Pathogenesis of diseases and injuries of the rotator cuff. The concept of a single pathological process (discussion article)

Background. Increased demand for the functioning of the rotator cuff contributes to the predisposition to various pathological processes that require adequate comprehensive treatment. But the lack of a clear understanding of the causes and, most importantly, the mechanisms of development of the pathological process in the rotator cuff often leads to negative consequences of treatment. The purpose of the work is to create a concept of the pathogenesis of shoulder joint diseases as a single pathological process. Materials and methods. The study included 40 patients diagnosed with tenosynovitis of the long head of the biceps, who underwent conservative treatment on an outpatient and inpatient basis. The duration of the disease ranged from 2–3 months to 4 years from its onset. Results. Based on systemic ideas about the development and course of various diseases, the conditions and causes of pathological changes in the shoulder girdle tissues were analyzed and the concept of the pathogenesis of rotator cuff diseases was proposed in accordance with the clinical manifestations of pathology. Conclusions. The nature of morphological changes in the shoulder girdle structures, in particular the rotator cuff, regardless of the cause, is identical and corresponds to a typical pathological process — reactive inflammation, which determines the features and nature of the pathological process in the rotator cuff with its subsequent chronicity.