{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:19:32Z","timestamp":1792034372775,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>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\u2010traumatic recurrent shoulder instability, to detect increased inflammatory activity that might be present inside the humeroscapular joint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010\u03b1, IL\u20106, CD\u20103 and CD\u201072. 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The subacromial impingement syndrome group comprised eight patients, median age 53 (45\u201374) years, while the instability group 12, median age 27 (22\u201348) years (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001). The amount of IL\u20106 and TNF\u2010\u03b1 was significantly higher in the subscapularis tendon of the patients with subacromial impingement syndrome compared with instability patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.0015 and <jats:italic>p<\/jats:italic>\u2009=\u20090.0008 respectively). In the capsular samples, significantly higher amount of TNF\u2010\u03b1 and CD\u201072 was found in patients with subacromial impingement syndrome compared with instability patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001 for both). On the other hand, the amount of CD\u20103 was significantly higher in the instability group (<jats:italic>p<\/jats:italic>\u2009=\u20090.0013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical relevance<\/jats:title><jats:p>To develop a treatment targeted towards intra\u2010articular inflammatory cytokines appears appealing.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-05992-9","type":"journal-article","created":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T09:04:01Z","timestamp":1588237441000},"page":"2228-2236","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Increased levels of inflammatory markers in the subscapularis tendon and joint capsule in patients with subacromial impingement"],"prefix":"10.1002","volume":"29","author":[{"given":"Stefanos","family":"Farfaras","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Research and Development NU\u2010Hospital Group Trollh\u00e4ttan\/Uddevalla 451 80 Uddevalla Sweden"},{"name":"<!--<label>4<\/label>--> Department of Orthopedics, Institute of Clinical Science Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyla","family":"Roshani","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Research and Development NU\u2010Hospital Group Trollh\u00e4ttan\/Uddevalla 451 80 Uddevalla Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Mulder","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Neurosciences, Science for Life Laboratory Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Mitsios","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Neurosciences, Science for Life Laboratory Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erling K.","family":"Hallstr\u00f6m","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of 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