Review of human supraspinatus tendon mechanics. Part II: tendon healing response and characterization of tendon health
Overuse injuries of the rotator cuff, particularly of the supraspinatus tendon (SST), are highly prevalent and debilitating in work, sport, and daily activities. Despite the clinical significance of these injuries, there remains a large degree of uncertainty regarding the pathophysiology of injury,...
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| Published in | Journal of shoulder and elbow surgery Vol. 31; no. 12; pp. 2678 - 2682 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier Inc
01.12.2022
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| Subjects | |
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| Abstract | Overuse injuries of the rotator cuff, particularly of the supraspinatus tendon (SST), are highly prevalent and debilitating in work, sport, and daily activities. Despite the clinical significance of these injuries, there remains a large degree of uncertainty regarding the pathophysiology of injury, optimal methods of nonoperative and operative repair, and how to adequately assess tendon injury and healing. The tendon response to fatigue damage resulting from overuse is different from that of acute rupture and results in either an adaptive (healing) or a maladaptive (degenerative) response. Factors associated with the degenerative response include increasing age, smoking, hypercholesterolemia, biological sex (variable by tendon), diabetes mellitus, and excessive load post fatigue damage. After injury, the average healing rate of tendon is approximately 1% per day and may be significantly influenced by biologic sex (females have lower collagen synthesis rates) and excessive load after damage. Although magnetic resonance imaging (MRI) is considered the gold standard in assessing acute tears as well as tendinopathic change in the SST, ultrasonography has proven to be a valuable tool to measure tendinopathic change in real time. Ultrasonography can determine multiple mechanical and structural parameters of the SST that are altered in fatigue loading. Thus, ultrasonography may be utilized to understand how these parameters change in response to SST overuse, and may aid in determining the activity level that places the SST at greater risk of rupture. |
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| AbstractList | Overuse injuries of the rotator cuff, particularly of the supraspinatus tendon (SST), are highly prevalent and debilitating in work, sport, and daily activities. Despite the clinical significance of these injuries, there remains a large degree of uncertainty regarding the pathophysiology of injury, optimal methods of nonoperative and operative repair, and how to adequately assess tendon injury and healing. The tendon response to fatigue damage resulting from overuse is different from that of acute rupture and results in either an adaptive (healing) or a maladaptive (degenerative) response. Factors associated with the degenerative response include increasing age, smoking, hypercholesterolemia, biological sex (variable by tendon), diabetes mellitus, and excessive load post fatigue damage. After injury, the average healing rate of tendon is approximately 1% per day and may be significantly influenced by biologic sex (females have lower collagen synthesis rates) and excessive load after damage. Although magnetic resonance imaging (MRI) is considered the gold standard in assessing acute tears as well as tendinopathic change in the SST, ultrasonography has proven to be a valuable tool to measure tendinopathic change in real time. Ultrasonography can determine multiple mechanical and structural parameters of the SST that are altered in fatigue loading. Thus, ultrasonography may be utilized to understand how these parameters change in response to SST overuse, and may aid in determining the activity level that places the SST at greater risk of rupture. |
| Author | Hammer, Liisa Charie Hsu, Jason Edward Gardner, Richard J. Iannuzzi, Nicholas P. Griffith, Kyle M. Gee, Albert O. Cotton, James D. Takatani, Karen C. Lack, William D. |
| Author_xml | – sequence: 1 givenname: Kyle M. orcidid: 0000-0003-1108-2198 surname: Griffith fullname: Griffith, Kyle M. email: kygriff@uw.edu organization: University of Washington School of Medicine, Seattle, WA, USA – sequence: 2 givenname: Liisa Charie surname: Hammer fullname: Hammer, Liisa Charie organization: Environment, Health & Safety, The Boeing Company, Seattle, WA, USA – sequence: 3 givenname: Nicholas P. orcidid: 0000-0001-6770-4967 surname: Iannuzzi fullname: Iannuzzi, Nicholas P. organization: Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA – sequence: 4 givenname: Karen C. surname: Takatani fullname: Takatani, Karen C. organization: Boeing Research & Technology, The Boeing Company, Seattle, WA, USA – sequence: 5 givenname: Jason Edward orcidid: 0000-0002-1411-3482 surname: Hsu fullname: Hsu, Jason Edward organization: Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA – sequence: 6 givenname: James D. surname: Cotton fullname: Cotton, James D. organization: Boeing Research & Technology, Issaquah, WA, USA – sequence: 7 givenname: Albert O. orcidid: 0000-0001-9422-204X surname: Gee fullname: Gee, Albert O. organization: Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA – sequence: 8 givenname: Richard J. surname: Gardner fullname: Gardner, Richard J. organization: Boeing Research & Technology, The Boeing Company, Seattle, WA, USA – sequence: 9 givenname: William D. orcidid: 0000-0001-5720-2808 surname: Lack fullname: Lack, William D. organization: Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA |
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