棘上・棘下筋腱接合部に生じる腱内空隙について

抄録

No detailed report has been published on the supra-infraspinatus tendon junction where tendons with different tractive directions compose the rotator cuff despite the fact that mechanical stresses are mainly placed upon this site. During cadaver autopsy we noticed the formation of various spaces in this junction and investigated the characteristics of these intratendinous spaces.
274 joints were taken as specimens from 137 cadavers (84 males and 53 f emales) from 43 to 98years of age with an average of 74 years. After examining the surface of the rotator cuff, an incision was made over the junction of the supraspinatus and the infraspinatus tendon from the greater tuberosity to the muscles interval. The presence of intratendinous space was examined and if an intratendinous space was found, a macroscopic and microscopic examinations were performed.
The formation of intratendinous space was observed in 46 joints (24 right joints and 22 left joints)of 33 cases (17 males and 16 females). The majority of spaces were found from the middle to the deep layer. Most of these spaces were located in tendon insertions and few were found in the more proximal portion. In many of the spaces formed in tendon insertions, the internal surface was irregular, whereas that of proximal spaces was smooth. Microscopic examination revealed two types of morphologic changes, in one the torn stump of tendon fibers was on the wall, and in the other it took the from of bursa enveloped with lining cells and areolar tissue.
There are two types of intratendinous spaces formed in the junction of the supraspinatus and infraspinatus tendons, one of which is caused by a tendon tear and the other is bursa-like. Both the tendon tear and the formation of bursa indicate that stress is centered upon this site.