This review discusses the pathogenesis and surgical treatment of tears of the rotator cuff. In the United Kingdom, the prevalence of shoulder problems based on consultations in primary care is estimated to be 2.4%.1 Between 30 % and 70 % of such shoulder pain is due to disorders of the rotator cuff.2,3 In their recent review Oh et al,4 stated that in 2002 in the United States there were 4.5 mil-lion physician visits and approximately 40 000 inpatient procedures for problems of the rota-tor cuff with a mean cost of $14 000 per case. This highlights how common such problems are and what a considerable health burden they present. It is therefore surprising that despite the endeavours of shoulder surgeon
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