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Non-invasive Assessment of Microvascular and Endothelial Function
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Microvascular blood flow in normal and pathologic rotator cuffs.

Shanmugam Karthikeyan1, Damian R Griffin2, Nicholas Parsons2

  • 1Warwick Medical School, University of Warwick, Coventry, UK; Department of Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

Journal of Shoulder and Elbow Surgery
|September 29, 2015
PubMed
Summary

Microvascular blood flow is reduced in rotator cuff tears and impingement syndromes. This study measured blood flow in normal and abnormal rotator cuff tendons, revealing lower flow in diseased tendons.

Keywords:
Rotator cuffblood flowcritical zonecuff tearimpingementlaser doppler flowmetrymicrovascularsupraspinatus

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomedical Engineering

Background:

  • Microvascular blood flow is crucial in rotator cuff tendon health.
  • Conflicting data exists regarding hypovascular zones in the supraspinatus tendon.
  • The blood flow pattern around partial-thickness tears remains understudied.

Purpose of the Study:

  • To quantify microvascular blood flow in normal and pathological rotator cuff tendons.
  • To investigate blood flow patterns in various rotator cuff abnormalities using laser Doppler flowmetry.

Main Methods:

  • 120 patients undergoing arthroscopic shoulder surgery were categorized into four groups: normal, subacromial impingement, partial-thickness tear, and full-thickness tear.
  • Microvascular blood flow was measured using a laser Doppler probe across five distinct regions of each rotator cuff.
  • Blood flow values were analyzed for intra-individual and inter-group variations.

Main Results:

  • Normal rotator cuffs exhibited greater total blood flow than pathological cuffs, most notably in impingement cases.
  • Blood flow varied within individuals, peaking at the musculotendinous junction and lowest at the lateral insertion.
  • Anteromedial and posteromedial regions showed significantly reduced blood flow in impingement and full-thickness tear groups compared to normal cuffs.

Conclusions:

  • In vivo laser Doppler analysis demonstrates non-uniform microvascular blood flow in the supraspinatus tendon.
  • Pathological rotator cuff tendons exhibit significantly diminished microvascular blood flow compared to normal tendons.