title: Blood supply of the subacromial bursa and rotator cuff tendons on the bursal side.
abstract: OBJECTIVE
  Vascularity of the subacromial bursa and rotator cuff tendons is key factors in the pathogenesis of subacromial bursitis and impingement syndrome, rotator cuff tendinitis, and rotator cuff tears. The purpose of this study was to investigate and describe blood supply to the cranial and caudal parts of the subacromial bursa and the vascularity of the rotator cuff tendons on the bursal side.
  
  
  METHODS
  Fourteen fresh cadaveric shoulders from six females and eight males with a mean age of 71.7 (±10.8) years were studied. Before dissection, an arterial injection of 10% aqueous dispersion of latex was administered. Post-injection, the shoulders were fixed in an alcohol-formalin-glycerol solution.
  
  
  RESULTS
  The cranial and caudal bursa of all specimens was mainly supplied by the thoracoacromial, suprascapular, and anterior and posterior circumflex humeral arteries. The cranial part of the bursa was supplied anteriorly by the thoracoacromial artery, and posteriorly and medially by the posterior circumflex humeral artery as far as the medial third. The caudal part received arterial blood anteriorly from the anterior circumflex humeral artery, and posteriorly and medially by the posterior circumflex humeral artery as far as the medial third of the caudal bursa. In addition, the suprascapular artery branched at the upper surface of the coracohumeral ligament, and the subcoracoid artery branched at the under surface of the same ligament.
  
  
  CONCLUSIONS
  The subacromial bursa appears well vascularized. The results of the present investigation showed that blood supply to the subacromial bursa at the caudal part and rotator cuff tendons on the bursal side was linked to the same arteries. The subcoracoid artery supplied interval rotator structures close to the caudal bursa. It is the wish of the authors that this meticulous anatomical work will help surgeons in their day-to-day clinical work, e.g. to minimize the risk of complications such as perioperative bleeding.
authors.affiliation: Department of Anatomy, University of Tartu, Ravila Street 19, 50411, Tartu, Estonia. elle.poldoja@ut.ee.
authors.forename: Elle
authors.initials: E
authors.lastname: Põldoja
authors.affiliation: Department of Anatomy, University of Tartu, Ravila Street 19, 50411, Tartu, Estonia.|Department of Orthopaedics, Noth Estonia Medical Centre Foundation, J, Sütiste tee 19, 13419, Tallinn, Estonia.
authors.forename: Madis
authors.initials: M
authors.lastname: Rahu
authors.affiliation: Department of Orthopaedics, Noth Estonia Medical Centre Foundation, J, Sütiste tee 19, 13419, Tallinn, Estonia.
authors.forename: Kristo
authors.initials: K
authors.lastname: Kask
authors.affiliation: Institute of Anatomy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Imke
authors.initials: I
authors.lastname: Weyers
authors.affiliation: Department of Anatomy, University of Tartu, Ravila Street 19, 50411, Tartu, Estonia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Kolts
mesh_terms: D000368:Aged; D002061:Bursa, Synovial / Q000098:blood supply*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D017006:Rotator Cuff / Q000098:blood supply*; D012785:Shoulder Joint / Q000098:blood supply
keywords: Rotator cuff tendons; Rotator interval; Shoulder joint; Subacromial bursa; Subcoracoid artery; Vascular anatomy