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The vascularity of the rotator cuff
1Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia.
Clinics in Sports Medicine
|October 1, 1991
Summary
Rotator cuff tears may be linked to blood supply changes. While cadavers show poor vascularity in critical zones, symptomatic patients exhibit increased blood vessels, suggesting a role in impingement-related degeneration.
Area of Science:
- Orthopedic Surgery
- Vascular Biology
- Sports Medicine
Background:
- Rotator cuff tears are a common cause of shoulder pain and dysfunction.
- The microvascular supply of the rotator cuff tendons is implicated in tear pathogenesis.
- Cadaver studies suggest a hypovascular "critical zone" in the supraspinatus tendon, linked to age-related degeneration.
Purpose of the Study:
- To investigate the microvascular supply of the supraspinatus tendon in symptomatic patients with impingement syndrome.
- To compare findings in symptomatic patients with previous cadaver studies.
Main Methods:
- Review of recent studies on microvascular supply in symptomatic rotator cuff disease.
- Analysis of findings in the critical zone of the supraspinatus tendon.
Main Results:
- In symptomatic patients with impingement syndrome, the critical zone of the supraspinatus tendon shows hypervascularity (increased blood vessels).
- This contrasts with cadaver studies that consistently demonstrate hypovascularity in the same area.
- Neovascularization in the critical zone appears associated with symptomatic rotator cuff disease due to mechanical impingement.
Conclusions:
- The microvascular response in the rotator cuff critical zone differs between asymptomatic (cadaver) and symptomatic (impingement) states.
- Hypervascularity or neovascularization in the critical zone may be a factor in rotator cuff disease progression secondary to mechanical impingement.
- Further research is needed to fully elucidate the role of vascularity in rotator cuff tear development and healing.