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Clin Shoulder Elbow > Volume 11(2); 2008 > Article
Journal of the Korean Shoulder and Elbow Society 2008;11(2):71-76.
DOI: https://doi.org/10.5397/CiSE.2008.11.2.071    Published online December 31, 2008.
Controversy in Pathophysiology of Rotator Cuff Tear: Degenerative Tear
Young Kyu Kim
Department of Orthopedic Surgery, Gil Medical Center, Gachon University, Inchon, Korea. kykhyr@gilhospital.com
회전근 개 파열의 병리 생태학에서의 논쟁점: 퇴행성 파열
김 영 규*
가천의과학대학교 길병원 정형외과학교실
Abstract
The pathophysiology of rotator cuff tears and the progression of asymptomatic tears to symptomatic tears are yet unclear and much controversy. It is likely to involve a number of factors such as a genetic predisposition, extrinsic impingement from structures surrounding the cuff and intrinsic degeneration from changes within the tendon itself. Degenerative changes in the rotator cuff with aging seem to be related to the anatomic and mechanical environment of the rotator cuff. The histopathologic appearance of rotator cuff tendon rupture specimens demonstrates a consequence of degenerative changes at the site of tendon insertion into bone. It weakens the tensile strength of the tendon. Is the process of degeneration intrinsic or extrinsic in nature? I suggest that degeneration is intrinsic and not caused by extrinsic factors. Even though, rotator cuff tear may be secondary to multiple factors, I believe that primary cause of rotator cuff tears is preexisting degenerative change.
Key Words: Rotator cuff tear; Pathophysiology; Degeneration
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