Many surgeons remove the bursa when repairing rotator cuff injuries, but a new animal study suggests that the small tissue helps with healing.
A common practice of shoulder surgeons may be impairing the success of rotator cuff surgery, a new study from orthopedic scientists and biomedical engineers at Columbia University suggests.
"But we really don't know the role of the bursa in rotator cuff disease, so we don't know the full implications of removing it," Thomopoulos says."Our findings in an animal model indicate that surgeons should not remove the bursa without carefully considering the consequences."If you haven't yet injured your shoulder, it may just be a matter of time.
Rotator cuff repairs usually fail because of poor healing between tendon and bone where the tendon is reattached to the bone.The bursa is a thin, fluid-filled sac originally thought to protect the tendons by providing a cushion between the tendons and adjacent bones. The researchers found that the presence of the bursa protected the undamaged tendon by maintaining its mechanical properties and protected the bone by maintaining its morphometry. When the bursa was removed, strength of the undamaged tendon deteriorated and the bone quality deteriorated.
"Overall, what we're seeing is a beneficial role of the bursa for rotator cuff health, in contrast with the historical view that the inflamed bursa is detrimental," says Thomopoulos. "The treatment results are somewhat preliminary and require additional timepoints and mechanical characterization before we can draw strong conclusions," Thomopoulos says,"but our initial data supports the idea that the bursa can be therapeutically targeted to improve rotator cuff healing."Brittany P. Marshall, Beth G. Ashinsky, Xavier E. Ferrer, Jennifer A. Kunes, Astia C. Innis, Andrew J. Luzzi, Lynn Ann Forrester, Kevin G. Burt, Andy J. Lee, Lee Song, Lauren E.
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