Abstract
The aim of this study was to assess the role of the subacromial bursa on the repair of a rotator cuff tear by the histopathological examination of the torn tendon. One hundred stumps of torn rotator cuff tendons were obtained from a hundred shoulders during surgery. A 10-mm length of torn tendon was prepared from along the torn edge of each stump. All specimens were sectioned at 3μm and stained histochemically and immunohistochemically. We divided the cases into four groups as follows: Group O: No bursal tissues in torn tendons (forty-five cases); G 1: Adhesion of bursal tissues on torn tendons (twenty-three cases); G 2: Bursal tissues invading or replacing the tendons within a half depth of the tendons (twenty-two cases); G 3: Bursal tissues invading or replacing the tendons diffusely (ten cases). The clinicopathological features were investigated and compared between the four groups. The duration of symptoms was longest in the G O and shortest in the G 2 with a high frequency of traumatic events. Most of the cases with massive tears were seen in G 2. Most cases with incomplete tears were seen in G 1or 2. Hyaline degeneration, chondroid metaplasia and calcification were frequently found in G O. Vascular proliferation and fatty infiltration were frequently observed in G 3. Subacromial bursal reaction against the tearing of the cuff was suspected to be a reparative process. Our findings suggested that bursal reaction after the tearing of the cuff might play an important role in the repair process. The bursa with underlying cuff should be preserved to repair the torn cuff tendons successfully.
