Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment

Chronic rotator cuff pathology is often complicated by fatty degeneration of the rotator cuff (FDRC) muscles, an insidious process associated with poor prognosis with or without surgical intervention. Currently there is no treatment for FDRC, and many studies have described a natural course for this...

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Autores principales:	Jacob Bogdanov, BS, Rae Lan, BS, Timothy N. Chu, BS, Ioanna K. Bolia, MD, MS, PhD, Alexander E. Weber, MD, Frank A. Petrigliano, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Fatty degeneration Rotator cuff Pathophysiology Stem cells Management Surgery RD1-811
Acceso en línea:	https://doaj.org/article/0e83879e07e64546b010b5abf4207b3e
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spelling	oai:doaj.org-article:0e83879e07e64546b010b5abf4207b3e2021-11-22T04:31:42ZFatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment2666-639110.1016/j.xrrt.2021.05.006https://doaj.org/article/0e83879e07e64546b010b5abf4207b3e2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666639121000572https://doaj.org/toc/2666-6391Chronic rotator cuff pathology is often complicated by fatty degeneration of the rotator cuff (FDRC) muscles, an insidious process associated with poor prognosis with or without surgical intervention. Currently there is no treatment for FDRC, and many studies have described a natural course for this disease almost always resulting in further degeneration and morbidity. Recapitulating FDRC using animal injury models, and using imaging-based studies of human FDRC, the pathophysiology of this disease continues to be further characterized. Researchers studying mesenchymal stem cell–derived progenitor cells and known fibrogenic and adipogenic signaling pathways implicated in FDRC seek to clarify the underlying processes driving these changes. While new cell- and molecular-based therapies are being developed, currently the strongest available avenue for improved management of FDRC is the use of novel imaging techniques which allow for more accurate and personalized staging of fatty degeneration. This narrative review summarizes the evidence on the molecular and pathophysiologic mechanisms of FDRC and provides a clinical update on the diagnosis and management of this condition based on the existing knowledge. We also sought to examine the role of newer biologic therapies in the management of RC fatty degeneration and to identify areas of future research.Jacob Bogdanov, BSRae Lan, BSTimothy N. Chu, BSIoanna K. Bolia, MD, MS, PhDAlexander E. Weber, MDFrank A. Petrigliano, MDElsevierarticleFatty degenerationRotator cuffPathophysiologyStem cellsManagementSurgeryRD1-811ENJSES Reviews, Reports, and Techniques, Vol 1, Iss 4, Pp 301-308 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fatty degeneration Rotator cuff Pathophysiology Stem cells Management Surgery RD1-811
spellingShingle	Fatty degeneration Rotator cuff Pathophysiology Stem cells Management Surgery RD1-811 Jacob Bogdanov, BS Rae Lan, BS Timothy N. Chu, BS Ioanna K. Bolia, MD, MS, PhD Alexander E. Weber, MD Frank A. Petrigliano, MD Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
description	Chronic rotator cuff pathology is often complicated by fatty degeneration of the rotator cuff (FDRC) muscles, an insidious process associated with poor prognosis with or without surgical intervention. Currently there is no treatment for FDRC, and many studies have described a natural course for this disease almost always resulting in further degeneration and morbidity. Recapitulating FDRC using animal injury models, and using imaging-based studies of human FDRC, the pathophysiology of this disease continues to be further characterized. Researchers studying mesenchymal stem cell–derived progenitor cells and known fibrogenic and adipogenic signaling pathways implicated in FDRC seek to clarify the underlying processes driving these changes. While new cell- and molecular-based therapies are being developed, currently the strongest available avenue for improved management of FDRC is the use of novel imaging techniques which allow for more accurate and personalized staging of fatty degeneration. This narrative review summarizes the evidence on the molecular and pathophysiologic mechanisms of FDRC and provides a clinical update on the diagnosis and management of this condition based on the existing knowledge. We also sought to examine the role of newer biologic therapies in the management of RC fatty degeneration and to identify areas of future research.
format	article
author	Jacob Bogdanov, BS Rae Lan, BS Timothy N. Chu, BS Ioanna K. Bolia, MD, MS, PhD Alexander E. Weber, MD Frank A. Petrigliano, MD
author_facet	Jacob Bogdanov, BS Rae Lan, BS Timothy N. Chu, BS Ioanna K. Bolia, MD, MS, PhD Alexander E. Weber, MD Frank A. Petrigliano, MD
author_sort	Jacob Bogdanov, BS
title	Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
title_short	Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
title_full	Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
title_fullStr	Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
title_full_unstemmed	Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
title_sort	fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/0e83879e07e64546b010b5abf4207b3e
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Fatty degeneration of the rotator cuff: pathogenesis, clinical implications, and future treatment

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