title: Adhesion of the subacromial bursa may cause subacromial impingement in patients with rotator cuff tears: pressure measurements in 18 patients.
abstract: In order to determine whether adhesion of the subacromial bursa leads to impingement, we measured the subacromial contact pressures before and after release of adhesion of this bursa. 18 shoulders with cuff tears and adhesion of the subacromial bursa were evaluated in 8 male and 10 female patients, of mean age 62 (53-71) years and who had no particular limitation of shoulder motion. We recorded subacromial pressures using a very sensitive film inserted under the acromion during surgery. In passive scapular plane elevation (scaption) at 100 degrees, the mean subacromial contact pressure and area declined from 1.43 (SD 0.23) MPa before release to 1.14 (SD 0.35) MPa after release (p < 0.001), and from 163 (SD 81) mm2 before release to 80 (SD 46) mm2 after release (p < 0.001), respectively. We suggest that adhesion of the subacromial bursa increases impingement between the acromion and the insertion of rotator cuff tendons.
authors.affiliation: Department of Orthopaedic Surgery, Osaka University School of Medicine, Suita, Japan. machida@hrc-hp.com
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Machida
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Sugamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Inui
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D000174:Acromion / Q000473:pathology / Q000503:physiopathology; D000368:Aged; D002061:Bursa, Synovial / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002062:Bursitis / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery; D000070636:Rotator Cuff Injuries; D019534:Shoulder Impingement Syndrome / Q000209:etiology*