The Microvascular Pattern of the Supraspinatus Tendon

Löhr, J. F.; Uhthoff, H K

doi:10.1097/00003086-199005000-00005

Cited by 289 publications

(195 citation statements)

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“…The reason for the lack of observable effect from the drug is debatable. It is plausible that the concentration of the drug in the tendon tissue was low because blood only reaches the torn cuff from the subacromial bursa and the musculotendinous junction [2,9]; therefore, the cuff tear margin, deprived of the vascular supply from the greater tuberosity, would be hypoxic. This would explain the presence of fibrocartilaginous areas observed not far from the inflammatory infiltrate.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory infiltrate of the edges of a torn rotator cuff

Gumina

Giorgio

Bertino

et al. 2006

International Orthopaedics (SICOT)

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There is still considerable controversy as to whether or not the inflamed margins of a cuff tear should be excised during surgical suture. We have tried to discover whether anti-inflammatory drugs used before surgical treatment could resolve this issue. Thirty-eight patients were randomly either treated with an anti-inflammatory drug for 2 weeks or not. During the subsequent arthroscopic repair, a few fragments of supraspinatus edge were excised and examined microscopically. No significant differences emerged among samples belonging to the two groups. In all cases, we observed inflammatory infiltratelined tear edges. Fibrocytes and newly formed vessels were detected near the margin. Dystrophic calcifications were observed in both groups. Away from the edge, the tendon appeared hypocellular; containing areas with myxoid or fatty degeneration. Our study demonstrates that an antiinflammatory drug is unable to resolve the inflammatory infiltrate. This failure is probably related to the poor blood supply to the cuff, which, in cases of rupture, is deprived of vessels coming from the humeral periosteum. Further studies are needed to understand how to eliminate the inflammatory process and clarify whether it might inhibit cuff healing and give rise to re-tearing of the sutured cuff.Résumé Quelle est la réponse à la controverse: faut-il exciser les tissus inflammatoires dans les lésions de la coiffe des rotateurs? Nous avons vérifié ce problème en invitant les patients à prendre un traitement inflammatoire avant le traitement chirurgical. Trente-huit patients ont été randomisés avec ou sans traitement anti-inflammatoire dans les quinze jours précédant l'intervention. Au cours de la réparation arthroscopique, de petits fragments sous épineux ont été excisés et étudiés microscopiquement sans différence significative entre les deux groupes. Dans tous les cas nous observons une infiltration inflammatoire des berges des lésions. Des fibrocytes et des néo-vaisseaux ont été détectés au niveau des marges, des calcifications ont été également observées dans les deux groupes. A distance des bords le tendon apparaît avec des lésions hypo-cellulaires, une dégénérescence mixoide ou graisseuse. Notre étude démontre que le traitement anti-inflammatoire n'est pas capable de résoudre le problème de l'infiltration inflammatoire, ceci est dû au fait que les lésions cicatricielles sont privées de vaisseaux venant du périoste huméral. Des études ultérieures seront nécessaires pour comprendre comment nous pouvons éliminer ce processus inflammatoire et permettre une meilleure cicatrisation de la coiffe après suture.

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Section: Discussionmentioning

confidence: 99%

Inflammatory infiltrate of the edges of a torn rotator cuff

Gumina

Giorgio

Bertino

et al. 2006

International Orthopaedics (SICOT)

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“…The majority of partial-thickness RCTs involve the articular side [7,15]. This might be secondary to hypovascularity and reduced biomechanical strength [15,19].…”

Section: Discussionmentioning

confidence: 99%

Partial-thickness Articular Surface Rotator Cuff Tears: An All-inside Repair Technique

Spencer

2010

Clinical Orthopaedics &Amp; Related Research

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Background Treatment of partial-thickness articular surface rotator cuff tears varies from simple débridement with or without an acromioplasty to various repair techniques. These repair techniques have included in situ transtendinous methods, as well as completion of the tear and repairing the full-thickness defect. The transtendinous techniques can be associated with stiffness and completing the tear takes down normal intact tissue. Therefore, a technique was developed that repairs the articular-side partial-thickness rotator cuff tears with an all-inside approach that does not violate the intact bursal tissue and does not complete the tear. Questions/purposes To compare the preoperative and postoperative Penn shoulder scores (PSS) associated with an in situ all-inside repair technique and the effects of such a repair on postoperative stiffness. Methods Twenty patients with partial-thickness articular rotator cuff tears greater than 50% of the width of the tendon repaired with an all-inside repair technique were retrospectively reviewed. Two of the patients were high school athletes and the rest self-described as recreational athletes. The minimum followup was 16 months (average, 29 months; range, 16-41 months). A validated outcome measure (PSS) was used to assess clinical outcome, and postoperative ROM was measured. Results The average PSS score improved from 74 (range, 56-84) to 92 (range, 86-99).

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“…usually develops in the 'critical area' between 1.25 and 2.5 cm proximal to the insertion site [1][2][3], owing to vascularisation deficits when the arm is in abduction [3][4][5][6][7], The rotator cuff tendons, particularly the deepest portion of the supraspinatus, undergo a transient irrigation deficiency. In 1872, Duplay [8] was the first to describe calcific tendinitis of the shoulder; he defined this arthropathy as "painful periarthritis of the shoulder".…”

mentioning

confidence: 99%

“…Rathbun & Macnab [6] described ischemia of the rotator cuff tissue during calcific tendinitis. Booth & Marvel [7] described degeneration of the tissue as a result of ischemic injury. Riley et al…”

mentioning

confidence: 99%

Ultra Sound Guided Needling for Giant Calcific Tendinitis of the Shoulder Joint - A Peculiar Case Report

Patnaik¹

2017

MOJOR

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The Microvascular Pattern of the Supraspinatus Tendon

Cited by 289 publications

References 0 publications

Inflammatory infiltrate of the edges of a torn rotator cuff

Inflammatory infiltrate of the edges of a torn rotator cuff

Partial-thickness Articular Surface Rotator Cuff Tears: An All-inside Repair Technique

Ultra Sound Guided Needling for Giant Calcific Tendinitis of the Shoulder Joint - A Peculiar Case Report

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