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Epidemiologie und Pathophysiologie der Rotatorenmanschettenrupturen

Epidemiology and pathophysiology of rotator cuff tears

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Zusammenfassung

Rotatorenmanschettenläsionen sind eine der häufigsten Sehnenverletzungen des Menschen. Verschiedene altersphysiologische und mechanische Vorgänge sind dazu beschrieben und für das Auftreten der Risse verantwortlich gemacht worden. Die heute gebräuchliche Einteilung unterscheidet „extrinsische“ von „intrinsische“ Ursachen, wobei extrinsische mechanische, von außen die Sehne treffende Ursachen beschreiben, wohingegen intrinsische die Sehne in ihrer Substanz selbst betreffen und durch altersphysiologische oder im Verlauf von Mikroverletzungen auftretende Veränderungen verursacht werden.

In den meisten Fällen kommt es zu ersten Teilrissen (Partialrupturen), die dann zu kompletten Rupturen führen können. Ein Verständnis der pathophysiologischen Abläufe wird es dem Orthopäden erleichtern, die Entscheidung zwischen einem konservativen oder operativen Vorgehen zu treffen.

Abstract

Tears of the rotator cuff are one of the most common injuries to any tendon in the human body. Various theories and observations have since been made as to the origin of these tears.

It is now commonly accepted to distinguish between“extrinsic” and“intrinsic” causes. Extrinsic describes an attrition which might have been caused by a subacromial bony conflict, while intrinsic changes originate within the tendon body itself due to age-related degenerative changes, giving rise to partial and later complete rupture of the tendon body.

A better understanding of the underlying pathophysiological mechanism will make it easier for the attending orthopedic surgeon to decide whether a more conservative or operative course will have the best outcome for the situation given.

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Authors and Affiliations

  1. Endoklinik, Holstenstraße 2, 22767, Hamburg, Deutschland

    J.F. Löhr

  2. University of Ottawa, Ottawa, Ontario, Kanada

    H.K. Uhthoff

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  1. J.F. Löhr
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  2. H.K. Uhthoff
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Correspondence to J.F. Löhr.

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Löhr, J., Uhthoff, H. Epidemiologie und Pathophysiologie der Rotatorenmanschettenrupturen. Orthopäde 36, 788–795 (2007). https://doi.org/10.1007/s00132-007-1146-8

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