Increased Synovial Inflammation and Tissue Degeneration Correlates with Tear Size of Diseased Rotator Cuff

INTRODUCTION: The clinical outcomes of rotator cuff repair vary among patients and are affected by multiple factors including chronic inflammation. Although inflamed synovium is a common clinical observation at the time of surgery, the role of this inflammation plays on clinical outcomes is not well elucidated. Several recent studies have shown that there is elevation of pro-inflammatory cytokines (IL-1, IL-6, TNF-α, COX-2) and matrix metalloproteinases (MMP-1, MMP-13) in the synovium and torn tendon [1-6]. However, it is not clear from these studies whether such pro-inflammatory changes are affected by tear size (partialthickness versus full thickness). The objective of this study was to test the hypothesis that tear size would affect pro-inflammatory cytokines, angiogenesis factors, and tissue remodeling genes in the synovium, bursa, and torn supraspinatus tendon present at the time of surgery.