title: Biological factors in the pathogenesis of rotator cuff tears.
abstract: Rotator cuff tears are common, and lead to shoulder pain and functional impairment. Despite their frequency and related disability, etiology and pathogenesis are still debated. Multiple factors contribute to tears of the rotator cuff. Extrinsic factors are anatomic variables, such as acromial morphologic characteristics, os acromiale, and acromial spurs that compress the rotator cuff by bony impingement or direct pressure from the surrounding soft tissue. Intrinsic factors arise from the tendon itself, because of tensile overload, aging, microvascular supply, traumatisms, or degeneration. Little information is available from a cellular and molecular point of view. We reviewed the biological factors involved in the pathogenesis of rotator cuff tears. Understanding the mechanism of rotator cuff pathology would facilitate the rationale for therapeutic interventions, by guiding the design, selection, and implementation of treatment strategies such as biologic modulation and preventive measures.
authors.affiliation: *Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, Mile End Hospital, London E1 4DG, England. n.maffulli@qmul.ac.uk
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Umile Giuseppe
authors.initials: UG
authors.lastname: Longo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Berton
authors.forename: Mattia
authors.initials: M
authors.lastname: Loppini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D017209:Apoptosis / Q000235:genetics; D001685:Biological Factors / Q000235:genetics / Q000378:metabolism*; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000235:genetics; D008297:Male; D045726:Metalloproteases / Q000235:genetics / Q000378:metabolism; D017006:Rotator Cuff / Q000503:physiopathology; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology; D013708:Tendon Injuries / Q000209:etiology / Q000503:physiopathology
chemical_list: D001685:Biological Factors; D016207:Cytokines; D045726:Metalloproteases