McFarland Edward G, Maffulli Nicola, Del Buono Angelo, Murrell George A C, Garzon-Muvdi Juan, Petersen Steve A
Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore MD, USA.
Department of Physical and Rehabilitation Medicine, University of Salerno School of Medicine and Surgery, Salerno, Italy. Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK.
Muscles Ligaments Tendons J. 2013 Aug 11;3(3):196-200. eCollection 2013 Jul.
Historically, many causes have been proposed for rotator cuff conditions. The most prevalent theory is that the rotator cuff tendons, especially the supraspinatus, make contact with the acromion and coracoacromial ligament, resulting in pain and eventual tearing of the tendon. However, more recent evidence suggests that this concept does not explain the changes in rotator cuff tendons with age. The role of acromioplasty and coracoacromial ligament release in the treatment of rotator cuff disease has become questioned. Evidence now suggests that tendinopathy associated with aging may be a predominant factor in the development of rotator cuff degeneration. We propose that the overwhelming evidence favors factors other than "impingement" as the major cause of rotator cuff disease and that a paradigm shift in the way the development of rotator cuff pathology is conceptualized allows for a more comprehensive approach to the care of the patient with rotator cuff disease.
从历史上看，针对肩袖疾病提出了许多病因。最普遍的理论是肩袖肌腱，尤其是冈上肌，与肩峰和喙肩韧带发生接触，导致疼痛并最终造成肌腱撕裂。然而，最近的证据表明，这一概念无法解释肩袖肌腱随年龄的变化。肩峰成形术和喙肩韧带松解在肩袖疾病治疗中的作用受到了质疑。现在有证据表明，与衰老相关的肌腱病可能是肩袖退变发展的主要因素。我们认为，压倒性的证据支持将“撞击”以外的因素作为肩袖疾病的主要病因，并且在肩袖病理发展的概念化方式上进行范式转变，有助于采用更全面的方法来治疗肩袖疾病患者。
