Some of the latest research on rotator cuff tears is finding out exactly what causes the patient to be symptomatic. And when I say that, I mean if you took a hundred people off the street and put them in an MRI scanner of their shoulder, even if they didn’t have pain, some patients would have rotator cuff tears. The real research has been finding people with tears. When do they develop pain and when does the tear become big enough that it imposes dysfunction on the shoulder? Much of this research has been done at Washington University in St. Louis with ultrasound and natural history studies that are funded by an NIH grant. What we seem to be able to conclude from these studies is that rotator cuff tears typically get larger with time and the larger they get, the more likely they are to become symptomatic. We also know that rotator cuff tears don’t heal themselves. And so in younger patients and patients with high demand activities and those who can’t do what they want to do, a recommendation is made for surgical repair because of these. Some of the other research has focused on the strength of the surgeon’s repair. Whether this means using one anchor in the shoulder for repair or using two anchors or sometimes even up to four anchors. We’re trying to figure out from a biomechanical standpoint, what’s the strongest repair that the surgeon can do to give patients the best chance to heal their tear? Some of this research is inconclusive, but different techniques such as single row repair or double row repair have been studied and we know that double row repairs are stronger. Unfortunately, no one has yet been able to show that this translates into clinical improvement. What I mean by that is that patients that have a single row rotator cuff repair and patients that have a double row rotator cuff repair seem to do the same in the end right now. This may change in the future as further research is taken under and the exact retear elucidated.