Rotator Cuff Disorders: Basic Science and Clinical Medicine

by Nicola Maffulli, John P Furia

The rotator cuff consists of four muscles namely subscapularis, supraspinatus, infraspinatus and teres minor. These muscles arise from scapula and their tendons combine with the subjacent capsule of the glenohumeral joint. This anatomical complex plays a key role in the normal functioning of the shoulder joint. The type of tear is based on tendon retraction, tear size, cuff mobility and tissue quality. Based on this information, anatomical repair can be done by the surgeon. To get exact pathology of rotator cuff, studies on asymptomatic people are necessary. The two important theories for the reason to occur cuff tears are extrinsic impingement and intrinsic degeneration. By applying this knowledge to future research, appropriate approach for rotator cuff tears can be determined. There are various modalities for assessing rotator cuff. Of them, magnetic resonance imaging (MRI) is the accurate modality for examination and assessing shoulder and suspicious rotator cuff pathology. The overhead throwing motion requires strength, flexibility, coordination and neuromuscular control. Shoulder arthropathy is an aching condition characterized by damage and deterioration of the articular cartilage associated with large number of irreparable cuff tear. Orthobiologics are an array of biologically active materials which influences the tissue healing in orthopaedic surgery. Many scoring systems have been established to satisfy the necessity to evaluate the functional status and efficiency of the treatment of patients with shoulder pain. The tissue engineering leads to augmented tendon healing after repair with improvised clinical outcomes.

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