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Clin Shoulder Elbow > Volume 19(4); 2016 > Article
Clinics in Shoulder and Elbow 2016;19(4):197-201.
DOI: https://doi.org/10.5397/cise.2016.19.4.197    Published online December 31, 2016.
Similar Degree of Degeneration in the Articular and Bursal Layers of Delaminated Rotator Cuff Tear
Chris Hyunchul Jo, Seung Hoo Lee, Ji Sun Shin, Ji Eun Kim
1Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. chrisjo@snu.ac.kr
2Department of Pathology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Received: 14 January 2016   • Revised: 27 May 2016   • Accepted: 30 May 2016
Abstract
BACKGROUND: The purpose of the study was to compare the degree of degeneration of the articular and bursal layers of delaminated supraspinatus tendons based on histological examination.
METHODS
Fifty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from the lateral torn edges of the articular and bursal layers of the delaminated tear. Harvested samples were stained with H&E dye and evaluated based on a semi-quantitative grading scale.
RESULTS
There were no significant differences in the seven histological characteristics of tendon degeneration: fiber structure, fiber arrangement, round nuclei, regional variations in cellularity, vascularity, collagen stainability, and hyalinization between the articular and bursal layers of the delaminated rotator cuff tear (all p>0.05). Total degeneration scores of articular and bursal sides were 13.1 ± 3.85 points and 13.2 ± 3.42 points, respectively, and were not significantly different (p=0.958).
CONCLUSIONS
The study demonstrates that tendon degeneration was similar in the articular and bursal sides of the delaminated fullthickness rotator cuff tear, suggesting that degeneration would be a main etiology for the rotator cuff tear not only in the articular side but also in the bursal side. Considering potential disadvantages of subacromial decompression, this study tentatively suggests routine use of subacromial decompression as well as the need for halting or recovery from rotator cuff degeneration for better rotator cuff repair.
Key Words: Rotator cuff; Delamination; Degeneration; Histology


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