Natural History of Degenerative Rotator Cuff Tears

Abstract

Purpose of Review In the past several years, there have been significant advances in our understanding of the natural history of rotator cuff disease. Studies have continued to provide valuable insight into the clinical, radiographic, and anatomic features of these atraumatic tears. Our purpose is to summarize the findings and contributions from these recent high-quality studies. Recent Findings Current research has continued to describe and provide understanding into the natural history of atraumatic rotator cuff disease, including symptom progression, tear enlargement, and the development of arthritis. This knowledge has allowed identification of tears with higher risk of disease progression. Additionally, studies have investigated, with long-term healing data, whether the natural history of degenerative rotator cuff tears can be altered with surgical intervention. Summary Recent studies have shown encouraging mid to long-term healing data and clinical outcome scores for smaller tears in younger patients with minimal fatty infiltration. Future research should focus on obtaining long-term healing data, functional outcome data, and refining surgical indications for rotator cuff repair. Identifying patients with specific tear characteristics amendable to healing will allow us to provide a long-term, durable repair, thus interrupting the natural history of degenerative rotator cuff disease.

The role of estrogen and progesterone receptors in the rotator cuff disease: a retrospective cohort study

“…Although the exact pathogenesis of RC tendinopathy is still under debate [ 5 , 7 ], it is thought to be a multifactorial disease [ 3 ], with several cofactors that contribute to weaken tendons until their rupture. Previous studies have indicated that repetitive motion disorders occur mainly in women [ 14 ] and in advanced age [ 5 , 6 ]. It may imply a potential role of postmenopausal hormonal modifications in influencing the natural history of these ailments.…”

“…In the USA, each year approximately 4.5 millions of people suffer from shoulder pain and the majority of them are due to RC tears [ 3 , 4 ]. The prevalence of the disease increases with age, affecting up to 67% of patients over 80 years [ 5 , 6 ].…”

“…Although several risk factors have been identified, actually, the pathogenesis and the natural history of RC tendinopathy remains unclear [ 5 , 7 ]. It is considered a multifactorial disease [ 3 ] with intrinsic (age, gender, genetic predisposition) and extrinsic (micro and macro-traumas) cofactors that contribute to its onset [ 8 – 10 ].…”

Editorial Commentary: Rotator Cuff Tear: Know When Not to Operate So You Don't Make It Worse

“…Do they behave different from conservatively treated full-thickness rotator cuff tears on natural history, which progress (and become symptomatic) over time? [8][9][10] Or are these more sustainable? In a systematic review (N ¼ 643) presented by Malahias et al, 11 all mean postoperative clinical and functional subjective scores, as well as the muscle strength of patients treated with arthroscopic partial repair, were significantly improved compared with the mean preoperative values.…”

Rotator cuff muscle stem cells: the double-edged sword in the skeletal muscle

“…Rotator cuff tear (RCT) is a representative muscletendinous disease-causing shoulder pain (1), and recently, its prevalence rate is remarkably increasing by an aging population and various sports activities (2,3). For RCTs, surgical repair is prevalent and has been a commonly accepted treatment, especially when the conservative management was failed (4).…”