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Finally, it is important to assess the function and strength ofthe shoulder joint (e.g., Constant–Murley score [CMS] [42]), and the quality of life andpatient satisfaction corresponding to the shoulder joint (e.g., the disabilities of the arm,shoulder and hand (DASH) score [43], the Neer score [44]). Potential nanoparticle–cellular inter-actions that may induce cytotoxicity and other cellularresponses include (i) interaction with plasma membrane,which may cause instability associated with ion transport,signal transduction, and cell death; (ii) interaction withmitochondria, which may alter metabolism or interfere withantioxidant defenses and ROS production; (iii) binding toDNA, which may damage DNA, cell cycle division, andprotein synthesis; (iv) interaction with cytoskeleton, whichmay halt vesicular trafficking and cause mechanical insta-bility and cell death; and (v) interaction with proteins,lipids, and other biomolecules, which may lead to differenttypes of “corona” and biological effects

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