Sunday, March 16, 2014

Rotator cuff tear: muscle atrophy and fatty infiltration

Work on Understanding Muscle Atrophy and Fatty Infiltration in Massive Rotator Cuff tears has won the 2013 Kappa Delta Young Investigator Award.

The authors point out that after surgery for large or massive tears, patients often sustain recurrent tears and, even if the repair remains intact, have poor muscle function. These poor results may be related to irreversible atrophy and fatty infiltration of the rotator cuff muscles.

They developed a small animal model of rotator cuff tears and used this model to identify the ways in which cuff tears affect the associated muscle. They found an intracellular signaling pathway (Akt/mTOR) that appears to be important in regulating muscle mass in normal muscle also has a central role in the development of muscle atrophy and fatty infiltration. Inhibiting this pathway decreases the development of fatty infiltration.

In a rat model the authors demonstrated that transecting the supraspinatus, infraspinatus, and teres minor tendons created muscle atrophy and fatty infiltration along with muscle fibrosis, changes that were increased by denervation.

They used MRI to quantitate muscle atrophy and fatty infiltration and to evaluate the role of Akt/mTOR and of transforming growth factor-beta (TGF-╬▓) in the development of these changes.

Finally, the authors investigated the cellular source of fibroblasts and adipocytes that infiltrate the muscle causing irreversible changes, suggesting that these cells arise from endothelial lineage stem cells. They are searching for a stimulus or small molecule inhibitors to drive these cells to make muscle instead of fibrous tissue and fat, avoiding atrophy and fatty infiltration.

Consultation for those who live a distance away from Seattle.

Check out the new Shoulder Arthritis Book - click here.

Click here to see the new Rotator Cuff Book

To see the topics covered in this Blog, click here

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'