Does This Patient With Shoulder Pain Have Rotator Cuff Disease?

Hermans, Job; Luime, Jolanda J.; Meuffels, Duncan E.; Reijman, Max; Simel, David L.; Bierma-Zeinstra, Sita M A

doi:10.1001/jama.2013.276187

Cited by 170 publications

(121 citation statements)

References 72 publications

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“…Rotator cuff tears are one of the most common causes of shoulder pain [1]. Approximately 50% of the US population has had a degenerative rotator cuff tear by age 60 [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of mechanical stimulation on bone marrow stromal cell–seeded tendon slice constructs: A potential engineered tendon patch for rotator cuff repair

et al. 2015

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Cell-based tissue engineered tendons have potential to improve clinical outcomes following rotator cuff repair, especially in large or massive rotator cuff tears, which pose a great clinical challenge. The aim of this study was to develop a method of constructing a functional engineered tendon patch for rotator cuff repair with cyclic mechanical stimulation. Decellularized tendon slices (DTSs) were seeded with BMSCs and subjected to cyclic stretching for 1, 3, or 7 days. The mechanical properties, morphologic characteristics and tendon-related gene expression of the constructs were investigated. Viable BMSCs were observed on the DTS after 7 days. BMSCs penetrated into the DTSs and formed dense cell sheets after 7 days of mechanical stretching. Gene expression of type I collagen, decorin, and tenomodulin significantly increased in cyclically stretched BMSC-DTS constructs compared with the unstrained control group (P < 0.05). The ultimate tensile strength and stiffness of the cyclically stretched tendon constructs were similar to the unstrained control group (P > 0.05). In conclusion, mechanical stimulation of BMSC-DTS constructs upregulated expression of tendon-related proteins, promoted cell tenogenic differentiation, facilitated cell infiltration and formation of cell sheets, and retained mechanical properties. The patch could be used as a graft to enhance the surgical repair of rotator cuff tears.

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“…Rotator cuff tears are one of the most common causes of shoulder pain [1]. Approximately 50% of the US population has had a degenerative rotator cuff tear by age 60 [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of mechanical stimulation on bone marrow stromal cell–seeded tendon slice constructs: A potential engineered tendon patch for rotator cuff repair

et al. 2015

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“…A positive arc test is documented if a patient experiences pain between 60° -120° of active abduction and is best used in conjunction with the Neer test and Hawkins Kennedy test [23]. The painful arc test has a sensitivity and specificity of 53% and 76% respectively, though a positive test has a likelihood ratio of 3.7, with a negative likelihood ratio of 0.36, suggesting that is an effective test for diagnosing rotator cuff pathology [24,25]. The Neer test, used to assess impingement, is positive with a passive painful arc maneuver, with the examiner flexing the glenohumeral joint while preventing shoulder shrugging [23].…”

Section: Diagnosismentioning

confidence: 99%

Nonoperative Management of Common Shoulder Conditions

Tauberg¹,

Denehy²,

Prodromo³

et al. 2015

JESO

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“…1,2) In the United States, rotator cuff disease is responsible for more than 4.5 million physician visits annually, and over 300,000 rotator cuff repairs are performed annually at a cost exceeding US $3 billion. 3,4) Thus, rotator cuff disease poses high socioeconomic costs and burdens.…”

Section: Introductionmentioning

confidence: 99%

Degeneration Exists along the Entire Length of the Supraspinatus Tendon in Patients with a Rotator Cuff Tear

Chang

2015

Clinics in Shoulder and Elbow

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Background: The purposes of the study were to examine rotator cuff tendon degeneration with respect to harvesting location, to determine a rationale for debridement of the torn end, and thus, to determine adequate debridement extent. Methods: Twenty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from three locations; from torn ends after minimal regularization of fraying (native end group, NE group), from torn ends after complete freshening of the frayed end (freshened end group, FE group), and from the macroscopically intact portion just distal to the musculotendinous junction (musculotendinous junction group, MTJ group). Control samples were harvested from patients admitted for surgery for proximal humerus fracture. Harvested samples were evaluated using a semi-quantitative grading scale. Results: Mean total degeneration scores in the NE group (13.3 ± 3.21), the FE group (12.5 ± 2.30), and in the MTJ group (10.8 ± 3.10) were significantly higher than those in the normal control group (5.0 ± 2.87; all p<0.001). Mean total degeneration score in the NE group was significantly higher than that in the MTJ group (p=0.012), but was not from that of the FE group. Mean total degeneration score in the FE group was not significantly different from that of the MTJ group. Conclusions: Tendon degeneration exists throughout the entire tendon to the macroscopically intact portion of full-thickness rotator cuff tear. Therefore, aggressive debridement to grossly normal appearing, bleeding tendon is unnecessary for enhancing healing after repair. (Clin Shoulder Elbow 2015;18(2):61-67)

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Does This Patient With Shoulder Pain Have Rotator Cuff Disease?

Cited by 170 publications

References 72 publications

Effect of mechanical stimulation on bone marrow stromal cell–seeded tendon slice constructs: A potential engineered tendon patch for rotator cuff repair

Effect of mechanical stimulation on bone marrow stromal cell–seeded tendon slice constructs: A potential engineered tendon patch for rotator cuff repair

Nonoperative Management of Common Shoulder Conditions

Degeneration Exists along the Entire Length of the Supraspinatus Tendon in Patients with a Rotator Cuff Tear

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