open access

Vol 76, No 2 (2017)
ORIGINAL ARTICLES
Published online: 2016-08-29
Submitted: 2016-03-31
Accepted: 2016-05-24
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An arthroscopic evaluation of the anatomical “critical zone”

N. Naidoo, L. Lazarus, S. A. Osman, K. S. Satyapal
DOI: 10.5603/FM.a2016.0049
·
Pubmed: 27665956
·
Folia Morphol 2017;76(2):277-283.

open access

Vol 76, No 2 (2017)
ORIGINAL ARTICLES
Published online: 2016-08-29
Submitted: 2016-03-31
Accepted: 2016-05-24

Abstract

Background: The “critical zone”, a region of speculated vascularity, is situated approximately 10 mm proximal to the insertion of the supraspinatus tendon. Despite its obvious role as an anatomical landmark demarcator, its patho-anatomic nature has been identified as the source of rotator cuff pathology. Although many studies have attempted to evaluate the vascularity of this region, the architecture regarding the exact length, width and shape of the critical zone, remains unreported. This study aimed to determine the shape and morphometry of the “critical zone” arthroscopically.

Materials and methods: The sample series, which was comprised of 38 cases (n = 38) specific to pathological types, employed an anatomical investigation of the critical zone during routine real-time arthroscopy. Demographic representation: i) sex: 19 males, 19 females; ii) age range: 18–76 years; iii) race: white (n = 29), Indian (n = 7) and coloured (n = 2).

Results: The incidence of shape and the mean lengths and widths of the critical zone were determined in accordance with the relevant demographic factors and patient history. Although the cresenteric shape was predominant, hemispheric and sail-shaped critical zones were also identified. The lengths and widths of the critical zone appeared markedly increased in male individuals. While the increase in age may account for the increased incidence of rotator cuff degeneration due to poor end-vascular supply, the additional factors of height and weight presented as major determinants of the increase in size of the critical zone.

Conclusions: In addition, the comparisons of length and width with each other and shape yielded levels of significant difference, therefore indicating a directly proportional relationship between the length and width of the critical zone. This detailed understanding of the critical zone may prove beneficial for the success of post-operative rotator cuff healing.

Abstract

Background: The “critical zone”, a region of speculated vascularity, is situated approximately 10 mm proximal to the insertion of the supraspinatus tendon. Despite its obvious role as an anatomical landmark demarcator, its patho-anatomic nature has been identified as the source of rotator cuff pathology. Although many studies have attempted to evaluate the vascularity of this region, the architecture regarding the exact length, width and shape of the critical zone, remains unreported. This study aimed to determine the shape and morphometry of the “critical zone” arthroscopically.

Materials and methods: The sample series, which was comprised of 38 cases (n = 38) specific to pathological types, employed an anatomical investigation of the critical zone during routine real-time arthroscopy. Demographic representation: i) sex: 19 males, 19 females; ii) age range: 18–76 years; iii) race: white (n = 29), Indian (n = 7) and coloured (n = 2).

Results: The incidence of shape and the mean lengths and widths of the critical zone were determined in accordance with the relevant demographic factors and patient history. Although the cresenteric shape was predominant, hemispheric and sail-shaped critical zones were also identified. The lengths and widths of the critical zone appeared markedly increased in male individuals. While the increase in age may account for the increased incidence of rotator cuff degeneration due to poor end-vascular supply, the additional factors of height and weight presented as major determinants of the increase in size of the critical zone.

Conclusions: In addition, the comparisons of length and width with each other and shape yielded levels of significant difference, therefore indicating a directly proportional relationship between the length and width of the critical zone. This detailed understanding of the critical zone may prove beneficial for the success of post-operative rotator cuff healing.

Get Citation

Keywords

critical zone, shape, length, width

About this article
Title

An arthroscopic evaluation of the anatomical “critical zone”

Journal

Folia Morphologica

Issue

Vol 76, No 2 (2017)

Pages

277-283

Published online

2016-08-29

DOI

10.5603/FM.a2016.0049

Pubmed

27665956

Bibliographic record

Folia Morphol 2017;76(2):277-283.

Keywords

critical zone
shape
length
width

Authors

N. Naidoo
L. Lazarus
S. A. Osman
K. S. Satyapal

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