Abstract
The rotator cuff of the shoulder commonly fails, through acute injury, repetitive stress, or chronic attrition. The patterns of its failure is governed by specific anatomic features that include the collagen framework of the tendon, the pattern of osseous insertion at its footprint, the presence of regions of decreased vascularity (i.e., critical zones), the nature and location of tensile force overload, the location of external or internal regions of potenzial impingement, and other characteristic anatomic features. In this presentation, the major causes of rotator cuff failure will be explored with emphasis given to new concepts including but not limited to the rotator cable and crescent, the layered structure of the muscles and tendons, and tensile undersurface fiber failure (TUFF).
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