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The Rotator Cuff Healing Index and other proxy risk factors for failed rotator cuff healing have implicated significant fatty infiltration, muscular atrophy, advanced chronological age, tear size and retraction, and ultimately, osteoporosis. Although structural (or biological) augmentation and tendon transfer have been proposed as solutions for the alarmingly high rate of failure after primary RCR, other options may preferentially focus on the enthesis and underlying osseous footprint. Currently, bisphosphonates are frequently used in the treatment of osteoporosis and prevention of fragility fractures. However, burgeoning evidence suggests that postoperative zoledronic acid may have clinical utility after rotator cuff and other tendon repairs. In the cost\u2010conscious world of evidence\u2010based medicine, the added economic burden of additional medications and office visits may or may not improve patient outcomes\u2014much less confer added value. Our advice to fellow shoulder surgeons: Wait for further information, but continue to holistically consider and optimize risk factors for poor soft\u2010tissue healing. Although the addition of postoperative bisphosphonates may improve suture anchor fixation and promote a better foundation for healing, it will not immediately transform your RCR success rates.<\/jats:p>","DOI":"10.1016\/j.arthro.2023.11.013","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T19:07:33Z","timestamp":1705518453000},"page":"723-725","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["<i>Editorial Commentary:<\/i>\n                    Postoperative Zoledronic Acid Improves Tendon Healing but Does Not Affect Outcomes in Rotator Cuff Repair Patients With Postmenopausal Osteoporosis"],"prefix":"10.1002","volume":"40","author":[{"given":"Robert S.","family":"Dean","sequence":"first","affiliation":[{"name":"Royal Oak Michigan (R.S.D.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian 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