Search Results (205)

Background/Objectives: Bacterial contamination of the surgical field during shoulder arthroplasty may contribute to periprosthetic joint infection (PJI), yet data on intraoperative bacterial load and its clinical correlates remain limited. This study aimed to evaluate culture positivity and bacterial load in specimens collected at the end of reverse total shoulder arthroplasty (RTSA) and to explore their association with patient-related factors. Methods: Fifty-five patients undergoing elective RTSA were consecutively enrolled. At the end of surgery, three specimens per patient (two prosthetic swabs and one periprosthetic tissue sample) were collected for qualitative and quantitative microbiological analysis. Associations between bacterial load and clinical variables were assessed using mixed-effects linear regression models, while time to culture positivity was analysed using mixed-effects Cox regression models. Results: Among 165 specimens, Cutibacterium acnes was isolated in 42.4% and coagulase-negative staphylococci in 29.1%. C. acnes showed significantly higher bacterial loads (1.38 × 10³ CFU/mL) compared with aerobic bacteria (6.54 × 10¹ CFU/mL). Higher C. acnes load was associated with male sex, older age, higher body mass index, smoking, and cuff tear arthropathy, whereas massive rotator cuff tear and longer time to positivity were inversely associated. Aerobic bacterial load was primarily associated with longer surgical duration. Time to positivity was shorter for aerobes than for C. acnes. Conclusions: Intraoperative bacterial contamination during RTSA is frequent and characterized by marked differences in bacterial load and growth kinetics. Quantitative assessment of bacterial burden may improve the interpretation of unexpected positive cultures. Full article

Background/Objectives: Rotator cuff tears (RCT) are one of the most common causes of shoulder pain and loss of function. The aim of this study was to evaluate shoulder morphometric and soft tissue parameters using magnetic resonance imaging (MRI) and to compare them between patients diagnosed with RCT and symptomatic controls without MRI-evident RCT. Methods: In this retrospective study, shoulder MRI images of 64 patients diagnosed with RCT and 63 control subjects without RCT aged 20–80 years were analyzed. The critical shoulder angle (CSA), lateral acromial angle (LAA), acromial index (AI), coracohumeral distance (CHD), acromiohumeral distance (AHD), coracoacromial ligament (CAL) thickness, and supraspinatus tendon (SST) thickness were measured. Binary logistic regression analysis was applied to identify independent factors associated with RCT. Results: CSA was significantly higher in the RCT group compared to the symptomatic control group without RCT (36.18 ± 4.0 vs. 32.61 ± 2.6, p < 0.001). In contrast, CHD (7.06 ± 1.13 vs. 8.05 ± 1.30 mm, p < 0.001), AHD (6.15 ± 1.27 vs. 7.23 ± 0.99 mm, p < 0.001), and SST thickness (5.17 ± 0.69 vs. 6.89 ± 0.64 mm, p < 0.001) were significantly lower in the RCT group. No significant differences were found between the groups in terms of LAA, AI, and CAL thickness (p > 0.05). In the logistic regression analysis, increasing age (OR = 1.159; p = 0.044) and CSA (OR = 1.808; p = 0.005) were identified as independent risk factors, while an increase in SST thickness was identified as inversely associated with RCT (OR = 0.35; p = 0.003). ROC analysis demonstrated that SST thickness had the highest discriminatory performance (AUC = 0.963), while the combined multivariable model achieved an AUC of 0.979. Conclusions: CSA, CHD, AHD, and SST thickness are important morphometric and soft tissue parameters associated with RCT. In particular, the assessment of CSA and SST thickness may provide a more robust and clinically meaningful approach to RCT-associated changes. The combined evaluation of CSA and SST thickness may contribute to the understanding of morphometric associations related to RCT. Full article

Acute or chronic rotator cuff tears are major causes of shoulder dysfunction, motivating the development of scaffolds with tailored thickness and mechanics for supraspinatus tendon regeneration. This study aimed to investigate the effect of bilayer poly(butylene adipate-co-terephthalate) (PBAT) scaffold thickness on the tenogenic differentiation of rat adipose mesenchymal stem cells (r-AdMSCs) and supraspinatus tendon regeneration. Aligned fibers with a diameter of approximately 476 nm were deposited onto randomly oriented layers at different times (4 h; 4S, 6 h; 6S, 8 h; 8S), and scaffolds with increasing thicknesses from 441 µm (4S) to 1132 µm (8S) were produced. Mechanical testing showed comparable tensile strength for 4S and 6S (≈1.9–2.0 MPa) and modulus (5.5–7.3 MPa), while 8S exhibited markedly reduced stiffness (0.5 MPa) and hyper elastic deformation. Mechanical performance across degradation conditions remained strongly thickness-dependent: thinner scaffolds retained integrity and strengthened, with modulus increases during hydrolytic and enzymatic degradation, whereas thicker matrices showed limited remodeling and instability. Rat-AdMSCs’ were cultured on the scaffolds for 21 days. Cell-free and cell-laden mechanical responses further reflected thickness effects: cell-free samples stiffened due to media-induced passive matrix tightening, whereas cell-laden scaffolds showed extracellular matrix (ECM)-driven reinforcement, most prominently in 4S, which reached 2.1 MPa tensile strength with improved elasticity and balanced deformation. The 4S scaffold exhibited the highest tensile strength and significantly increased collagen-1 (col1), tenomodulin (tnmd) and scleraxis (scx) expression compared with the other groups. In conclusion, among all groups, 4S scaffolds demonstrated the most favorable mechanical and biological performance, suggesting that scaffold thickness plays a critical role in regulating tendon regeneration and will become even more suitable when matured in bioreactors. Full article

Background: Osteoarthritis involves the degeneration of cartilage, subchondral bone, and the synovial membrane, often associated with rotator cuff (RC) tears, causing pain and functional limitations. While non-surgical treatments can provide relief, surgery is sometimes necessary. Autologous adipose-derived mesenchymal stem cells (ADMSCs) have shown promise in tissue repair. Objective: This study compared clinical outcomes between patients treated with arthroscopic RCR alone and those treated with RCR combined with intra-articular AdMSC injection. Methods: This retrospective study included 61 patients. Group A (n = 30) underwent standard RCR, while Group B (n = 31) received RCR combined with intra-articular ADMSC injections. Participants had comparable baseline age, BMI, height, CMS, and VAS scores. Shoulder function was assessed using the Constant–Murley Score, and pain intensity was assessed using the visual analog scale at baseline, 3, 6, and 12 months. Statistical significance was set at p < 0.05. Results: At 3 months, Group B showed lower VAS scores than Group A (13.09 ± 8.34 vs. 25.14 ± 13.57, p < 0.001), while CMSs did not differ significantly (70.55 ± 23.46 vs. 63.01 ± 24.33, p = 0.223). At 6 months, Group B showed better VAS and CMSs than Group A (VAS: 5.31 ± 4.38 vs. 23.74 ± 15.72, p < 0.001; CMS: 83.29 ± 18.98 vs. 65.66 ± 11.58, p < 0.001). At 12 months, Group B maintained better VAS and CMSs than Group A (VAS: 4.45 ± 5.67 vs. 18.34 ± 12.65, p < 0.001; CMS: 85.55 ± 13.12 vs. 66.36 ± 9.38, p < 0.001). Conclusions: In this preliminary retrospective non-randomized cohort, AdMSC use as an adjunct to arthroscopic rotator cuff repair was associated with better pain and functional scores over 12 months. Because of the retrospective design and lack of imaging follow-up, these findings should be interpreted as clinical associations and require confirmation in randomized studies. Full article

Background: The prevalence of adhesive capsulitis (AC) is estimated to be 2–5% in the general population. However, the etiology of AC remains unclear. Among the various proposed factors, the precise role of cervical disease, and the severity of cervical degeneration, in the development of AC has not been fully elucidated. This study aimed to analyze the contribution of cervical disease to AC in patients with shoulder pain. Methods: A total of 409 patients who visited the Department of Rehabilitation Medicine for shoulder pain were retrospectively reviewed. The outcome variable was the presence of AC. In addition to cervical disease, other independent variables affecting AC, including sex, diabetes, obesity, dyslipidemia, thyroid disease, immobilization after surgery, rotator cuff tear, subacromial spur, and shoulder joint osteoarthritis were reviewed. To compare the two groups, an independent t-test or chi-square test was performed for continuous and categorical data. Multivariate regression analysis was used to assess the effects of independent factors on AC, adjusting for confounders. Results: Among the 409 patients, 176 (43.0%) were diagnosed with AC. Multivariate analysis demonstrated that diabetes (OR 3.03, 95% CI 1.55–5.91, p = 0.001) and cervical disease (OR 3.03, 95% CI 1.75–5.25, p < 0.001) were significantly associated with increased odds of AC. In contrast, increasing age (OR 0.95, 95% CI 0.92–0.98, p = 0.007), dyslipidemia (OR 0.55, 95% CI 0.31–0.98, p = 0.044), and postoperative immobilization (OR 0.64, 95% CI 0.41–0.99, p = 0.046) were associated with decreased odds of AC. The prevalence of AC increased with the severity of cervical degeneration. Conclusion: In patients with shoulder pain, diabetes and cervical disease were positively associated with AC, whereas age, dyslipidemia, and postoperative immobilization showed inverse associations. These findings suggest that both metabolic and cervical factors may contribute to the development of AC, highlighting the importance of considering cervical pathology in patients with shoulder pain. Full article

Background: Rotator cuff tears, a prevalent pathology with significant functional impact, primarily find their therapeutic approach in arthroscopic repair. The long-term success of this intervention is modulated by various factors, among which shoulder morphology stands out. In this context, the critical shoulder angle (CSA) has gained relevance as a potential predictor of postoperative prognosis. Objectives: To determine if the CSA influences the need for reoperation after retears and functional outcomes following the arthroscopic repair of chronic rotator cuff tears. Methods: A retrospective cohort study has been conducted, which includes 74 patients (between 47 and 86 years old, mean age of 58.85 ± 2.21 years) who underwent arthroscopic shoulder surgery for the repair of chronic rotator cuff tears by the traumatology service of a tertiary level hospital in the period between 2009 and 2022, to study variables such as the appearance of complications, reoperation, and functional outcomes. Results: Patients with a CSA greater than 40° represent 56.75% (n = 42). Functional improvement was achieved in 59.52%, in contrast to 40.48% of patients who did not obtain significant functional improvement (OR = 1.470; 95% CI = 1.009–2.141). The reoperation rate in this group was 21.4% (n = 9) (OR = 1.562; 95% CI = 1.085–2.249). Conclusions: This study provides statistically significant evidence that a high CSA (>40°) behaves as a risk factor for the reoperation rate and poorer functional outcomes after the arthroscopic repair of chronic rotator cuff tears. Full article

Background: Sugaya type III rotator cuff re-tears are characterized by preserved tendon continuity with reduced thickness and are often associated with persistent pain and functional impairment. Bioinductive collagen implants may enhance tendon healing, but clinical evidence in this population remains limited. This study aimed to evaluate the clinical and radiologic outcomes of arthroscopic repair with bioinductive collagen implant augmentation in patients with Sugaya type III re-tears. Methods: This retrospective case series (Level IV) included 15 patients (mean age 61.7 years) with MRI-confirmed Sugaya type III re-tears. An a priori power analysis based on a large effect size (Cohen’s d = 0.80) indicated that a sample size of 15 would provide 80% power to detect clinically meaningful changes in the primary endpoint. Clinical outcomes were assessed preoperatively and at 6 and 12 months postoperatively using VAS, ASES, SANE, and WORC scores. MRI was used to evaluate changes in supraspinatus tendon thickness. Non-parametric statistical analysis with Bonferroni correction was applied. Results: The median VAS pain score improved from 6.5 (IQR, 6.0–7.0) preoperatively to 2.8 (IQR, 2.0–3.5) at 6 months and to 2.1 (IQR, 1.5–2.8) at 12 months (adjusted p < 0.001). The median ASES score increased from 45.0 (IQR, 39.0–51.0) to 78.0 (IQR, 72.0–85.0), with a median improvement of 33 points. SANE and WORC scores also showed significant improvements. Supraspinatus tendon thickness increased from 4.8 mm (IQR, 3.7–5.7) to 6.9 mm (IQR, 5.4–8.3) at 12 months (adjusted p < 0.001). No graft failure was observed on follow-up MRI. Conclusions: Arthroscopic repair with bioinductive collagen implant augmentation may be associated with short-term improvements in pain, function, and tendon thickness in patients with Sugaya type III re-tears. Given the small sample size and lack of a control group, these findings should be interpreted cautiously, and further prospective comparative studies are needed. Full article

Background and Objectives: This study aimed to assess the association between the aponeurotic expansion of the supraspinatus tendon (AEST) and supraspinatus tendon tears utilizing magnetic resonance (MR) arthrography in an extensive patient cohort and to determine its clinical relevance. Materials and Methods: All MR arthrography images were retrospectively assessed by two radiologists with expertise in arthrography. In both the AEST group and the comparison group consisting entirely of patients with rotator cuff tendon tears, the location and extent of the tear were documented, along with the distance between the tear and the AEST in the study group. In patients with AEST, it was also noted whether the tear extended to or structurally involved the AEST. Results: AEST was identified in 61 (7.4%) of the 827 MR arthrograms. The isolated supraspinatus tendon tear emerged as the most prevalent, representing 33.3% of patients with AEST. The triple combination of tears involving the supraspinatus, subscapularis, and infraspinatus accounted for 25.9% of patients with AEST. AEST tears alone were observed in just 3.3% of cases. The incidence of triple combination tears in patients with AEST was found to be significantly lower at 25.9% compared to 59.3% in the control group without AEST (p = 0.028). Conclusions: In this study, the authors found that the incidence of combined tendon tears in patients with AEST was significantly lower compared to the control group. This result suggests that the AEST likely acts as a structural barrier limiting the anterior progression of rotator cuff tears, particularly toward the subscapularis tendon. Full article

Background: Patients increasingly rely on freely available artificial intelligence tools, such as Chat-GPT, to obtain diagnostic and therapeutic information for different orthopedic conditions. While preliminary studies have evaluated its educational potential, evidence regarding its diagnostic accuracy and treatment recommendations in rotator cuff pathology remains limited. This study aimed to assess the ability of Chat-GPT 5.2 to correctly diagnose rotator cuff tears and propose treatment strategies, comparing its performance with that of expert shoulder surgeons. Materials and Methods: Five clinical cases representing common rotator cuff tear patterns were retrospectively selected in an exploratory pilot analysis. For each case, MRI images, radiologic reports, and clinical information were sequentially provided to Chat-GPT 5.2 using standardized prompts simulating a patient inquiry. Responses were compared with those of three experienced shoulder surgeons. Diagnostic accuracy, treatment recommendations, postoperative management suggestions, and complication descriptions were analyzed. Krippendorff’s alpha was used to assess interobserver agreement. Results: Chat-GPT 5.2 did not correctly diagnose any case using MRI images alone, whereas human examiners reached accurate diagnosis in most cases. Treatment recommendations provided by Chat-GPT were non-specific when based solely on imaging or radiologic reports, but became more defined after a detailed lesion description. Interobserver agreement between Chat-GPT and surgeons regarding treatment was inconsistent across cases. Postoperative rehabilitation advice and complication descriptions were accurate and comprehensive, demonstrating high consistency with published data. Conclusions: The results of this pilot analysis suggest that the use of Chat-GPT 5.2 by patients affected by rotator cuff tears could potentially lead to misdiagnosis and wrong treatment advice, while on the contrary it could be used by physicians to better illustrate postoperative protocols, complications and expected outcomes. Full article

The in vivo effect of platelet-rich plasma (PRP) on supraspinatus tendon morphology and subacromial bursa cell gene expression in degenerative rotator cuff tears remains unclear. This randomized controlled trial evaluated the effect of preoperative leukocyte-poor PRP (LP-PRP) subacromial injection on supraspinatus tendon histology and subacromial bursa gene expression. Sixteen patients with full-thickness supraspinatus tears were randomized to receive an ultrasound-guided LP-PRP injection (n = 8) or no injection (n = 8) six weeks before arthroscopic repair. Tendon biopsies were assessed using the modified Movin score. Gene expression of collagen type I, II and III, metalloproteinase 3 and 13, and interleukin 1β and 6 genes from subacromial bursa cells was quantified using quantitative real-time PCR. The results of the two groups were compared to determine any statistically significant difference regarding all the examined parameters. The PRP group demonstrated a significantly lower total modified Movin score than controls (6.5 vs. 12.1, p = 0.002), with lower scores for fiber structure, fiber arrangement, nuclear rounding, inflammation and cell density (all p < 0.003), while angiogenesis did not differ (p = 0.149), indicating an architecture closer to that of normal tendon. No statistically significant differences in gene expression were observed (all p > 0.05), although collagen II and metalloproteinase 3 and 13 showed biologically relevant downregulation [fold change 0.23 (95%CI 0.05–1.09), 0.24 (95%CI 0.002–26.10), and 0.26 (95%CI 0.02–2.76), respectively]. The LP-PRP injection was associated with improved supraspinatus tendon histological characteristics and biologically relevant reductions in selected bursal genes, in the setting of supraspinatus tendon tear. Full article

Background/Objectives: Rotator cuff repair (RCR) is a common orthopedic procedure, with healing outcomes strongly influenced by patient-specific factors such as tissue quality, tear characteristics, and biological healing potential. Bioinductive collagen implants have shown great results in enhancing tendon healing and reducing retear rate. This study aimed to evaluate the clinical and imaging outcomes of RCR augmented with a xeno-derived collagen membrane over 24 months and to assess complications or implant failures. Methods: Patients underwent arthroscopic RCR using anchors (single or double-row) with additional xeno-derived matrix augmentation. The study included patients older than 40 years with full-thickness supraspinatus and/or infraspinatus tendon tears (DeOrio–Cofield grade 3–4) who were candidates for arthroscopic rotator cuff repair and provided informed consent. Clinical outcomes were assessed using the Constant–Murley Score (CMS), Disabilities of the Arm, Shoulder and Hand score (DASH), and Visual Analogue Score (VAS) at baseline, 3, 6, 12, and 24 months. MRI was performed preoperatively and at 24 months to assess tendon thickness. Results: All scores improved significantly. CMS increased from 16.3 ± 4.1 to 82.9 ± 5.8, VAS decreased from 7.8 ± 1.0 to 1.5 ± 0.8, and DASH improved from 70.3 ± 6.4 to 12.4 ± 4.5 (p < 0.05). Tendon thickness in the supraspinatus (T3) increased from 4.2 ± 0.9 mm to 6.8 ± 1.2 mm (p < 0.05). Retear rate was 7.55%, with no major complications. Conclusions: The bioinductive collagen implant showed notable results in improving tendon thickness, healing, and excellent clinical outcomes in RCR, without membrane-related complications. The study was designed as a prospective single-arm case series without a control group and that was the main limitation; The absence of adverse reactions in this cohort further supports the favorable safety profile of this implant in the present study population. Full article

Background and Objectives: It is crucial to determine physical findings and outcome measures that affect functional status of the patients, and the impact levels of these parameters on patients. Therefore, the aim of this study was to investigate the determinant and predictive effect of pain levels, shoulder range of motion (ROM) values, disability and health-related quality of life factors on functional status in individuals with partial-thickness rotator cuff tears (PRCT). Materials and Methods: Firstly, the functional status of 45 patients (mean age: 50.78 ± 5.28 years; 29 female) with PRCT, then activity and night pain levels with Numeric Pain Rating Scale, active flexion, abduction and external rotation of the shoulder ROM values with goniometer, disability level with Quick Disabilities of Arm, Shoulder & Hand Questionnaire, and health-related quality of life levels with Short Form-12 were evaluated and recorded. Results: It was detected that all determinants whose effect on functionality was evaluated with a multiple regression model explained 76% of the variance, and this effect level was statistically significant (R square = 0.760, adjusted R square = 0.707, F = 14.272, p < 0.001). Detailed evaluation showed that flexion and external rotation ROM values (respectively; β = 0.54, p < 0.001; β = 0.38, p = 0.001) and disability level (β = 0.44, p < 0.001) had statistically significant determinant effects on functional status. No statistically significant results which could be correlated with functional status were found for activity and night pain, abduction ROM value, and health-related quality of life domains (p > 0.05). Conclusions: Shoulder flexion and external rotation ROMs and disability level were found to have a predictive effect on the functional status in individuals with PRCT. It is noteworthy that more subjective and patient-reported findings and outcome measures such as pain and health-related quality of life had no predictive effect on functionality. By determining the level of these effects, results were reached that can shed light on the literature by guiding the development of reliable assessment algorithms. Full article

Background/Objectives: The optimal surgical timing for rotator cuff tears (RCTs) remains controversial, particularly regarding how tear etiology influences the final functional recovery. This study aimed to compare the clinical outcomes of early versus delayed arthroscopic repair stratified by etiology, providing evidence for etiology-specific surgical timing. Methods: A retrospective cohort study was conducted on 183 patients who underwent arthroscopic rotator cuff repair for isolated full-thickness supraspinatus tears. Patients were stratified into traumatic (n = 74) and degenerative (n = 109) groups based on etiology. They were further divided into early-repair and delayed-repair subgroups based on symptom duration (traumatic cut-off: 3 months; degenerative cut-off: 6 months). Clinical outcomes were assessed preoperatively and at the final follow-up using the Visual Analog Scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) score, and range of motion. Complications, including retear rates and stiffness, were recorded. Results: In the traumatic group, early repair yielded significantly better postoperative pain relief (VAS) and higher functional scores (ASES and UCLA) compared to delayed repair. Notably, the delayed traumatic group exhibited a significantly higher retear rate compared to the early group (16.7% vs. 2.6%; p = 0.039). Conversely, in the degenerative group, comparisons between early and delayed repair revealed no significant differences in the final functional scores, pain levels, or complication rates (p > 0.05). Conclusions: Surgical timing significantly impacts outcomes in traumatic RCTs, where early repair is critical to optimize functional recovery and minimize retear risks. In contrast, delayed arthroscopic repair for degenerative tears yielded comparable outcomes to early repair, suggesting that an initial trial of conservative management is safe and does not compromise final surgical outcomes. Full article

Backgrounds/Objectives: Fatty infiltration (FI) of rotator cuff (RC) muscles is a critical prognostic factor after surgical repair. While the Goutallier–Fuchs grading system is widely used, its reproducibility is often debated. This study aimed to validate a previously reported three-dimensional (3D) magnetic resonance imaging (MRI)-based volumetric quantification method by comparing it with histologic findings in a chronic rotator cuff tear (RCT) rabbit model. Methods: Eighteen shoulders from nine rabbits were randomly assigned to three groups (n = 6 each): repair (A), chronic tear (B), and control (C). In groups A and B, a chronic RCT model was established by detaching the supraspinatus tendon, with group A receiving repair after six weeks. At 12 weeks after repair, 7.0T MRI was performed, and volumetric quantification of intra-muscular fat was performed using semi-automated 3D Slicer software. Histologic fat proportion was measured via Oil Red O staining and ImageJ analysis. Results: The muscle weight and MRI-based muscle volume were significantly lower in group B than group C (p < 0.05). The radiologically measured fat proportion was significantly higher in groups A (1.8 ± 0.8) and B (2.8 ± 0.7) compared to group C (0.5 ± 0.4, p < 0.001). Histologic analysis showed a corresponding pattern (3.0 ± 1.2%, 5.2 ± 1.0%, 1.7 ± 1.0% for groups A, B, and C, respectively; p < 0.001). A strong positive correlation was identified between the radiologic and histologic measurements of FI (r = 0.784, p < 0.001). Conclusions: Direct histologic comparison validates the reliability of 3D MRI-based volumetric quantification for evaluating FI of the RC muscle in a chronic RCT rabbit model. This objective approach may address the inherent limitations of the conventional qualitative grading system. Full article

Background: This study aimed to investigate the potential biomechanical implications of biologically motivated modulation scenarios—Resolvin E1 (RvE1), Resolvin D1 (RvD1) and carvacrol—in the context of rotator cuff tears by using a reduced finite element (FE) modeling approach. The primary objective was to compare stress distribution and deformation behavior at the tendon–bone interface under standardized loading scenarios. Materials and Methods: A three-dimensional reduced FE model of the shoulder, including the scapula and proximal humerus, was constructed based on computed tomography data. A rotator cuff tear was represented at the tendon footprint on the greater tuberosity. Standardized boundary scenarios and loading vectors were applied. Three conceptual biological modulation scenarios (RvE1, RvD1, and carvacrol) were evaluated and compared with a baseline model representing a rotator cuff tear under identical geometric, material, boundary, and loading scenarios, without any biologically motivated modulation. Von Mises stress distribution at the greater tuberosity and tendon footprint, as well as maximum displacement of the proximal humerus, were analyzed descriptively and comparatively. Results: Compared with baseline scenarios, the RvE1 and RvD1 scenarios demonstrated reduced peak von Mises stress at the tendon footprint and lower overall humeral displacement. Peak footprint stress decreased from 10.8 MPa in the baseline model to 7.9 MPa (−26.9%) in the RvE1 scenario and to 8.6 MPa (−20.4%) in the RvD1 scenario. Similarly, maximum humeral displacement was reduced from 4.6 mm at baseline to 3.4 mm (−26.1%) with RvE1 and to 3.9 mm (−15.2%) with RvD1. In contrast, the carvacrol scenario exhibited increased localized stress concentration at the tendon footprint (12.4 MPa; +14.8%) and greater maximum displacement (5.8 mm; +26.1%). Conclusions: The findings suggested that modulation scenarios associated with specialized pro-resolving mediators (SPMs) were aligned with a more favorable mechanical environment at the tendon–bone interface compared with baseline scenarios, whereas the carvacrol scenario demonstrated less favorable biomechanical behavior under the modeled assumptions. Although the biological effects were represented conceptually and the results were interpreted as relative trends, this study highlighted the potential importance of resolution-oriented pathways in influencing tendon-to-bone biomechanics and supported further experimental and translational investigations in rotator cuff repair. Full article