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Rotator cuff tears

delete2024-02-08
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PRE
AI
A
Asheesh Bedi
J
Julie Y. Bishop
J
Jay D. Keener
D
Drew A. Lansdown
O
Ofer Levy
P
Peter B. MacDonald
N
Nicola Maffulli
J
Joo Han Oh
V
Vani J. Sabesan
J
Joaquín Sánchez‐Sotelo
R
Riley J. Williams
B
Brian T. Feeley *
DOI:10.1038/s41572-024-00492-3delete
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Abstract

Abstract

En 中文
Rotator cuff tears are the most common upper extremity condition seen by primary care and orthopaedic surgeons, with a spectrum ranging from tendinopathy to full-thickness tears with arthritic change. Some tears are traumatic, but most rotator cuff problems are degenerative. Not all tears are symptomatic and not all progress, and many patients in whom tears become more extensive do not experience symptom worsening. Hence, a standard algorithm for managing patients is challenging. The pathophysiology of rotator cuff tears is complex and encompasses an interplay between the tendon, bone and muscle. Rotator cuff tears begin as degenerative changes within the tendon, with matrix disorganization and inflammatory changes. Subsequently, tears progress to partial-thickness and then full-thickness tears. Muscle quality, as evidenced by the overall size of the muscle and intramuscular fatty infiltration, also influences symptoms, tear progression and the outcomes of surgery. Treatment depends primarily on symptoms, with non-operative management sufficient for most patients with rotator cuff problems. Modern arthroscopic repair techniques have improved recovery, but outcomes are still limited by a lack of understanding of how to improve tendon to bone healing in many patients. Rotator cuff tears occur due to trauma or, most commonly, due to degenerative changes to tendon structure. This Primer summarizes the epidemiology and pathophysiology of this condition, discusses its diagnosis and management, and highlights patients' quality of life and future research questions.
Keywords:
SUBACROMIAL IMPINGEMENT SYNDROME
TOTAL SHOULDER ARTHROPLASTY
RANDOMIZED CONTROLLED-TRIAL
PLATELET-RICH PLASMA
LONG-TERM OUTCOMES
10-YEAR FOLLOW-UP
SUPERIOR CAPSULE RECONSTRUCTION
FATTY MUSCLE DEGENERATION
ARTHROSCOPIC SINGLE-ROW
GENOME-WIDE ASSOCIATION

Journal

N
Nature Reviews Disease Primers
IF:
60.6
Papers:
645
Citations:
3.8W

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university of california san francisco
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Seoul National University Hospital
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university of chicago
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mayo clinic
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washington university (wustl)
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University of California System
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Ohio State University
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seoul national university (snu)
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S
sapienza university rome
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Citations: 381
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