Abstract
Summary: Rotator cuff tendinopathy is a degenerative disease characterized by regressive changes at the insertion of the cuff into bone. Although all three major cuff tendons are equally affected by degeneration, tearing always starts at the insertion of the supraspinatus. This points to the importance of additional pathogenetic factors. The articular half of the cuff tendon is always more affected by degeneration than the bursal half. The etiology of degeneration is still open to debate. Among the diagnostic tests, sonography is the method of choice. If in doubt, magnetic resonance imaging can be performed. When surgical repair of a complete tear is indicated, an anterior acromioplasty should only by performed to ensure unimpeded gliding. The same applies to bursectomy, as the bursa is an important source of cells and vessels for healing after a successful repair. Cutting back of the medial stump to bleeding tissue is not indicated, because the tendon proper contributes little to the healing process.
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