Inflammatory infiltrate of the edges of the torn rotator cuff

Aims: There is still considerable controversy as to whether or not the margins of a cuff tear, lined with an inflammatory infiltrate, should be excised during surgical suture. We have verified whether this problem could be resolved in advance by inviting patients to take an anti- inflammatory drug before surgical treatment. Material: Thirty-eight patients were randomly either treated with an anti-inflammatory drug for two weeks. During the arthroscopic repair, few fragments of supraspinatus edge were excised and microscopically evaluated. Results: No significant differences emerged among samples belonging to the two groups. ln all cases, we observed inflammatory infiltrate lined tear edges. Fibrocytes and newly formed vessels were detected near the margin. Dystrophic calcifications were observed in both groups. Distant from the edge, the tendon appeared hypocellular; containing areas with myxoid or fatty degeneration. Conclusion: Our study demonstrates that an anti-inflammatory drug is unable to resolve the inflammatory infiltrate. This incapacity is reasonably due to a scarce blood supply to the cuff, which, in case of rupture, is deprived of vessels coming from the great tuberosity. Further studies are needed to understand how to eliminate the inflammatory process and clarify whether it might be an obstacle to cuff healing and promote a re-tearing of the sutured cuff.