Wednesday, December 17, 2014

Chronic rotator cuff tears - it's not just about the tendon

Reduced muscle fiber force production and disrupted myofibril architecture in patients with chronic rotator cuff tears.

These authors studied the contractility of muscle fibers from biopsy specimens of supraspinatus muscles of 13 patients with chronic full-thickness posterosuperior rotator cuff tears, comparing the results to healthy vastus lateralis muscle fibers.

They found that chronically torn supraspinatus muscles had a 30% reduction in maximum isometric force production and a 29% reduction in normalized force compared with controls. They identified disordered sarcomeres along with an accumulation of lipid-laden macrophages in the extracellular matrix surrounding supraspinatus muscle fibers.

Comment: The figures in this paper are quite striking. These results show that in addition to the re-estabishment of a durable tendon attachment to bone, recovery from the repair of a chronic rotator cuff tear would hopefully include reversion of the muscle force generation and sarcomere architecture towards normal.


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