Rotator cuff tear oxidative stress induces tenocyte apoptosis causing further rotator cuff tendon degeneration. A neural theory also exists that suggests neural overstimulation leads to the recruitment of inflammatory cells and may also contribute to tendon degeneration. Tears of the rotator cuff tendon are described as partial or full thickness, and full thickness with complete detachment of the tendons from bone. Shoulder pain is variable and may not be proportional to the size of the tear. Neer promoted the concept of three stages of rotator cuff disease. Stage I, according to Neer, occurred in those younger than 25 years and involved edema and
Rotator cuff tear or arthritis. Superior labral anterior-posterior lesions produce pain similar to that of rotator cuff tears. Those most prone to failed rotator cuff syndrome are patients 65 years of age or older; and those with large, sustained tears. Smokers, diabetes sufferers, patients with muscle atrophy and/or fatty infiltration, and those who do not follow postoperative-care recommendations also are at greater risk. Doctors examine patients and conduct imaging tests to identify the causes of continued discomfort. Depending upon the diagnosis, several treatment alternatives are available. They include revision repair, nonanatomic repair, tendon transfer and arthroplasty. When possible, surgeons make tension-free repairs in