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Improvement in the Contractility and Muscle Stem Cell Density of the Rotator Cuff Following Surgical RepairA Case Report
Max E. Davis, BA1; Patrick L. Stafford, BS1; Joshua R. Bradley, BS1; Asheesh Bedi, MD1; Christopher L. Mendias, PhD, ATC1
1 Department of Orthopaedic Surgery, University of Michigan, 109 Zina Pitcher Place, BSRB 2017, Ann Arbor, MI 48109. E-mail address for C.L. Mendias: cmendias@umich.edu
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Investigation performed at the Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Dec 12;2(4):e75 1-4. doi: 10.2106/JBJS.CC.L.00023
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Large or massive tears of the rotator cuff can cause severe pain and substantially limit mobility, and thus negatively impact quality of life1. Following surgical repair, an estimated 50% of patients still have symptoms at six months and 40% have symptoms at one year2, demonstrating that surgical repair is often unable to fully restore the normal function and strength of the involved muscles. A common pathophysiological change that occurs in torn rotator cuff muscles is atrophy of muscle fibers and an accumulation of fat in the muscle extracellular matrix, collectively referred to as “fatty atrophy.” Despite improvements in surgical repair techniques to achieve biomechanically strong repairs to bone in a minimally invasive arthroscopic approach, studies of rotator cuff muscles with use of magnetic resonance imaging (MRI) or computed tomography (CT) scans often fail to demonstrate a reduction in fatty atrophy following surgical repair3,4. While these imaging modalities are commonly used as a benchmark of rotator cuff healing, there is little information regarding the cellular and molecular changes associated with fatty atrophy in patients who sustain rotator cuff tears.
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