bone) [figure 8] with an artificial one especially designed for that purpose [figure 9]. The humeral ball is fixed to the humerus (arm bone) by press fitting its stem inside the bone.
Shoulder joint replacement arthroplasty with a cuff tear arthropathy head is a highly technical procedure and is best performed by a surgical team who performs this surgery often. Such a team can maximize the benefit and minimize the risks.
Rotator cuff tear arthropathy (or shoulder arthritis with a large rotator cuff tear) is a severe and complex form of shoulder arthritis in which the shoulder has lost not only the cartilage that normally covers its joint surface but also the tendons of the rotator cuff tear which help position and power the joint.
Rotator cuff tear arthropathy appears to be a condition with a succession of stages depending on the stability of the humeral head (ball of the shoulder joint) in respect to the glenoid (socket of the shoulder joint). These stages have been described at the beginning of this article.
Rotator cuff tear arthropathy (or shoulder arthritis with a large rotator cuff tear) is diagnosed by a history of progressive loss of shoulder function usually without an injury along with a physical examination showing weakness and grinding on movement and a typical appearance on X-ray. In these films the humeral head can be seen contacting the undersurface of the coracoacromial arch as indicated by the arrows. [Figure 13] The most important test for cuff tear arthropathy is the x-ray characteristically showing rounding off of the humeral head as it contacts with the undersurface of the coracoacromial arch. [Figure 14]
Rotator cuff tear arthropathy (arthritis of the shoulder associated with a massive cuff tear) is best diagnosed by an orthopedic surgeon with experience in shoulder disorders. Certain surgeons specialize in rotator cuff tear arthropathy (arthritis of the shoulder associated with a massive cuff tear). Such individuals may be found in the shoulder services of major schools of medicine.
If the symptoms of rotator cuff tear arthropathy (shoulder arthritis with a massive rotator cuff tear) are mild the condition may be treated with gentle motion exercises and exercises to strengthen the deltoid and other muscles around the shoulder that remain intact.
When combined with a good rehabilitation effort shoulder joint replacement arthroplasty with a cuff tear arthropathy (CTA) head prosthesis allows arthritic shoulders to regain some of their lost comfort and function. In experienced hands this procedure can address the restricting scar tissue that frequently accompanies rotator cuff tear arthropathy. It can also restore smooth stabilizing joint surfaces when these surfaces have been damaged by rotator cuff tear arthropathy.
Joint replacement surgery can improve the mechanics of the shoulder but cannot make the joint as good as it was before the onset of rotator cuff tear arthropathy. In cuff tear arthropathy the tendons and muscles around the shoulder have deteriorated before the shoulder replacement. After the surgery it may take months of gentle exercises before the shoulder achieves maximum improvement.
The effectiveness of the procedure depends on the health and motivation of the individual the condition of the shoulder and the expertise of the surgeon. When performed by an experienced surgeon experience has shown that shoulder replacement arthroplasty with a cuff tear arthropathy head can provide improved shoulder comfort and function. The greatest improvements are in the ability of the individual to sleep and to perform some of the simple activities of daily living. In that the tendons of the rotator cuff are not repairable in this condition normal strength and function of the shoulder cannot be regained. 59ce067264