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Adults over the age of 60 are more susceptible to a rotator cuff tear, with the overall frequency of tears increasing with age. [92] By the age of 50 10% of people with normal shoulders have a rotator cuff tear. [93] In an autopsy study of rotator cuff tears, the incidence of partial tears was 28%, and of complete rupture 30%.
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]
[26] [27] Second, a computerized three-dimensional study failed to support impingement by any portion of the acromion on the rotator cuff tendons in different shoulder positions. [28] Third, most partial-thickness cuff tears do not occur on bursal surface fibers, where mechanical abrasion from the acromion does occur.
Because strengthening the serratus anterior improves shoulder stability, the exercise is recommended for people suffering from shoulder pain or bad posture [4] and is recommended in one treatment protocol as non-surgical treatment for a rotator cuff tear. [5]
Massive irreparable rotator cuff tear without osteoarthritis has also been an accepted indication for a number of years, given numerous studies have reported good functional outcomes. Over the last 10 years the indications for RTSA have seen a huge expansion, including for patients with osteoarthritis and intact rotator cuff tendons. [ 11 ]
The most commonly affected tendon is that of the supraspinatus muscle. Defects in the rotator cuff can come from an injury (cuff tear) or from degeneration (cuff wear). The degree to which a tendon is reparable depends on its quantity and quality. Degenerated tendons are often frail and retracted and may not be amenable to repair.
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