The prevalence of neovascularity in patients clinically diagnosed with rotator cuff tendinopathy (original) (raw)
Related papers
2020
A review was conducted to synthesize the available research literature on the pathogenesis of rotator cuff tendinopathy. Musculoskeletal disorders of the shoulder are extremely common. An understanding of the anatomy and biomechanics of the rotator cuff may provide some insight into the pathologic process involved in this tendinopathy. The patho etiology of rotator cuff failure is multifactorial and results from a combination of intrinsic, extrinsic and environmental factors. Profound changes within the subacromial bursa are strongly related to the pathology and resulting symptoms. A considerable body of research is necessary to more fully understand the etiology and pathogenic factors of rotator cuff tendinopathy Profound changes within the subacromial bursa are strongly related to the pathology and resulting symptoms. A considerable body of research is necessary to more fully understand the etiology and pathohistology of rotator cuff tendinopathy and its relationship with bursal pathology.
Current Concepts of Rotator Cuff Tendinopathy
International Journal of Sports Physical Therapy, 2014
Purpose/Background:Tendinopathies are a broad topic that can be examined from the lab to their impact upon function. Improved understanding will serve to bring this pathology to the forefront of discussion, whether in the clinic or the classroom. The purpose of this current concepts clinical commentary is to explore intrinsic and extrinsic mechanisms of rotator cuff (RC) tendinopathy in order to improve clinical and research understanding.Methods:Pubmed, Medline, Cinahl, PEDro, and Cochrane databases were searched, limiting results to those published in the English language, between the years of 2005 and 2012. The key search terms utilized were intrinsic mechanisms, tendinopathy, stem cells, biologics, platelet‐rich plasma (PRP), healing, rotator cuff tears, full‐thickness tears, tests, impingement, imaging, ultrasound, Magnetic Resonance Imaging (MRI), radiograph, shoulder advances, treatment, diagnoses, tendon disorders, pathogenesis, matrix metalloproteinase, injections, and RC repair. Over 150 abstracts were reviewed and 43 articles were analyzed for quality and relevance using the University of Alberta Evidence Based Medicine Toolkit.Results/Conclusions:Current evidence suggests that tendinopathies arise from a multivariate etiology.It is increasingly evident that intrinsic mechanisms play a greater role than extrinsic mechanisms in this process. Emphasis should be placed on patient information (i.e. background information and personal description of symptoms) and imaging/ injection techniques in order to aid in diagnosis. Future treatment technologies such as cell therapy and biological engineering offer the hope of improving patient outcomes and quality of life.Level of Evidence:Level 5 – Clinical Commentary Related to a Review of Literature
Mechanisms of rotator cuff tendinopathy: Intrinsic, extrinsic, or both?
2011
The etiology of rotator cuff tendinopathy is multi-factorial, and has been attributed to both extrinsic and intrinsic mechanisms. Extrinsic factors that encroach upon the subacromial space and contribute to bursal side compression of the rotator cuff tendons include anatomical variants of the acromion, alterations in scapular or humeral kinematics, postural abnormalities, rotator cuff and scapular muscle performance deficits, and decreased extensibility of pectoralis minor or posterior shoulder. A unique extrinsic mechanism, internal impingement, is attributed to compression of the posterior articular surface of the tendons between the humeral head and glenoid and is not related to subacromial space narrowing. Intrinsic factors that contribute to rotator cuff tendon degradation with tensile/shear overload include alterations in biology, mechanical properties, morphology, and vascularity. The varied nature of these mechanisms indicates that rotator cuff tendinopathy is not a homogenous entity, and thus may require different treatment interventions. Treatment aimed at addressing mechanistic factors appears to be beneficial for patients with rotator cuff tendinopathy, however, not for all patients. Classification of rotator cuff tendinopathy into subgroups based on underlying mechanism may improve treatment outcomes.
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015
To evaluate a possible association of shoulder pain with the clinical features and the histopathological changes occurring in the ruptured tendon and subacromial bursa of patients with rotator cuff tear. One hundred and eighty patients were clinically evaluated with the constant score and the visual analogue pain scale. Radiographs and MRI were performed. The chronology of the rupture, the muscle fatty degeneration according to Goutallier's scale and the tear size were evaluated. For each patient, a biopsy of the supraspinatus tendon and subacromial bursa was performed during arthroscopic rotator cuff tear repair and the specimens were histopathologically analysed. Clinically, the shoulder was more painful in females, in the presence of a chronic cuff lesion and a low Goutallier's grade (P < 0.05). No association was found between pain and age of the patient and between pain and tear size. Histologically, hypertrophy and inflammation of the tendon and hypertrophy, inflamm...
Management of rotator cuff pathology
2016
The rotator cuff refers to a group of four muscles, which arise from the scapula and insert into the head of humerus forming a cuff around the shoulder joint. They contribute to shoulder movements and provide dynamic stability at the shoulder joint. Pathology of the rotator cuff is the commonest cause for shoulder pain and its severity can vary from subacromial impingement to full thickness tears. NSAIDs and corticosteroids are two of the commonest group of drugs used in treating subacromial impingement syndrome but with conflicting evidence about their relative efficacy and risk of complications. I explored the efficacy of a subacromial NSAID (Tenoxicam) injection in a double blind randomised controlled trial but found it to be less effective compared to a subacromial corticosteroid injection as measured by functional shoulder scores at six weeks. During the trial, I recognised that there were unresolved challenges in using Ultrasonography to diagnose rotator cuff pathology especia...
Risk Factors for Rotator Cuff Disease: An Experimental Study on Intact Human Subscapularis Tendons
Journal of Orthopaedic Research, 2019
Although several studies revealed a multifactorial pathogenesis of degenerative rotator cuff disorders, the impact and interaction of extrinsic variables is still poorly understood. Thus, this study aimed at uncovering the effect of patient-and pathologyspecific risk factors that may contribute to degeneration of the rotator cuff tendons. Between 2015 and 2018, 54 patients who underwent arthroscopic shoulder surgery at three specialized shoulder clinics were prospectively included. Using tendon samples harvested from the macroscopically intact subscapularis (SSC) tendon, targeted messenger RNA expression profile analysis was performed in the first cohort (n = 38). Furthermore, histological analyses were conducted on tendon tissue samples obtained from a second cohort (n = 16). Overall, both study cohorts were comparable concerning patient demographics. Results were then analyzed with respect to specific extrinsic factors, such as patient age, body mass index, current as well as previous professions and sport activities, smoking habit, and systemic metabolic diseases. While patient age, sports-activity level, and preexisting rotator cuff lesions were considered to contribute most strongly to tendinopathogenesis, no further coherences were found. With regards to gene expression analysis, change in expression correlated most strongly with patient age and severity of the rotator cuff pathology. Further, chronic disorders increased overall gene expression variation. Taken together, our study provides further evidence that tendon degeneration is the consequence of a multifactorial process and pathological changes of the supraspinatus tendon affect the quality of SSC tendon and most likely vice versa. Therefore, the rotator cuff tendons need to be considered as a unit when managing rotator cuff pathologies.
Mri in the Evaluation of Rotator Cuff Tendons in Chronic Shoulder Pain
Journal of Chitwan Medical College
Background: Shoulder pain is the third most common cause of non- traumatic musculoskeletal pain with rotator cuff pathology being the most common cause. Magnetic Resonance Imaging (MRI) is the imaging modality of choice which helps in accurate diagnosis for making a treatment plan as wrong treatment strategy may lead to poor prognosis. Methods: A descriptive prospective study conducted in 100 individuals with non-traumatic chronic shoulder pain referred to referred to Department of Radiodiagnosis and Imaging, Dhulikhel Hospital, Kavre between 27th August 2020 to 29th August 2021. MRI images were acquired and analyzed by using IBM SPSS 21.0 version Pearson correlation coefficient, Spearman correlation and chi square tests were used for statistical analysis. Results: Rotator cuff pathology was most commonly encountered with supraspinatus being the most frequently involved tendon seen in 28(63.6%), followed by subscapularis 10(22.7%), infraspinatus 4(9%) and teres minor 2(4.5%).Similar...