Aging-Related Rotator Cuff Tears: Molecular Mechanisms and Implications for Clinical Management

Area of Science:

• Orthopedics
• Gerontology
• Biomedical Engineering

Background:

• Rotator cuff tears (RCT) are a major cause of shoulder pain and disability in older adults.
• High retear rates post-surgery present a significant challenge, especially in the elderly population.
• Aging exacerbates degeneration in muscle, tendon, enthesis, and bone, contributing to RCT development and poor outcomes.

Purpose of the Study:

• To systematically review the pathophysiological changes associated with aging in rotator cuff tears.
• To explore the clinical significance and molecular mechanisms of aging-related RCT.
• To identify potential therapeutic strategies for reducing RCT incidence and improving surgical outcomes in the elderly.

Main Methods:

• Systematic literature review of studies on aging and rotator cuff tears.
• Analysis of pathophysiological mechanisms including muscle atrophy, fatty infiltration, tendon alterations, enthesis degeneration, and bone density reduction.
• Examination of molecular pathways involved in aging-related RCT.

Main Results:

• Aging significantly impairs muscle quality, tendon integrity, enthesis, and bone health, all critical factors in RCT.
• Specific molecular mechanisms driving age-related degeneration in the rotator cuff are identified.
• Current research provides insights into the complex interplay of aging factors in RCT.

Conclusions:

• Aging-related degeneration is a key factor in the development and poor prognosis of rotator cuff tears in the elderly.
• A comprehensive understanding of these aging processes is essential for novel therapeutic interventions.
• Targeting age-related molecular pathways may offer new avenues to improve RCT treatment and patient outcomes.