# Understanding the Mechanical Underpinnings of Rotator Cuff Tear and Surgical Repair

> **NIH NIH F31** · NORTH CAROLINA STATE UNIVERSITY RALEIGH · 2022 · $38,672

## Abstract

Project Summary
Rotator cuff injuries affect 4.5 million Americans and the increase in prevalence of rotator cuff injuries correlates
with increasing age. Around 250,000 rotator cuff repairs are performed each year, equating to over three billion
dollars in economic cost. The rotator cuff is critically important in activities of daily living, and therefore damage
to the rotator cuff can limit independence and quality of life. Rotator cuff tears are commonly treated with surgical
reattachment of the tendon; however, surgery is not always advisable due to the high probability of retear. High
repair tension during reattachment surgery is not only technically challenging during repair but also is often
followed by post-surgical retear, limited functional capacity, and/or shoulder instability due to altered joint contact
forces. Thus, a method to predict repair tension could play a key role in surgical selection. Repair tension is
intraoperatively measured; therefore, it cannot inform the decision to operate. Surgeons currently must select
patients for surgical repair based on other MR imaging parameters associated with poor outcomes and more
severe injury. Following injury of the rotator cuff, the muscle-tendon unit undergoes physiological changes
including retraction, muscle atrophy, and increased intramuscular fat and fibrous tissue. However, it is unclear
whether there is a direct relationship between repair tension and the three main clinical parameters typically
used for determining surgical candidacy (intramuscular fat, muscle atrophy, and retraction). Given the financial
costs associated with surgical intervention and the physical burden experienced by patients, an improved
understanding of the factors that influence rotator cuff injury and repair tension are needed to provide a higher
level of care for surgery patients, thus positively impacting the quality of life for millions of Americans. Our overall
objective is to understand the mechanical underpinnings of rotator cuff repair to identify relationships between
physiological changes and post-surgical outcomes. This research will provide crucial information needed to
inform likelihood of surgical success and better predict surgical outcomes, thereby guiding development of a
standard of practice for rotator cuff repair surgery. The proposed research combines an experimental and
computational framework to (1) determine the relationship between rotator cuff injury-induced physiological
changes and repair tension, and (2) determine how physiological changes due to rotator cuff injury and elevated
repair tension influences post-surgical outcomes.

## Key facts

- **NIH application ID:** 10536970
- **Project number:** 1F31AR081691-01
- **Recipient organization:** NORTH CAROLINA STATE UNIVERSITY RALEIGH
- **Principal Investigator:** Morgan Dalman
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $38,672
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10536970

## Citation

> US National Institutes of Health, RePORTER application 10536970, Understanding the Mechanical Underpinnings of Rotator Cuff Tear and Surgical Repair (1F31AR081691-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10536970. Licensed CC0.

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