BACKGROUND:Currently,arthroscopic rotator cuff repair has become the main method for treating rotator cuff tears.The recurrence of rotator cuff tears after arthroscopic rotator cuff repair is the result of multiple factors,and the occurrence of recurrent tears is a current research hotspot.Currently,comprehensive reviews of non-surgical factors that contribute to recurrent tears after arthroscopic rotator cuff repair are less common.OBJECTIVE:To explore the non-surgical risk factors that lead to the rotator cuff tear again after arthroscopic rotator cuff repair,provide theoretical guidance for clinical intervention,and reduce the occurrence of postoperative rotator cuff tear again.METHODS:The first author searched PubMed,Web of Science,and China National Knowledge Infrastructure in May 2023 and supplemented the literature from May 2023 to July 2024 for observational studies on non-surgical risk factors for rotator cuff retear after arthroscopic repair.The search used a combination of subject terms and free words.The literature search period was 2000-01-01/2024-07-01.RESULTS AND CONCLUSION:(1)A total of 70 articles were included for review according to the inclusion and exclusion criteria.(2)We analyzed the influence of non-surgical factors such as demographic and social risk factors,anatomical factors,rotator cuff quality,postoperative rehabilitation,type of rotator cuff tear,and timing of surgery on rotator cuff retear.(3)Aging was associated with degenerative changes in the rotator cuff,increasing the possibility of re-tearing.Metabolic diseases such as diabetes and hyperlipidemia could indirectly affect the quality and stability of repair by affecting local blood supply and tissue quality.(4)Critical shoulder angle and joint glenoid inclination were considered to be a key anatomical parameter that affects the risk of re-tearing.Patients with a critical shoulder angle＞35° had a significantly increased risk of re-tearing.A larger glenoid inclination would change the biomechanical environment of the shoulder and increase the risk of tearing.(5)The quality of the rotator cuff tendon,such as fatty infiltration and muscle retraction,and the type of tear(such as large or complex tear shape)also affected the re-tear rate.(6)Postoperative rehabilitation also had a significant impact on re-tear,including the time and method of recovery.Moderate activity helped improve blood circulation and tendon healing,but premature or excessive activity might increase the risk of tearing.Customized personalized rehabilitation programs played an important role in preventing rotator cuff re-tearing.(7)Although surgical technique is crucial to the success of rotator cuff repair,these non-surgical factors also affect postoperative outcomes and risk of retearing,and should be fully considered in clinical practice.

BACKGROUND:Bone microenvironment is also rich in various immune cells and cytokines,which are closely related to bone cells and form an interactive network.Therefore,bone aging is not only caused by the senescence of osteocytes,but also accelerated by age-related changes in the immune system.OBJECTIVE:To review the age-related changes of bone marrow mesenchymal stem cells,osteoblasts,osteoclasts,and immune cells in the bone microenvironment,emphasize the key role of the immune microenvironment in bone aging,and the potential of immunotherapy in the treatment of bone aging.METHODS:We searched PubMed and China National Knowledge Infrastructure for articles on the interaction between bone cell senescence and immune cell senescence using"osteocytes,bone aging,immune microenvironment,immune cells,cytokines,immunosenescence,immunotherapy"as Chinese and English search terms.According to the inclusion and exclusion criteria,128 articles were finally included in the review.RESULTS AND CONCLUSION:Bone aging is a common pathological condition in the elderly,characterized by the interaction of multiple biological processes,among which immune factors play a key role.The cells,molecules,and signaling pathways in the immune microenvironment together constitute a complex network,and the imbalance of this network will accelerate the process of bone aging.The combination of anti-cellular aging and immunotherapy may bring new methods for the treatment of bone aging diseases,including the removal of senescent cells,targeted drugs for senescence-related secretory phenotypes,targeted therapy of inflammatory cytokines,immune cell regulation therapy,stem cell therapy,and molecular therapy.To more effectively and reasonably remove senescent cells,a deeper understanding of the mechanism of senescent cells is needed,which will help to identify senescent cells more accurately.Immunotherapy shows great potential and prospects in the treatment of bone aging,but there are some potential risks.It is believed that with the advancement of science and technology,people can more accurately understand the genetic information and immune status of the human body and develop more personalized immunotherapy plans.

BACKGROUND:Bone microenvironment is also rich in various immune cells and cytokines,which are closely related to bone cells and form an interactive network.Therefore,bone aging is not only caused by the senescence of osteocytes,but also accelerated by age-related changes in the immune system.OBJECTIVE:To review the age-related changes of bone marrow mesenchymal stem cells,osteoblasts,osteoclasts,and immune cells in the bone microenvironment,emphasize the key role of the immune microenvironment in bone aging,and the potential of immunotherapy in the treatment of bone aging.METHODS:We searched PubMed and China National Knowledge Infrastructure for articles on the interaction between bone cell senescence and immune cell senescence using"osteocytes,bone aging,immune microenvironment,immune cells,cytokines,immunosenescence,immunotherapy"as Chinese and English search terms.According to the inclusion and exclusion criteria,128 articles were finally included in the review.RESULTS AND CONCLUSION:Bone aging is a common pathological condition in the elderly,characterized by the interaction of multiple biological processes,among which immune factors play a key role.The cells,molecules,and signaling pathways in the immune microenvironment together constitute a complex network,and the imbalance of this network will accelerate the process of bone aging.The combination of anti-cellular aging and immunotherapy may bring new methods for the treatment of bone aging diseases,including the removal of senescent cells,targeted drugs for senescence-related secretory phenotypes,targeted therapy of inflammatory cytokines,immune cell regulation therapy,stem cell therapy,and molecular therapy.To more effectively and reasonably remove senescent cells,a deeper understanding of the mechanism of senescent cells is needed,which will help to identify senescent cells more accurately.Immunotherapy shows great potential and prospects in the treatment of bone aging,but there are some potential risks.It is believed that with the advancement of science and technology,people can more accurately understand the genetic information and immune status of the human body and develop more personalized immunotherapy plans.

BACKGROUND:Currently,arthroscopic rotator cuff repair has become the main method for treating rotator cuff tears.The recurrence of rotator cuff tears after arthroscopic rotator cuff repair is the result of multiple factors,and the occurrence of recurrent tears is a current research hotspot.Currently,comprehensive reviews of non-surgical factors that contribute to recurrent tears after arthroscopic rotator cuff repair are less common.OBJECTIVE:To explore the non-surgical risk factors that lead to the rotator cuff tear again after arthroscopic rotator cuff repair,provide theoretical guidance for clinical intervention,and reduce the occurrence of postoperative rotator cuff tear again.METHODS:The first author searched PubMed,Web of Science,and China National Knowledge Infrastructure in May 2023 and supplemented the literature from May 2023 to July 2024 for observational studies on non-surgical risk factors for rotator cuff retear after arthroscopic repair.The search used a combination of subject terms and free words.The literature search period was 2000-01-01/2024-07-01.RESULTS AND CONCLUSION:(1)A total of 70 articles were included for review according to the inclusion and exclusion criteria.(2)We analyzed the influence of non-surgical factors such as demographic and social risk factors,anatomical factors,rotator cuff quality,postoperative rehabilitation,type of rotator cuff tear,and timing of surgery on rotator cuff retear.(3)Aging was associated with degenerative changes in the rotator cuff,increasing the possibility of re-tearing.Metabolic diseases such as diabetes and hyperlipidemia could indirectly affect the quality and stability of repair by affecting local blood supply and tissue quality.(4)Critical shoulder angle and joint glenoid inclination were considered to be a key anatomical parameter that affects the risk of re-tearing.Patients with a critical shoulder angle＞35° had a significantly increased risk of re-tearing.A larger glenoid inclination would change the biomechanical environment of the shoulder and increase the risk of tearing.(5)The quality of the rotator cuff tendon,such as fatty infiltration and muscle retraction,and the type of tear(such as large or complex tear shape)also affected the re-tear rate.(6)Postoperative rehabilitation also had a significant impact on re-tear,including the time and method of recovery.Moderate activity helped improve blood circulation and tendon healing,but premature or excessive activity might increase the risk of tearing.Customized personalized rehabilitation programs played an important role in preventing rotator cuff re-tearing.(7)Although surgical technique is crucial to the success of rotator cuff repair,these non-surgical factors also affect postoperative outcomes and risk of retearing,and should be fully considered in clinical practice.