Resolvin E1, Resolvin D1 and Carvacrol in Rotator Cuff Tears: Pro-Resolving and Antioxidant Mechanisms with Implications for Tendon-to-Bone Healing

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.