By Nicola Maffulli, John P., M.D. Furia
This hugely illustrated textual content highlights most up-to-date most sensible perform within the administration of rotator cuff and linked pathologies. It comprises finished simple technological know-how and medical chapters authored by way of a few of the world's so much skilled and professional shoulder surgeons. presents a entire evaluation of the pathophysiology of rotator cuff illness at a suitable point for non-specialist orthopedists, activities drugs physicians and actual therapists. bargains well timed, reader-friendly and sensible tools for the prognosis and remedy of rotator cuff problems, and suggestion on components of discussion in the box, e.g. using Platelet wealthy plasma in tendon therapeutic. overseas contributor checklist essentially from North the United States and Europe comprises one of the most revered and finished shoulder surgeons on this planet, thereby making sure the ebook displays international most sensible perform. Chapters written to template to make sure consistency of method and clarity.
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Extra info for Rotator Cuff Disorders: Basic Science & Clinical Medicine
The supraspinatus footprint: an anatomic study of the supraspinatus insertion. Arthroscopy 2004;20:246–249. Schneeberger AG, Nyffeler R, Gerber C. Structural changes of the rotator cuff caused by experimental subacromial impingement in the rat. J Shoulder Elbow Surg 1998;7:375–380. Schoenfeld AJ, Lippitt SB. Rotator cuff tear associated with a posterior dislocation of the shoulder in a young adult: a case report and literature review. J Orthop Trauma 2007;21:150–152. Sharkey NA, Marder RA, Hanson PB.
When tendon degeneration did occur, secondary vascular changes could be seen. In 1990, a study by Lohr and Ulthoff showed that the bursal side of the cuff was well vascularized whereas the articular side had a sparse vascular supply. They concluded that this may predispose the articular side of the rotator cuff to failure. Intraoperative laser Doppler flowmetry has also been used to assess cuff vascularity. The aim of the study by Swiontowski and coworkers (1990) was to clarify the discrepancy between the prior cadaveric studies that showed hypovascular zones within the supraspinatus tendon and surgical findings of increased vascularity in patients with impingement syndrome.
They further suggested that this was consistent with the increased prevalence of rotator cuff pathology in older age groups because the decreased blood supply may predispose a patient to tendinopathy and possible attrition or failure. By contrast, other studies have failed to show decreases in the vascular supply to critical portions of the rotator cuff (anterosuperior corner of supraspinatus). Moseley and Goldie (1963) performed microinjection studies on cadaveric shoulders and found a watershed area that corresponded to the critical zone of the tendon (that was most susceptible to tears), but that this area was not necessarily less vascularized than other portions of the cuff.