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Pathophysiology of Rotator Cuff Tears

  • Trevor P. Scott
  • Adam Z. Khan
  • Frank A. PetriglianoEmail author
Chapter

Abstract

The development of rotator cuff pathology is multifactorial in nature, resulting from a combination of intrinsic and extrinsic factors. Age-related degeneration, oxidative stress, vascular changes, and inflammation are all potential contributors to the intrinsic pathology of the rotator cuff. Of the variety of cellular and morphologic changes that are observed in the setting of massive rotator cuff tears, two changes—muscle atrophy and fatty degeneration—are strongly correlated with high repair failure rates and worsening functional outcomes. Yet, the precise molecular basis for these changes is largely unknown.

Massive tears of the rotator cuff prevent the cuff from stabilizing the humeral head on the glenoid to allow other muscles to generate motion across the joint. It is unclear exactly how large a tear must be to cause a loss of the force coupling effect of the rotator cuff and normal shoulder biomechanics. Another major question, still unanswered, is the mechanism behind the evolution of subjective pain in the setting of rotator cuff pathology as many cuff tears are asymptomatic. Investigation and further understanding of these fundamental mechanisms will not only lead to better diagnostic and prognostic capabilities but will also aid in the development of better treatment modalities and adjunctive therapies for massive rotator cuff tears.

Keywords

Rotator Cuff Humeral Head Rotator Cuff Tear Rotator Cuff Repair Glenohumeral Joint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Trevor P. Scott
    • 1
  • Adam Z. Khan
    • 2
  • Frank A. Petrigliano
    • 3
    Email author
  1. 1.Department of Orthopedic SurgeryUCLA Santa Monica Orthopaedic CenterSanta MonicaUSA
  2. 2.Department of Orthopaedic SurgeryDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.UCLA David Geffen School of MedicineLos AngelesUSA

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