Basic training in shoulder surgery: investigating molecular mechanisms of rotator cuff disease.

Abstract

Rotator cuff disease is one of the most common shoulder problems in adults. In the U.S. alone, up to 40% of individuals sixty years of age and older are affected, with approximately 75,000 rotator cuff repairs performed annually. Despite advances in treatments, failure of rotator cuff repairs continues to pose a major problem. Furthermore, little is known about the basic mechanisms that play a role in rotator cuff healing, including tendon degeneration and repair, tendon-to-bone healing, the role of inflammation and bursitis in repair, and the role of muscle response to injury. One of the potential causes of failed rotator cuff repair is inability of the rotator cuff muscles to respond to injury and promote repair. In prior studies, authors have shown that the rotator cuff muscles are replaced by fat in the presence of a massive rotator cuff tear, chronic rotator cuff disease, and muscle denervation from neurologic injury1-5. Some earlier molecular studies have also shown that gene expression is altered in response to rotator cuff injury and that alterations are associated with muscle …