Subacromial Bursa Of Rotator Cuff Tear In The Role And Significance Of Research

AIM: To investigate the histology and infrastructure of the subacromial bursa (SAB) in rotator cuff tear (RCT) patients. To investigate cytokines and Vimentin expression in SAB, such as Interleukin 6 (IL-6), Tumor necrosis factor a (TNF- a ) and Vascular endothelial growth factor (VEGF). To learn about the role of SAB in RCT and cytokines in SAB of RCT patients. Methods: For the experimental group, the subacromial bursa was obtained from patients with rotator cuff tear both at the tear site and distal to the tear site during surgery of rotator cuff repair. For the control group, the normal SAB was obtained from patients without rotator cuff tear. The specimens were processed for HE staining of hitology, for ultrastructure observation , and for immunohistochemical analysis of IL - 6, VEGF, TNF - a and Vimentin. The number of the positive expression was quantitated in the SAB using a computer image analysis system.Results: There is no great inflammatory cells infiltration in the SAB of the RCT patients. We can find the comprehensive increase of cell quantity as a reaction. The Type B cells predominate in ultrastructure and the cells are long and narrow. For the experimental group, the positive expression of IL-6, VEGF, TNF-a and Vimentin is much higher than the control. There's no significance between the tear site and distal site.Conclusions The alteration of the SAB in RCT patients is secondary to the RCT. It is a reaction to the RCT. There is inflammation in the SAB and tissue repair is accompanied. It's one major factor in chronic shoulder pain. The increase of cytokines in the SAB has great relation with inflammation. The increase is found both at the tear site and distal site. The reaction of the SAB might be secondary to the inflammation and be involved in the rotator cuff tear. The SAB play a key role in the process about the rotator cuff tearing and repairing. It's better not to make resection of SAB.