This 2004 review by Visotsky et al. synthesizes the history, pathomechanics, and classification of cuff tear arthropathy (CTA), then presents a case series of 60 shoulders reconstructed with a CTA extended humeral head prosthesis, stratified by the Seebauer biomechanical classification, to propose a treatment algorithm for this condition.
When evaluating a patient with massive rotator cuff tear and glenohumeral arthritis, apply the Seebauer classification: stable, centered or minimally migrated heads (Types IA/IB) can be managed with extended-head hemiarthroplasty, while severely migrated, unstable patterns (Type IIB) require reverse shoulder arthroplasty to restore a functional fulcrum.
Preserving the coracoacromial arch is critical — it is the last passive restraint against superior escape of the humeral head in this setting.
This 2004 review by Visotsky et al. synthesizes the history, pathomechanics, and classification of cuff tear arthropathy (CTA), then presents a case series of 60 shoulders reconstructed with a CTA extended humeral head prosthesis, stratified by the Seebauer biomechanical classification, to propose a treatment algorithm for this condition.
When evaluating a patient with massive rotator cuff tear and glenohumeral arthritis, apply the Seebauer classification: stable, centered or minimally migrated heads (Types IA/IB) can be managed with extended-head hemiarthroplasty, while severely migrated, unstable patterns (Type IIB) require reverse shoulder arthroplasty to restore a functional fulcrum.
Preserving the coracoacromial arch is critical — it is the last passive restraint against superior escape of the humeral head in this setting.