Serial clinical and MRI examinations after arthroscopic rotator cuff reconstruction using double-row technique

Pfalzer, Florian; Huth, Jochen; Stürmer, E.; Endele, D.; Kniesel, B.; Mauch, Frieder

doi:10.1007/s00167-017-4437-6

Cited by 16 publications

(28 citation statements)

References 31 publications

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“…We speculated that a possible explanation might be the effect of decreased inflammation 24 (less water concentration) and tendon loading during the postoperative period after rehabilitation or daily activities. 47 These results are consistent with the findings of Pfalzer et al 37 and Malavolta et al 33 They demonstrated that it took 6 months until the repaired tendon showed normal signals, although their studies did not use quantitative MRI method.…”

Section: Discussionsupporting

confidence: 86%

“…The region of interest was manually drawn according to a method published previously. 37 Specifically, the region of interest was located directly over the medial-row anchor on the coronal-oblique UTE-T2* images (Figure 1). All segmentations on UTE-T2* images were performed by a musculoskeletal radiologist (Y.X.)…”

Section: Methodsmentioning

confidence: 99%

“…Current information obtained from conventional MRI sequences of repaired tendon has been based on the semiquantitative Sugaya classification. 33,37 However, sensitivity and specificity of this semiquantitative method still vary. 26 In addition, given that conventional MRI sequences produce little or no detectable signal for the tendon, changes in subsurface tendon prosperities are difficult to identify.…”

mentioning

confidence: 99%

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Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Tendon Healing After Arthroscopic Rotator Cuff Repair: A Longitudinal Study

Xie

Liu

et al. 2020

Am J Sports Med

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Background: Quantitative ultrashort echo time–T2* (UTE-T2*) mapping shows promise for the detection of potential tendon biochemical conditions, while validation against established clinical studies in the shoulder is needed. Purpose: To evaluate and characterize the healing process of the repaired rotator cuff based on longitudinal changes in UTE-T2* values, clinical outcomes, and repair status in patients after arthroscopic rotator cuff repair (ARCR). Study Design: Cohort study; Level of evidence, 2. Methods: Patients with ARCR (n = 25) underwent quantitative MRI and clinical examinations at serial follow-up time points: 3, 6, 12, and 24 months postoperatively. Age-matched healthy controls (n = 15) were evaluated at 3 and 12 months after enrollment. Clinical scores included the Constant, American Shoulder and Elbow Surgeons, and Fudan University Shoulder score, and visual analog scale for pain. The MRI examination included UTE-T2*mapping. UTE-T2* maps were generated for T2* values at the healing site. Sugaya classification was adopted to evaluate the repair status. Longitudinal analyses of clinical outcomes, UTE-T2* changes, and Sugaya classification were conducted. Results: The overall retear rate was 8% (2/25, all Sugaya type IV). All patients (including the ones with retear) achieved satisfactory outcomes at 12 months that lasted to 24 months on the basis of clinical scores. The mean UTE-T2* values at the healing site showed an increase from 3 to 6 months ( P = .03) and then decreased to a level similar to that observed in age-matched healthy tendons at 12 months ( P = .1). No significant differences were found between UTE-T2* values at 12 and 24 months ( P = .6). UTE-T2* values at the healing site significantly varied with the repair status according to Sugaya classification ( P < .05). Moreover, significant correlations were noted between clinical scores and UTE-T2* values at 6 months ( r = −0.6 to −0.3; all P < .05) and 12 months ( r = −0.6 to −0.2; all P < .05). Conclusion: This study indicated a healing-related relationship between clinical outcomes and quantitative UTE-T2* values, which highlights the potential of using UTE-T2* mapping to track the tendon-healing process noninvasively. Moreover, the repaired tendon was comparable to age-matched healthy controls at 12-month follow-up based on UTE-T2* values.

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Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Tendon Healing After Arthroscopic Rotator Cuff Repair: A Longitudinal Study

Xie

Liu

et al. 2020

Am J Sports Med

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“…The slice in which the anchor was fully imaged was selected for all measurements. 41 To quantify the normalized SI of the tendon, the SNQ was calculated with the following equation: SNQ = SI of tendon / signal of background. 27 Therefore, the SNQ of the distal supraspinatus tendon (SNQd) and the SNQ of the proximal supraspinatus tendon (SNQp) were evaluated.…”

Section: Methodsmentioning

confidence: 99%

Tendon Healing Progression Evaluated With Magnetic Resonance Imaging Signal Intensity and Its Correlation With Clinical Outcomes Within 1 Year After Rotator Cuff Repair With the Suture-Bridge Technique

et al. 2020

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Background: After a rotator cuff (RC) is repaired, its signal intensity (SI) on magnetic resonance imaging (MRI) gradually changes to normal and could reflect the degree of RC healing. Nevertheless, it remains unclear how long it takes for SI to recover to normal and whether the SI progression correlates with clinical outcomes after RC repair (RCR). Purpose: To serially evaluate the SIs of the repaired RC tendon on MRI and the postoperative clinical outcomes and then analyze the correlation between them. Study Design: Case series; Level of evidence, 4. Methods: This study prospectively included 25 patients who underwent arthroscopic RCR with the suture-bridge technique between June 2016 and July 2017. Twenty-three patients accepted full follow-ups at 1, 3, 6, 9, and 12 months. Before surgery and at each follow-up, visual analog scale (VAS) for pain and 4 functional scores were evaluated: Constant-Murley score, American Shoulder and Elbow Surgeons shoulder evaluation form, modified University of California at Los Angeles score, and Fudan University shoulder score. The patients underwent MRI examinations at every follow-up. The values of the signal/noise quotient at the distal (SNQd) and proximal (SNQp) areas were calculated to evaluate the SI of the repaired tendon. The correlations of clinical outcomes with SNQd and SNQp values were analyzed, and subgroup analyses were performed. Results: Overall, the mean postoperative VAS score significantly decreased at postoperative 1 month ( P < .001), and the functional scores were all significantly higher than the preoperative values at 6 months (all P < .001). SNQd and SNQp values were both significantly higher than normal at 1 and 3 months (all P < .001) and reduced to normal after 9 and 6 months, respectively. Correlation analyses showed that the SNQp value significantly correlated with VAS score (positive) and all functional scores (negative) at 1 and 3 months postoperatively. Further comparison indicated that the patients with VAS score >3 had higher SNQp values than patients with VAS score ≤3 at 1 and 3 months postoperatively (both P = .01). Conclusion: After RCR with the suture-bridge technique, it took longer for SI to become relatively normal than it did to have a significant clinical improvement. Early after surgery (1-3 months), worse clinical outcome correlated with higher SI on proximal cuff tendon.

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“…Compared to intramedullary nailing in MIPO, MIPO rarely causes postoperative knee pain and is gradually accepted by more and more orthopaedic surgeons. Therefore, it is believed that the reconstruction of the rotator cuff function by non-absorbable suture technique has certain clinical significance [12][13][14][15] . The purpose of this study was to compare the clinical and radiographic outcomes of auxiliary tension suture fixation to MIPO in PHF.…”

mentioning

confidence: 99%

Comparison of Radiographic and Clinical Results between MIPO Internal Fixation and Auxiliary Tension Suture Fixation for Proximal Humeral Fractures

Yu¹,

Zhang²,

Xu³

et al. 2020

pharmaceutical-sciences

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The aim of this study was to evaluate the efficacy of auxiliary tension suture fixation and minimally invasive percutaneous osteosynthesis internal fixation on proximal humeral fractures in patients. From May 2012 to May 2017, 66 patients with proximal humeral fractures were enrolled in the Affiliated Suzhou Hospital of Nanjing Medical University. A prospective follow-up cohort study was conducted on 47 patients with proximal humeral fractures, including 11 males and 36 females, average age 64.6 y, range This article was originally published in a special issue, "Biomedical applications in Pharmaceutical Sciences" Indian J Pharm Sci 2020:82(2)Spl issue3;109-114 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms

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Serial clinical and MRI examinations after arthroscopic rotator cuff reconstruction using double-row technique

Abstract: I.

Cited by 16 publications

References 31 publications

Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Tendon Healing After Arthroscopic Rotator Cuff Repair: A Longitudinal Study

Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Tendon Healing After Arthroscopic Rotator Cuff Repair: A Longitudinal Study

Tendon Healing Progression Evaluated With Magnetic Resonance Imaging Signal Intensity and Its Correlation With Clinical Outcomes Within 1 Year After Rotator Cuff Repair With the Suture-Bridge Technique

Comparison of Radiographic and Clinical Results between MIPO Internal Fixation and Auxiliary Tension Suture Fixation for Proximal Humeral Fractures

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