{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:52Z","timestamp":1787755132558,"version":"build-2784847793"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,4,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The literature is certain regarding the multifactorial etiology of rotator cuff degeneration. However, it remains unclear if rotator cuff degeneration exclusively depends on intrinsic and extrinsic factors or if it is also genetically determined. We compared the health status of cuff tendons, evaluated with a magnetic resonance imaging (MRI) study, between elderly monozygotic and dizygotic twins with the aim of separating the contributions of genetics from shared and unique environments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The rotator cuff tendon status was assessed using the Sugaya classification by MRI. Heritability, defined as the proportion of total variance of a specific characteristic in a particular population due to a genetic cause, was calculated as twice the difference between the intraclass correlation coefficients for monozygotic and dizygotic pairs. The influence of shared environment, which contributes to twin and sibling similarity, was calculated as the difference between the monozygotic correlation coefficient and the heritability index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 33 pairs of elderly twins: 17 monozygotic pairs and 16 dizygotic pairs, with a mean age (and standard deviation) of 64.62 \u00b1 3.32 years. The polychoric correlation was 0.62 in monozygotic twins and 0.53 in dizygotic twins. The calculated heritability index was 0.18 (18%), and the contribution was 0.44 (44%) for the shared environment and 0.38 (38%) for the unique environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The role of genetics in rotator cuff degeneration is quantified by our study on elderly monozygotic and dizygotic twins; however, it is only partial with respect to the contribution of shared and unique environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.18.00761","type":"journal-article","created":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T14:49:10Z","timestamp":1554475750000},"page":"600-605","source":"Crossref","is-referenced-by-count":14,"title":["Rotator Cuff Degeneration"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6097-4136","authenticated-orcid":false,"given":"Stefano","family":"Gumina","sequence":"first","affiliation":[{"name":"Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7442-3258","authenticated-orcid":false,"given":"Ciro","family":"Villani","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0868-2830","authenticated-orcid":false,"given":"Valerio","family":"Arceri","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit, San Camillo Forlanini Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5771-7772","authenticated-orcid":false,"given":"Corrado","family":"Fagnani","sequence":"additional","affiliation":[{"name":"Centre for Behavioural Sciences and Mental Health, Italian Institute of Health, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1805-6240","authenticated-orcid":false,"given":"Lorenza","family":"Nistic\u00f2","sequence":"additional","affiliation":[{"name":"Centre for Behavioural Sciences and Mental Health, Italian Institute of Health, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4638-0734","authenticated-orcid":false,"given":"Teresa","family":"Venditto","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2029-3539","authenticated-orcid":false,"given":"Alessandro","family":"Castagna","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit, Humanitas Clinic, Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5962-2598","authenticated-orcid":false,"given":"Vittorio","family":"Candela","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza, University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,4,3]]},"reference":[{"issue":"2","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1302\/0301-620X.77B2.7706351","article-title":"Rotator-cuff changes in asymptomatic adults. 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In vivo assessment with orthogonal polarization spectral imaging during arthroscopy of the shoulder","volume":"85","author":"Biberthaler","year":"2003","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"96S","DOI":"10.1016\/j.jse.2007.07.004","article-title":"Contrast-enhanced ultrasound characterization of the vascularity of the rotator cuff tendon: age- and activity-related changes in the intact asymptomatic rotator cuff","volume":"17","author":"Rudzki","year":"2008","journal-title":"J Shoulder Elbow Surg."},{"issue":"7","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1302\/0301-620X.90B7.19918","article-title":"Measurement of blood flow in the rotator cuff using laser Doppler flowmetry","volume":"90","author":"Levy","year":"2008","journal-title":"J Bone Joint Surg Br."},{"issue":"2","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jse.2012.05.023","article-title":"The association between arterial hypertension and rotator cuff tear: the influence on rotator cuff tear sizes","volume":"22","author":"Gumina","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"6","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1007\/s11999-009-0781-2","article-title":"Cigarette smoking increases the risk for rotator cuff tears","volume":"468","author":"Baumgarten","year":"2010","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jse.2011.01.039","article-title":"The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes","volume":"21","author":"Carbone","year":"2012","journal-title":"J Shoulder Elbow Surg."},{"issue":"3","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1002\/art.21672","article-title":"Expression profiling of metalloproteinases and tissue inhibitors of metalloproteinases in normal and degenerate human Achilles tendon","volume":"54","author":"Jones","year":"2006","journal-title":"Arthritis Rheum."},{"issue":"3","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/JSA.0b013e318227b07b","article-title":"Role of metalloproteinases in rotator cuff tear","volume":"19","author":"Garofalo","year":"2011","journal-title":"Sports Med Arthrosc Rev."},{"issue":"1","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/jor.20009","article-title":"Overexpression of nitric oxide synthases in tendon overuse","volume":"24","author":"Szomor","year":"2006","journal-title":"J Orthop Res."},{"issue":"11","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1007\/s00167-007-0395-8","article-title":"Light microscopic histology of supraspinatus tendon ruptures","volume":"15","author":"Longo","year":"2007","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"issue":"6","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/S0736-0266(02)00075-X","article-title":"Apoptosis in rotator cuff tendonopathy","volume":"20","author":"Yuan","year":"2002","journal-title":"J Orthop Res."},{"issue":"4","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1177\/0363546506295702","article-title":"Excessive apoptosis in patellar tendinopathy in athletes","volume":"35","author":"Lian","year":"2007","journal-title":"Am J Sports Med."},{"issue":"5","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jse.2012.06.005","article-title":"The possible role of the transcription factor nuclear factor-\u03baB on evolution of rotator cuff tear and on mechanisms of cuff tendon healing","volume":"22","author":"Gumina","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"23","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1136\/bjsports-2015-095100","article-title":"Is higher serum cholesterol associated with altered tendon structure or tendon pain? 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