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    Microvascular blood flow in normal and pathologic rotator cuffs

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    URI
    http://hdl.handle.net/11287/593975
    Author
    Karthikeyan, S.
    Griffin, D. R.
    Parsons, N.
    Lawrence, T. M.
    Modi, C. S.
    Drew, S. J.
    Smith, Christopher D.
    Date
    2015-12-01
    Journal
    Journal of shoulder and elbow surgery
    Type
    Journal Article
    Publisher
    Elsevier
    DOI
    10.1016/j.jse.2015.07.014
    Metadata
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    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.
    Citation
    J Shoulder Elbow Surg. 2015 Dec;24(12):1954-60
    Publisher URL
    http://www.sciencedirect.com/science/article/pii/S1058274615003882
    Collections
    • 2015 RD&E publications
    • General Trauma & Orthopaedics

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