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Microvascular blood flow in normal and pathologic rotator cuffs
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Karthikeyan, S., Griffin, Damian R., Parsons, N., Lawrence, T. M., Modi, C. S., Drew, S. J. and Smith, C. D. (2015) Microvascular blood flow in normal and pathologic rotator cuffs. Journal of Shoulder and Elbow Surgery, 24 (12). pp. 1954-1960. doi:10.1016/j.jse.2015.07.014 ISSN 1058-2746.
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Official URL: https://doi.org/10.1016/j.jse.2015.07.014
Abstract
Background: Microvascular blood flow in the tendon plays an important role in the pathogenesis of rotator cuff abnormalities. There are conflicting views about the presence of a hypovascular zone in the supraspinatus tendon. Besides, no studies have looked at the pattern of blood flow around a partial-thickness tear. Our aim was to measure microvascular blood flow in normal and a range of pathologic rotator cuff tendons using laser doppler flowmetry.
Methods: A total of 120 patients having arthroscopic shoulder surgery were divided into 4 equal groups on the basis of their intraoperative diagnosis: normal rotator cuff, subacromial impingement syndrome, and partial-thickness or full-thickness rotator cuff tear. Microvascular blood flow was measured at 5 different regions of each cuff using a laser doppler probe. The values were compared to assess variability within and between individuals.
Results: Total blood flow was greater in the normal rotator cuff group compared with the groups with pathologic rotator cuffs, with the largest difference seen in the subacromial impingement group. Within individuals, blood flow was highest at the musculotendinous junction and lowest at the lateral insertional part of the tendon. Among groups, the blood flow was significantly lower at the anteromedial and posteromedial cuff in the groups with impingement and full-thickness tears compared with the group with normal cuff.
Conclusion: Real-time in vivo laser doppler analysis has shown that microvascular blood flow is not uniform throughout the supraspinatus tendon. Blood flow in the pathologic supraspinatus tendon was significantly lower compared with the normal tendon. (C) 2015 Journal of Shoulder and Elbow Surgery Board of Trustees.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > R Medicine (General) | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Shoulder and Elbow Surgery | ||||||
| Publisher: | Mosby-Elsevier | ||||||
| ISSN: | 1058-2746 | ||||||
| Official Date: | 29 December 2015 | ||||||
| Dates: |
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| Volume: | 24 | ||||||
| Number: | 12 | ||||||
| Page Range: | pp. 1954-1960 | ||||||
| DOI: | 10.1016/j.jse.2015.07.014 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR), Academy of Medical Sciences (Great Britain) | ||||||
| Grant number: | R.MRHS.0054 |
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