Abstract - 2017 Volume.8 Issue.3

Background and aim: Overnight pain is considered as one of the symptoms bothering patients with rotator cuff tear. This pain results in sleep disorders and thus reduces one’s quality of life. Overnight pain in patients with rotator cuff tear has been attributed to various causes including shoulder impingement syndrome (which is the result of pressure increase in sub acromial bursa) and inflammatory changes. However, there hasn’t been any agreement with regard to the causes of overnight pain in patients with rotator cuff tear. During arthroscopic surgery, vascularized synovium was seen in patients with rotator cuff injury. Thus, in this study, it has been hypothesized that synovitis is the main cause of overnight pain in such patients. Increase in synovial vessels' flow would probably result in increase in vessels' flow through the artery feeding joint capsule. Hence, this study aimed to examine the relationship between the blood flow in anterior humeral circumflex artery and overnight pain in patients with rotator cuff tear using pulse Doppler ultrasonography.

Method: 24 patients with rotator cuff's injury were investigated in this study. Peak systolic velocity and the resistance index of blood flow in anterior humeral circumflex artery's ascending branch were investigated using pulse Doppler ultrasonography. In addition, 12 healthy subjects (without any shoulder damage) volunteered and they were studied as the control group. Peak systolic velocity and the resistance index in the mentioned artery were compared between the affected and unaffected shoulders in patients’ group and between the dominant and non-dominant sides within control group. 

Results: A significant difference was observed between the peak systolic velocity and the resistance index for anterior humeral circumflex artery of affected and unaffected shoulders in patients with rotator cuff tear and overnight pain. However, no significant difference was found between the peak systolic velocity and the resistance index in anterior humeral circumflex artery in control group subjects as well as patients with rotator cuffs tear without overnight pain.

Conclusion: In the present study, it has been attempted to scrutinize the hemodynamics of anterior humeral circumflex artery in patients with injured rotator cuff and healthy subjects using sonographic Doppler data. Overnight pain in patients with rotator cuff tear might be the result of hemodynamic changes in this artery. An investigation involving patients with rotator cuff tear and overnight pain will help better understand the etiology of this symptom.

 

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