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Preserving shoulder health in individuals with a degenerative rotator cuff tear

Award Number: R01AR086139
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/23/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2031

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Preserving shoulder health in individuals with a degenerative rotator cuff tear - PROJECT SUMMARY Rotator cuff tears affect about 40% of people over age 60. Tears often cause significant pain and dysfunction, although asymptomatic tears are also common. Unfortunately, it remains unclear what causes a degenerative rotator cuff tear to become symptomatic. This gap in our knowledge is consequential because the clinical management of patients with a symptomatic rotator cuff tear is challenging when the factors that drive symptomatic dysfunction are unknown. If reversible, these factors represent ideal targets for treatment and may therefore inspire the development of innovative therapies or the improvement of current approaches. We propose a novel theoretical framework to investigate glenohumeral dynamic stability – or controlled movement of the humeral head on the glenoid – as a biomarker of symptomatic progression. Although gross impairments in glenohumeral dynamic stability (e.g., proximal humeral migration) are seen in individuals with larger tears, our preliminary data suggest that subtle changes are present in those with smaller tears. Our central hypothesis is that maintaining glenohumeral dynamic stability is a critical objective for individuals with a rotator cuff tear to preserve shoulder function and remain asymptomatic. To test this hypothesis, we will recruit 100 people with a symptomatic rotator cuff tear and an asymptomatic contralateral shoulder. This recruitment model enhances study feasibility by leveraging a relatively high prevalence of asymptomatic rotator cuff tears in the contralateral shoulder and adds rigor by capturing shoulders at key stages within the natural history timeline: asymptomatic intact tendon, asymptomatic tear, and symptomatic tear. Individualized, shoulder-specific profiles of biomechanical, tear, and functional characteristics will be evaluated over a 2-year observation period using advanced methodologies, including biplane videoradiography, 3D morphology analysis, and musculoskeletal modeling. We will pursue the following hypothesis-driven specific aims: 1) Determine the factors that are associated with tear and symptom status at baseline; 2) Determine the factors that are associated with changes in symptoms and tear severity during a 2-year observation period; and 3) Determine the biomechanical factors that underly glenohumeral dynamic stability. We anticipate establishing that a loss of glenohumeral dynamic stability is a key biomarker for the symptomatic progression of a rotator cuff tear. Further, we anticipate that the effect of a tear on glenohumeral dynamic stability and shoulder function depends on the extent of other destabilizing factors. Together these data will not only help to reconcile the persistent disconnect between tear severity and function often observed clinically (i.e., small symptomatic tear, large asymptomatic tear) but will uncover factors necessary to leverage glenohumeral dynamic stability as a potential biomarker and therapeutic target. Regardless of outcomes, the novelty, accuracy, and clinical relevance of our data will be valuable in the effort to identify factors that drive a tear to become symptomatic, and the associated changes in joint mechanics which has translational relevance to other conditions including glenohumeral instability and osteoarthritis.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $641,604 )
2026	2026	WASHINGTON UNIVERSITY, THE	1 BROOKINGS DR	SAINT LOUIS	MO	63130	SAINT LOUIS	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	9/17/2026	NEW	$641,604
														Subtotal = $641,604

Grand Total All Awards = $641,604

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Preserving shoulder health in individuals with a degenerative rotator cuff tear

Award Number: R01AR086139

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/23/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2031

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