The four rotator cuff tendons — supraspinatus, infraspinatus, teres minor, and subscapularis — blend together to form a continuous cuff around the humeral head, inserting on the greater and lesser tubercles to provide dynamic glenohumeral stabilisation.
Rotator cuff disease is the most common cause of shoulder disability in adults over 40. Tears progress from partial to full-thickness and can extend to massive tears involving multiple tendons. Repair failure is more likely in larger tears and older patients.
Partial or complete tearing of one or more cuff tendons — supraspinatus most commonly — producing a painful arc, weakness in resisted abduction or rotation, and night pain.
Failure of two or more tendons producing significant weakness, pseudoparalysis (inability to actively elevate the arm), and progressive superior migration of the humeral head — the precursor to cuff tear arthropathy.
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