Rotator cuff degeneration and lateral epicondylitis: a comparative histological study

OBJECTIVES--Rotator cuff tendinitis and lateral epicondylitis are common in clinical practice but the underlying pathology is poorly understood. The study examined both normal and biopsy tendon specimens histologically, to determine the mechanisms involved in tendon degeneration. METHODS--Rotator cu...

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Bibliographic Details
Published in:Annals of the rheumatic diseases 1994-01, Vol.53 (1), p.30-34
Main Authors: Chard, M D, Cawston, T E, Riley, G P, Gresham, G A, Hazleman, B L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Aging - pathology
Biological and medical sciences
Biopsy
Calcinosis
Child
Collagen - metabolism
Diseases of the osteoarticular system
Female
Glycosaminoglycans - metabolism
Histocytochemistry
Humans
Juxtaarticular diseases. Extraarticular rhumatism
Male
Medical sciences
Middle Aged
Rotator Cuff - blood supply
Rotator Cuff - metabolism
Rotator Cuff - pathology
Tennis Elbow - metabolism
Tennis Elbow - pathology
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Summary:OBJECTIVES--Rotator cuff tendinitis and lateral epicondylitis are common in clinical practice but the underlying pathology is poorly understood. The study examined both normal and biopsy tendon specimens histologically, to determine the mechanisms involved in tendon degeneration. METHODS--Rotator cuff tendons from 83 cadavers aged 11-94 and tendon biopsy specimens from 20 patients with lateral epicondylitis aged 27-56 years were examined histologically. RESULTS--The microscopic changes found in the tendon biopsies from the elbow were similar to those found in the cadaveric rotator cuff tendons. Abnormalities ranged from minor blood vessel wall changes and loss of tenocytes to calcification. The most frequent abnormality was glycosaminoglycan infiltration and fibrocartilaginous transformation. There appeared to be some sequence in the changes observed which were milder in younger patients. Only 17% of cadaver tendons, below the age of 39 were abnormal but abnormalities increase in later life to around 40-50%. CONCLUSIONS--There was an increasing incidence of degenerative changes in tendons with age. The changes observed in biopsy samples of common extensor tendons were the same as those seen in aged supraspinatus tendons, but these changes were not seen in control common extensor tendons.
ISSN:0003-4967
1468-2060
DOI:10.1136/ard.53.1.30