Wang Ni, Wang Haoyuan, Shen Longxiang, Liu Xudong, Ma Yanhong, Wang Chongyang
Department of Rehabilitation Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Adv Biol (Weinh). 2024 Apr;8(4):e2300331. doi: 10.1002/adbi.202300331. Epub 2024 Jan 31.
Shoulder pain and disabilities are prevalent issues among the elderly population, with rotator cuff tear (RCT) being one of the leading causes. Although surgical treatment has shown some success, high postoperative retear rates remain a great challenge, particularly in elderly patients. Aging-related degeneration of muscle, tendon, tendon-to-bone enthesis, and bone plays a critical role in the development and prognosis of RCT. Studies have demonstrated that aging worsens muscle atrophy and fatty infiltration, alters tendon structure and biomechanical properties, exacerbates enthesis degeneration, and reduces bone density. Although recent researches have contributed to understanding the pathophysiological mechanisms of aging-related RCT, a comprehensive systematic review of this topic is still lacking. Therefore, this article aims to present a review of the pathophysiological changes and their clinical significance, as well as the molecular mechanisms underlying aging-related RCT, with the goal of shedding light on new therapeutic approaches to reduce the occurrence of aging-related RCT and improve postoperative prognosis in elderly patients.
肩部疼痛和功能障碍在老年人群中是普遍存在的问题，肩袖撕裂（RCT）是主要原因之一。尽管手术治疗已取得一些成效，但术后高再撕裂率仍然是一个巨大挑战，尤其是在老年患者中。与年龄相关的肌肉、肌腱、肌腱与骨结合部以及骨骼的退变在RCT的发生和预后中起关键作用。研究表明，衰老会加重肌肉萎缩和脂肪浸润，改变肌腱结构和生物力学特性，加剧结合部退变，并降低骨密度。尽管最近的研究有助于理解与年龄相关的RCT的病理生理机制，但仍缺乏对该主题的全面系统综述。因此，本文旨在综述与年龄相关的RCT的病理生理变化及其临床意义，以及其潜在的分子机制，以期为减少与年龄相关的RCT的发生和改善老年患者术后预后的新治疗方法提供思路。
