A new article titled “Histological Evidence of Muscle Degeneration in Advanced Human Rotator Cuff Disease” by Gibbons et al from UC San Diego was published article in The Journal of Bone and Joint Surgery , the premier Orthopedic research journal. This is the first study that demonstrates at a cellular level what has happened to the muscles of the rotator cuff in chronic tears.
The lifetime prevalence of rotator cuff tear is estimated to be as high as 20% of the general population, where risk increases significantly with age . Because rotator cuff tears may remain asymptomatic for years, and the onset of symptoms is often insidious, many patients do not seek treatment until the disease has progressed to a more chronic state. When accompanied by other factors such as smoking, diabetes, and age, this late-stage intervention results in surgical failure rates as high as 50%.
In other words, the chances of someone having a rotator cuff tear increases with age, even without any injury or event and without symptoms- it is simply a part of the aging process. Many simply become symptomatic insidiously.
After taking biopsies of what looked like residual muscle tissue on MRI, they found it has been replaced with with fat and connective tissue and it was not muscle at all. Thus, even if these tears are repaired, the muscle will no longer function and can make patients worse.
IMPORTANCE: Rotator cuff tears should be repaired when identified. Even if repairable at a later stage, the chances of functional success is only 50% or less. Thus, treating tears with pain masking techniques such as cortisone injections and rehab are not necessarily in a patient’s long term best interest and can lead to non-repairable tears. DO NOT IGNORE SHOULDER PAIN ESPECIALLY AFTER THE AGE OF 50 TO AVOID THIS PROBLEM. Seek out evaluation and treatment from a fellowship trained, BOARD CERTIFIED shoulder sub-specialist in Orthopedic Surgery to make sure you understand exactly what problem exists and what options are best to treat that problem.