Clinical and biological aspects of rotator cuff tears.
Rotator cuff tears are common and are a frequent source of shoulder pain and disability. A wide variation in the prevalence of rotator cuff tears has been reported. The clinical diagnosis is not always easy. Painful conditions of the long head of the biceps or acromioclavicular joint may result in high false positive rate. Physical examination should include inspection, palpation, the evaluation of active and passive range of motion, the execution of strength and provocative tests.
The etiology of rotator cuff tear remains multifactorial and attempts to unify intrinsic and extrinsic theories tried to explain the etiopathogenesis of rotator cuff tears. Knowledge of the etiopathogenesis of rotator cuff tears is important to improve therapies, surgical techniques and promote tendon repair.
Several strategies have been proposed to enhance tendon healing and recently research has focused on regenerative therapies, such as Growth Factors (GFs) and Plasma Rich Platelet (PRP) but a little evidence to support the use of injections with PRP in the treatment of rotator cuff rupture can be found in literature. Further studies using a proper control group, randomization, blinding and validated disease-specific outcome measures for pain and function are needed. > From: Giai Via et al., Muscles, Ligaments and Tendons J 3 (2013) 70-79. All rights reserved to the Muscles, Ligaments and Tendons Journal.
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The supraspinatus tendon has a poorly vascularized zone, the critical zone (A), around the collum anatomicum.
At the site of the critical zone near the collum anatomicum most (partial) supraspinatus tendon tears do occur.
