Skip to main content
SpringerLink
Log in

Biology of Rotator Cuff Healing

  • Chapter
Rotator Cuff Across the Life Span

  • 1121 Accesses

Abstract

Rotator cuff tears are the most common source of shoulder pain and dysfunction in adults worldwide. It is estimated that 30–40% of the current population over the age of 60 will suffer a full-thickness rotator cuff tear [1]. Due to the enormity of this population, significant research efforts have been undertaken to identify strategies for prevention, treatment, and rehabilitation of rotator cuff tears. The rate of recurrence of rotator cuff tears, estimated to range from 5% to 85%, is also a significant factor to consider when assessing the overall burden that these injuries impart upon healthcare systems. The majority of recurrent tears occur in the first 3 months following primary repair, and this high rate of recurrence is primarily attributed to poor healing [2]. Despite ever-improving biomechanics of fixation, biological failure following rotator cuff repair remains a significant burden on healthcare systems worldwide.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kinsella K, Velkoff V. An aging world. Washington, DC: US Government Printing Office; 2001.

    Google Scholar 

  2. Yang J, Robbins M, Reilly J, et al. The clinical effect of a rotator cuff retear: a meta-analysis of arthroscopic single-row and double-row repairs. Am J Sports Med. 2017;45(3):733–41.

    Article  CAS  Google Scholar 

  3. Paxton ES, Teefey SA, Dahiya N, Keener JD, Yamaguchi K, Galatz LM. Clinical and radiographic outcomes of failed repairs of large or massive rotator cuff tears: minimum ten-year follow-up. J Bone Joint Surg Am. 2013;95(7):627–32.

    Article  Google Scholar 

  4. Merline R, Schaefer RM, Schaefer L. The matricellular functions of small leucine-rich proteoglycans (SLRPs). J Cell Commun Signal. 2009;3(3–4):323–35.

    Article  Google Scholar 

  5. Cook JL, Feller JA, Bonar SF, Khan KM. Abnormal tenocyte morphology is more prevalent than collagen disruption in asymptomatic athletes’ patellar tendons. J Orthop Res. 2004;22(2):334–8.

    Article  CAS  Google Scholar 

  6. Hays PL, Kawamura S, Deng XH, Dagher E, et al. The role of macrophages in early healing of a tendon graft in a bone tunnel. J Bone Joint Surg Am. 2008;90(3):565–79.

    Article  Google Scholar 

  7. Zumstein MA, Lädermann A, Raniga S, Schär M. The biology of rotator cuff healing. Orthop Traumatol Surg Res. 2017;103(1S):S1–S10.

    Article  Google Scholar 

  8. Lundgreen K, Lian OB, Engebretsen L, Scott A. Tenocyte apoptosis in the torn rotator cuff: a primary or secondary pathological event? Br J Sports Med. 2001;45(13):1035–9.

    Article  Google Scholar 

  9. Frey E, Regenfelder F, Sussman P, Zumstein M, Gerber C, Born W, et al. Adipogenic and myogenic gene expression in rotator cuff muscle of the sheep after tendon tear. J Orthop Res. 2009;27(4):504–9.

    Article  CAS  Google Scholar 

  10. Hashimoto T, Nobuhara K, Hamada T. Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res. 2003;415:111–20.

    Article  Google Scholar 

  11. Rudzki JR, Adler RS, Warren RF, et al. Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age- and activity-related changes in the intact asymptomatic rotator cuff. J Shoulder Elb Surg. 2008;17(suppl 1):96S–100S.

    Article  Google Scholar 

  12. Hemigou P, Merouse G, Duffiet P, et al. Reduced levels of mesenchymal stem cells at the tendon-bone interface tuberosity in patients with symptomatic rotator cuff tear. Int Orthop. 2015;39(6):1219–25.

    Article  Google Scholar 

  13. Dourte LM, Perry SM, Getz CL, Soslowsky LJ. Tendon properties remain altered in a chronic rat rotator cuff model. Clin Orthop Relat Res. 2010;468(6):1485–92.

    Article  Google Scholar 

  14. DeFranco MJ, Cole BJ. Current perspectives on rotator cuff anatomy. Arthroscopy. 2009;25(3):305–20.

    Article  Google Scholar 

  15. Uhtoff HK, Sarkar K. Surgical repair of rotator cuff ruptures. The importance of the subacromial bursa. J Bone Joint Surg Br. 1991;73:399–401.

    Article  Google Scholar 

  16. Clark T, Guerrero E, Song A, O’Brien M, Savoie F. Do vented suture anchors make a difference in rotator cuff healing. Ann Sports Med Res. 2016;3(3):1–4.

    Google Scholar 

  17. Chahal J, Mall N, MacDonald PB, Van Theil G, Cole BJ, Romeo AA, Verma NN. The role of subacromial decompression in patients undergoing arthroscopic repair of full-thickness tears of the rotator cuff: a systematic review and meta-analysis. Arthroscopy. 2012;28(5):720–7.

    Article  Google Scholar 

  18. Zunkiewicz M, Savoie F, Field L, O’Bien M. A comparison of short term functional outcomes in patients undergoing revision arthroscopic repair of massive rotator cuff tears with and without arthroscopic suprascapular nerve release. Arthroscopy. 2010;26(S):e6.

    Article  Google Scholar 

  19. Boykin RE, Friedman DJ, Higgins LD, Warner JJ. Suprascapular neuropathy. J Bone Joint Surg Am. 2010;92:2348–64.

    Article  Google Scholar 

  20. Ciampi P, Scotti C, Nonis A, Vitali M, Di Serio C, Peretti GM, et al. The benefit of synthetic versus biological patch augmentation in the repair of posterosuperior massive rotator cuff tears: a 3-year follow up study. Am J Sports Med. 2014;42(5):1169–75.

    Article  Google Scholar 

  21. Butler DL, Juncosa-Melvin N, Boivin GP, et al. Functional tissue engineering for tendon repair: a multidisciplinary strategy using mesenchymal stem cells, bioscaffolds, and mechanical stimulation. J Orthop Res. 2008;26:1–9.

    Article  Google Scholar 

  22. Steinhaus ME, Makhni EC, Cole BJ, et al. Outcomes after patch use in rotator cuff repair. Arthroscopy. 2016;32(8):1676–90.

    Article  Google Scholar 

  23. Chen J, Xu J, Wang A, Zheng M. Scaffolds for tendon and ligament repair: review of the efficacy of commercial products. Expert Rev Med Devices. 2009;6(1):61–73.

    Article  Google Scholar 

  24. Ryu R, Ryu J, Abrams J, Savoie F. Arthroscopic implantation of a bio-inductive collagen scaffold for treatment of an articular-sided partial rotator cuff tear. Arthrosc Tech. 2015;4(5):e483–5.

    Article  Google Scholar 

  25. Chahal J, Van Thiel GS, Mall N, Heard W, Bach BR, Cole BJ, Nicholson GP, Verma NN, Whelan DB, Romeo AA. The role of platelet-rich plasma in arthroscopic rotator cuff repair: a systematic review with quantitative synthesis. Arthroscopy. 2012;28(11):1718–27.

    Article  Google Scholar 

  26. Rodeo SA, Potter HG, Kawamura S, Turner AS, Kim JH, Atkinson BL. Biologic augmentation of rotator cuff tendon-healing with use of a mixture of osteoinductive growth factors. J Bone Joint Surg Am. 2007;89(11):2485–97.

    Article  Google Scholar 

  27. Savin D, Meadows M, Verma N, Cole B. Rotator cuff healing: improving biology. Oper Tech Sports Med. 2017;25:34–40.

    Article  Google Scholar 

  28. Dicknson RN, Kuhn JE, Bergner JL, Rizzone KH. A systematic review of cost-effective treatment of postoperative rotator cuff repairs. J Shoulder Elb Surg. 2017;26(5):915–22.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA

    Hunter Hood & Felix H. Savoie III

Authors
  1. Hunter Hood
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Felix H. Savoie III
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Hunter Hood or Felix H. Savoie III .

Editor information

Editors and Affiliations

  1. Orthopaedic Sportsmedicine, University of Munich (TUM), Orthopaedic Sportsmedicine, Munich, Bayern, Germany

    Andreas B. Imhoff

  2. Department of Orthopaedics, Tulane University School of Medicine, Department of Orthopaedics, New Orleans, LA, USA

    Felix H. Savoie III

Rights and permissions

Reprints and permissions

Copyright information

© 2019 ISAKOS

About this chapter

Cite this chapter

Hood, H., Savoie, F.H. (2019). Biology of Rotator Cuff Healing. In: Imhoff, A.B., Savoie, F.H. (eds) Rotator Cuff Across the Life Span. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58729-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58729-4_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58728-7

  • Online ISBN: 978-3-662-58729-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation