Magnetic Resonance Imaging Identification of Rotator Cuff Retears After Repair

Khazzam, Michael; Kuhn, John E.; Mulligan, Edward P.; Abboud, Joseph A.; Baumgarten, Keith M.; Brophy, Robert H.; Jones, Grant L.; Miller, Bruce S.; Smith, Matthew V.; Wright, Rick W.

doi:10.1177/0363546512449424

Cited by 82 publications

(116 citation statements)

References 39 publications

(23 reference statements)

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“…First, because both sides of the infraspinatus tendon are covered by the patellar tendon, this telescoping structure guarantees contact between the 2 tendon tissues, provided that the relative displacement does not exceed the length of patellar tendon (Figure 5). This setup may be able to diminish potential gap formation in the healing process from infraspinatus tendon retraction, which contributes to postoperative failure with current repair methods 29; 30 . Second, the higher stiffness at the TFBC–greater tuberosity repair site (i.e., the shorter displacement compared with the traditional repair) provides a more secure environment for tissue healing.…”

Section: Discussionmentioning

confidence: 99%

Rotator cuff repair with a tendon–fibrocartilage–bone composite bridging patch

Chen

Thoreson

et al. 2015

Clinical Biomechanics

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Background To compare the mechanical performance of a rotator cuff repaired with a novel tendon-fibrocartilage-bone composite bridging patch vs the traditional Mason-Allen repair in an in vitro canine model. Methods Twenty shoulders and 10 bridging patches from patellar tendon were harvested. The patches were trimmed and sliced into 2 layers. An infraspinatus tendon tear was created in each shoulder. Modified Mason-Allen sutures were used to repair the infraspinatus tendon to the greater tuberosity, with or without the bridging patch (bridging patch group and controls, respectively). Shoulders were loaded to failure under displacement control at a rate of 0.5mm/sec. Findings The ultimate tensile load was significantly higher in the bridging patch group than control (mean [SD], 365.46 [36.45] vs 272.79 [48.88] N; P<.001). Stiffness at the greater tuberosity repair site and the patch-infraspinatus tendon repair site was significantly higher than the control repair site (93.96 [27.72] vs 42.62 [17.48] N/mm P<.001; 65.94 [24.51] vs 42.62 [17.48] N/mm P=.02, respectively). Interpretation The tendon-fibrocartilage-bone composite bridging patch achieved higher ultimate tensile load and stiffness at the patch–greater tuberosity repair site compared with traditional repair in a canine model. This composite tissue transforms the traditional tendon-to-bone healing interface (with dissimilar tissues) into a pair of bone-to-bone and tendon-to-tendon interfaces, which may improve healing quality and reduce retear rate.

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Section: Discussionmentioning

confidence: 99%

Rotator cuff repair with a tendon–fibrocartilage–bone composite bridging patch

Chen

Thoreson

et al. 2015

Clinical Biomechanics

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“…It is known that, in the preoperative setting, MRI (sensitivity, 92.1%, and specificity, 92.9%) and ultrasound (sensitivity, 92.3%, and specificity, 94.4%) are relatively equivalent, with MR arthrogram (sensitivity, 95.4%, and specificity, 98.9%) demonstrating better sensitivity and specificity at detecting full-thickness rotator cuff tears 51 . Khazzam et al 52 examined interobserver and intraobserver reliability of MRI following rotator cuff repair and found only moderate agreement. In a recent study, Park et al 53 demonstrated that ultrasound showed excellent reliability following rotator cuff repair.…”

Section: Clinical Outcome Scoresmentioning

confidence: 99%

Structural Integrity After Rotator Cuff Repair Does Not Correlate with Patient Function and Pain

Russell

Knight

Mulligan

et al. 2014

Journal of Bone and Joint Surgery

167

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“…One image cannot fully capture morphological changes in other areas of the muscle, 14 but little work has focused on the acquisition of three-dimensional measurements of muscle morphology to evaluate whether a single image is indicative of three-dimensional muscle information. Further, the Goutallier score does not have high reliability, 15–18 suggesting that more objective methods should be used. 15,16 …”

Section: Introductionmentioning

confidence: 99%

Assessments of Fatty Infiltration and Muscle Atrophy From a Single Magnetic Resonance Image Slice Are Not Predictive of 3-Dimensional Measurements

Vidt

Santago

Tuohy

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose The purpose was to 1) determine whether standard clinical muscle fatty infiltration and atrophy assessment techniques using a single image slice for patients with a rotator cuff tear (RCT) are correlated with three-dimensional measures in older individuals (60+ years), and 2) determine whether age-associated changes to muscle morphology and strength are compounded by a RCT. Methods Twenty older subjects were studied, 10 with a RCT of the supraspinatus (5M/5F) and 10 matched controls. Clinical imaging assessments (Goutallier, Fuchs scores; cross-sectional area ratio) were made for RCT subjects. Three-dimensional measurements of rotator cuff muscle and fat tissues were made for all subjects using MRI. Isometric joint moment was measured at the shoulder. Results There were no significant associations between single-image assessments and three-dimensional measurements of fatty infiltration for supraspinatus and infraspinatus. Compared to controls, RCT subjects had significantly increased fatty infiltration percentages for each rotator cuff muscle (all p≤0.023), reduced whole muscle volume for supraspinatus, infraspinatus, and subscapularis (all p≤0.038), and reduced fat-free muscle volume for supraspinatus, infraspinatus, and subscapularis (all p≤0.027). Only teres minor (p=0.017) fatty infiltration volume was significantly greater for RCT subjects. Adduction, flexion, and external rotation strength (all p≤0.021) were significantly reduced for RCT subjects, and muscle volume was a significant predictor of strength for all comparisons. Conclusions Clinical scores using a single image slice do not represent three-dimensional muscle measurements. Efficient methods are needed to more effectively capture three-dimensional information for clinical applications. RCT subjects had increased fatty infiltration percentages likely driven by muscle atrophy rather than increased fat volume. Muscle volume’s significant association with strength production suggests that treatments to preserve muscle volume should be pursued for older RCT patients. Level of Evidence Level II, diagnostic study, with development of diagnostic criteria on the basis of consecutive patients with universally applied reference “gold” standard.

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Magnetic Resonance Imaging Identification of Rotator Cuff Retears After Repair

Cited by 82 publications

References 39 publications

Rotator cuff repair with a tendon–fibrocartilage–bone composite bridging patch

Rotator cuff repair with a tendon–fibrocartilage–bone composite bridging patch

Structural Integrity After Rotator Cuff Repair Does Not Correlate with Patient Function and Pain

Assessments of Fatty Infiltration and Muscle Atrophy From a Single Magnetic Resonance Image Slice Are Not Predictive of 3-Dimensional Measurements

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