Healing of the rotator cuff: Affecting the biologic and mechanical environment

Increasing interest in biological and tissue engineering approaches to improving rotator cuff healing has been motivated by the relatively high failure rates after rotator cuff repairs. A number of recent studies have offered improved understanding of the pathophysiologic processes that contribute to the development of rotator cuff tears and have identified a number of treatment targets. While a number of in-vitro and animal studies have reported promising results for enhancing rotator cuff healing, few studies have demonstrated clinical efficacy. Optimizing the dose, timing and delivery method for therapies to modulate the biological or mechanical environment of the rotator cuff may be the key determinant of ultimate clinical success.