Yamanaka K
Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1988 Dec;62(12):1121-38.
To clarify the aging process and pathogenesis of rotator cuff tears, left supraspinatus tendons from 268 cadaveric specimens (171 men and 97 women, ages 0 to 87 years) were studied. The incidence of complete thickness tear was 6.7%, and that of incomplete thickness tear was 13.8% (bursal side tears: 2.6%, intratendinous tears: 7.5% and joint side tears: 3.7%). Microscopic examinations were conducted topographically in five sites near the supraspinatus insertion. In the articular side of the tendon, there were fewer tenocytes, fewer arterioles and more chondrocyte like cells than in any other portions. The incidence of hyperplasia of intima was higher in the specimens of aged persons in all portions. At the insertion in the aged specimens the arrangement of four transitional zones became much more irregular and the numbers of tidemark was occasionally increased with granulomatous tissue. The pathogenesis of the rotator cuff tear can be ascribed to the combination of aging, enthesopathy, inherent property of the supraspinatus tendon, injury and subacromial impingement.
为阐明肩袖撕裂的老化过程和发病机制，对268例尸体标本（171例男性和97例女性，年龄0至87岁）的左冈上肌腱进行了研究。全层撕裂的发生率为6.7%，非全层撕裂的发生率为13.8%（滑囊侧撕裂：2.6%，肌腱内撕裂：7.5%，关节侧撕裂：3.7%）。在冈上肌止点附近的五个部位进行了显微镜检查。在肌腱的关节侧，与其他任何部位相比，肌腱细胞较少、小动脉较少且软骨样细胞较多。在所有部位，老年人标本内膜增生的发生率更高。在老年标本的止点处，四个过渡区的排列变得更加不规则，潮线数量偶尔会因肉芽肿组织而增加。肩袖撕裂的发病机制可归因于老化、附着点病、冈上肌腱的固有特性、损伤和肩峰下撞击的综合作用。
