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Increased levels of inflammatory markers in the subscapularis tendon and joint capsule in patients with subacromial impingement

Artikel i vetenskaplig tidskrift
Författare Stefanos Farfaras
L. Roshani
J. Mulder
N. Mitsios
E. K. Hallstrom
Jüri Kartus
Publicerad i Knee Surgery Sports Traumatology Arthroscopy
Sidor 9
ISSN 0942-2056
Publiceringsår 2020
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 9
Språk en
Länkar dx.doi.org/10.1007/s00167-020-05992...
Ämnesord Subacromial impingement syndrome, Shoulder instability, Shoulder, arthroscopy, Cytokines, Pathogenesis, Biopsy analyses, shoulder pain, rotator, interleukin-1-beta, pathophysiology, prevalence, expression, cytokines, acromion, bursitis, cd72, Orthopedics, Sport Sciences, Surgery
Ämneskategorier Ortopedi

Sammanfattning

Purpose To analyze biopsy samples from the subscapularis tendon and from the joint capsule from male patients with subacromial impingement syndrome and compare them with samples from male patients with post-traumatic recurrent shoulder instability, to detect increased inflammatory activity that might be present inside the humeroscapular joint. Methods Twenty male patients scheduled for surgery for either subacromial decompression or Bankart reconstruction were included. Four biopsies from each patient were obtained during surgery from the capsule and the subscapularis tendon. Each specimen was analyzed for TNF-alpha, IL-6, CD-3 and CD-72. Multiplex fluorescence immunohistochemistry was performed on histological samples from the capsule and tendon to demonstrate the level of inflammatory markers. Fluorescence microscope images were acquired using an automated scanning system. On each slide, the number of pixels was registered and used in the analyses. Results The subacromial impingement syndrome group comprised eight patients, median age 53 (45-74) years, while the instability group 12, median age 27 (22-48) years (p < 0.00001). The amount of IL-6 and TNF-alpha was significantly higher in the subscapularis tendon of the patients with subacromial impingement syndrome compared with instability patients (p = 0.0015 and p = 0.0008 respectively). In the capsular samples, significantly higher amount of TNF-alpha and CD-72 was found in patients with subacromial impingement syndrome compared with instability patients (p < 0.0001 for both). On the other hand, the amount of CD-3 was significantly higher in the instability group (p = 0.0013). Conclusions This study provides evidence that an extended inflammatory process is present, not only in the subacromial bursa but also in the glenohumeral joint in patients with subacromial impingement syndrome.

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