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First published on April 15, 2008, doi:10.1177/0363546508317344
This version was published on May 1, 2008
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The American Journal of Sports Medicine 36:987-993 (2008)
© 2008 American Orthopaedic Society for Sports Medicine


Basic Science Update

Rotator Cuff Degeneration

Etiology and Pathogenesis

Shane J. Nho, MD*, Hemang Yadav, MBBS, Michael K. Shindle, MD and John D. MacGillivray, MD

From the Hospital for Special Surgery, New York, New York

* Address correspondence to Shane J. Nho, The Hospital for Special Surgery, 535 East 70th Street, York, NY 10021 (e-mail: nhos{at}hss.edu).

By virtue of its anatomy and function, the rotator cuff is vulnerable to considerable morbidity, often necessitating surgical intervention. How we intervene is governed by our understanding of the pathological mechanisms in cuff disease. These factors can be divided into those extrinsic to the rotator cuff (impingement, demographic factors) and those intrinsic to the cuff (age-related degeneration, hypovascularity, inflammation, and oxidative stress, among others). In an era where biologic interventions are increasingly being investigated, our understanding of these mechanisms is likely to become more important in designing effective new interventions. Here we present a literature review summarizing our current understanding of the pathophysiological mechanisms underlying rotator cuff degeneration.

Key Words: rotator cuff tears • rotator cuff degeneration • degenerative microtrauma







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