Anterior Rotator cuff tears are one of the most common surgically addressed disorders, as the tears in the tendon can affect anyone regardless of risk factors or activity level. The rotator cuff is responsible for most of the shoulder motion, hence the tendon-bone interface experiences immense stress making it incredibly prone to failure. Rotator cuff tendon tears can either occur due to trauma or natural degeneration of the rotator cuff. To help mitigate effects of high stress on the rotator cuff tendon-bone interface, the rotator cuff is intrinsically designed to redistribute stress through protective mechanisms, such as the rotator crescent or coronal-transverse force. But when the tear goes through the intrinsic protective mechanisms, the glenohumeral joint is left unstable and thus is no longer capable of its normal range of motion. Location, size, and type of rotator cuff tendon tears are the strongest indicators for interventional therapy. Surgical therapies demonstrate low success rates, as seen by the significantly high recurrence rate of rotator cuff reinjury following initial repair. This is due to extrinsically healing of rotator cuff tendons, instead of the more intrinsic healing, which causes rotator cuff tendons to not undergo the necessary biomechanical remodeling to prevent reinjury leading to a mechanically and functionally inferior healed tendon. In this article, we thoroughly discussed the underlying pathophysiology of rotator cuff tears from onset to repair to healing, demonstrating that rotator cuff tendon healing is an intrinsically flawed process, irrespective of the risk factors, occurrence of rotator cuff tears, or surgical treatment. Rotator cuff healing can only be successful if rotator cuff tendon repair surgery is augmented with biologics to promote a successful intrinsic healing environment.
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http://dx.doi.org/10.26502/josm.511500167 | DOI Listing |
J Shoulder Elbow Surg
January 2025
Background: Shoulder arthroplasty is increasingly performed for shoulder conditions such as arthritis, rotator cuff arthropathy, and traumatic injuries. Registries and other compilations of patient data provide the opportunity to detect meaningful differences in outcomes between alternative techniques and implants. A wide range of outcome measurements are reported after shoulder arthroplasty, but the sample sizes needed to identify meaningful differences has not been studied systematically.
View Article and Find Full Text PDFPhys Ther
January 2025
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Importance: Rotator cuff tendinopathy represents the most prevalent cause of shoulder pain, the third most common musculoskeletal disorder after low back pain and knee pain.
Objective: The objective of this study was to determine the effectiveness of corticosteroid injection(s), alone or in combination with anesthetic injection or any other physical therapist interventions, compared to physical therapist interventions alone in adults with rotator cuff tendinopathy.
Design: This study was a systematic review and meta-analysis of randomized controlled trials.
Am J Sports Med
January 2025
Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, Texas, USA.
Background: Views surrounding acromioplasty at the time of arthroscopic rotator cuff repair (RCR) have shifted dramatically over time. In recent years, various studies have argued against acromioplasty, citing equivocal functional outcomes after arthroscopic RCR with or without acromioplasty.
Purpose: To assess the statistical fragility of functional outcomes after arthroscopic RCR with and without acromioplasty using the reverse continuous fragility index (RCFI).
J Orthop Surg Res
January 2025
Department of Orthopaedic Surgery, Yeosu Baek Hospital, 50, Yeosu 1-ro, Yeosusi, Yeosu-si, Jeollanam-do, Republic of Korea.
Background: There are various options of tendon transfer according to the different types of irreparable rotator cuff tears (IRCTs). However, there were no clear treatment options for the IRCTs involving the anterior, superior and posterior rotator cuff tears (global IRCTs). Latissimus dorsi and teres major (LDTM) could be transferred anteriorly or posteriorly in global IRCTs.
View Article and Find Full Text PDFJ Ultrasound
January 2025
Department of Physical Medicine and Rehabilitation, University of Health Science Fatih Sultan Mehmet Training and Research Hospital, E5 Karayolu Üzeri, İçerenköy-Ataşehir, 34752, Istanbul, Turkey.
Shoulder Injury Related to Vaccine Administration (SIRVA) is a complication caused by improperly administered vaccinations. It triggers an inflammatory cascade that damages shoulder structures, resulting in prolonged shoulder pain and restricted range of motion. Common diagnoses in SIRVA patients include shoulder bursitis (all classified as subacromial bursitis), adhesive capsulitis, and rotator cuff injuries such as tears or tendinopathy.
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