MRI and histological features of supraspinatus tendon degeneration in rotator cuff tears: An underexplored perspective

BackgroundThe supraspinatus muscle and tendon are an integral part of shoulder joint function and stability. The supraspinatus tendon is one of the four tendons forming the rotator cuff in the shoulder. Supraspinatus tendon tear is a frequent lesion that occurs due to various causes like lifting heavy objects, falls onto the shoulder, a dislocation of the shoulder, swimming, trauma, sports injury, occupational activity and degenerative change. Smoking, hypercholesterolemia, and hereditary predisposition are all established risk factors for developing RC tears, which affect the age dependent tendon degeneration process. Only a few articles were found discussing the histological characteristics of degenerative change of the supraspinatus tendon in rotator cuff tears.ObjectiveTo evaluate the histological characteristics of degenerative changes in the supraspinatus tendon associated with rotator cuff tears.MethodsRotator cuff disease is a major cause of shoulder pain and shoulder dysfunction in adults; not every patient is symptomatic, though. We examined morphological features of human surgical specimens of the supraspinatus tendon in patients with full thickness tears of the rotator cuff.ResultsHistological analysis of the surgical specimen revealed significant degenerative changes, including disorganization and tearing of the collagen fiber bundles, sparingly distributed, rounded tenocytes, and increased vascularity (neovascularization) within the tendon matrix.ConclusionThese findings provide direct evidence of intrinsic tendon degeneration as a key pathological factor in full thickness rotator cuff tears, which may be helpful for future research on the pathophysiology of the condition.