The role of tendon and subacromial bursa in rotator cuff tear pain: a clinical and histopathological study.
Knee Surg Sports Traumatol Arthrosc
; 24(12): 3779-3786, 2016 Dec.
Article
en En
| MEDLINE
| ID: mdl-26003482
ABSTRACT
PURPOSE:
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.METHODS:
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.RESULTS:
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, inflammation, oedema and necrosis of the subacromial bursa were directly associated with pain (P < 0.05). Pain decreased significantly in the presence of fatty metaplasia and necrosis of the tendon (P < 0.05).CONCLUSIONS:
This study defines the main clinical and histopathological features of painful rotator cuff tear. In particular, a greater association of pain was observed with the histopathological changes in the bursa compared with those in the rotator cuff. Considering that the bursa plays also an essential role during the healing process, this "new" role of the subacromial bursa as pain generator has important repercussions in both pharmacological and surgical treatments of rotator cuff tears. LEVEL OF EVIDENCE IV.Palabras clave
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Base de datos:
MEDLINE
Asunto principal:
Traumatismos de los Tendones
/
Bolsa Sinovial
/
Dolor de Hombro
/
Lesiones del Manguito de los Rotadores
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Asunto de la revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Año:
2016
Tipo del documento:
Article