Shoulder after Rotator Cuff Repair: MR Imaging Findings in Asymptomatic Individuals—Initial Experience

Spielmann, Audrey L.; Forster, Bruce B.; Kokan, Peter; Hawkins, Robert H.; Janzen, D L

doi:10.1148/radiology.213.3.r99dc09705

Cited by 111 publications

(74 citation statements)

References 21 publications

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“…We found comparable re-tear rates in the two groups. One reason for this can be that MRI over-estimates cuff defects [8]: we ignored many signal intensity alterations frequently seen after repair [20], considering a re-tear only when the tendon was missing and could not be visualised [21]. In line with previous studies [22], these patients were not symptomatic and had returned to their daily activity.…”

Section: Discussionmentioning

confidence: 99%

Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial

Franceschi

Papalia

Buono

et al. 2013

International Orthopaedics (SICOT)

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Purpose To compare two groups of patients who underwent two different arthroscopic procedures for repair of articularsided partial-thickness rotator cuff tears (PTRCTs). Materials this is a comparative prospective study of two methods for repair of partial cuff tears Thirty-two patients underwent arthroscopic rotator cuff repair with a transtendon technique (group 1); 28 underwent arthroscopic full-thickness conversion and repair of the lesion (group 2). ROM measures, clinical findings, MRI features (tendon healing and re-tear), Constant-Murley and ASES scores were assessed pre-and postoperatively and compared. Patients were also asked about return to sport and level of activity. Results At the last appointment, patients of both the groups were significantly improved for clinical findings, ROM measures, imaging features, Constant-Murley and ASES scores than at baseline, without any significant inter-group difference. In group 1, 15 of 20 patients (75 %) who practiced recreational sport activities had returned to sport at the same level as before the onset of symptoms, without any discomfort. In group 2, 12 of 18 patients (67 %) had returned to the same level of sport activity they practiced before symptoms. At the last follow up, MRI showed rotator cuff healing in 31 patients of Group 1 and 27 patients of Group 2 (p=0.83). Conclusions The two procedures are safe, effective, and comparable.

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Section: Discussionmentioning

confidence: 99%

Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial

Franceschi

Papalia

Buono

et al. 2013

International Orthopaedics (SICOT)

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“…71,72 Tendon degeneration, or tendinosis, can lead to matrix disorganization, mucoid degeneration, and fatty infiltration. [73][74][75][76] The hypovascular and bFGF, basic fibroblast growth factor; ACL, anterior cruciate ligament; MCL, medial collateral ligament; PT, patellar tendon; GDF, growth and differentiation factor; IGF, insulin-like growth factor; MSC, mesenchymal stem cell; TGFb, transforming growth factor b; PDGF, plateletderived growth factor; VEGF, vascular endothelial growth factor; SDF-1, stromal cell-derived factor-1. hypocellular nature of tendons combined with added complications from degeneration over time complicates the treatment choices.…”

Section: Tendon Injury and Repairmentioning

confidence: 99%

What We Should Know Before Using Tissue Engineering Techniques to Repair Injured Tendons: A Developmental Biology Perspective

Liu

Aschbacher-Smith

Barthelery

et al. 2011

Tissue Engineering Part B: Reviews

141

129

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“…18 Bone marrow oedema-like signals might also be observed in the humeral head, sometimes from artefacts (secondary to a failure of fat suppression) or as a result of residual cystic changes in the greater tuberosity. 19 Third, in the acromion, decreased signal intensity on both short echo-time (T 1 or intermediate weighted) and long echo-time (T 2 weighted) images represents fibrosis in the acromial marrow. 1 An important cause of poor outcome after rotator cuff surgery is the failure to recognize pathology in other areas around the cuff, such as the acromioclavicular joint, which may be the aetiology of new postoperative symptoms.…”

Section: Expected Post-operative Findings Osseous Findingsmentioning

confidence: 99%

“…19 For the distinction of the latter entities, techniques to separate T 2 signal intensities might prove useful, but they have not been studied as yet in the post-operative shoulder. On fluid-sensitive sequences, frank fluid signal intensity within the post-operative rotator cuff tendons can be an asymptomatic finding:…”

Section: Soft-tissue Findingsmentioning

confidence: 99%

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

Thakkar¹,

Thakkar²,

Srikumaran³

et al. 2014

BJR

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When pain or disability occurs after rotator cuff surgery, post-operative imaging is frequently performed. Post-operative complications and expected post-operative imaging findings in the shoulder are presented, with a focus on MRI, MR arthrography (MRA) and CT arthrography. MR and CT techniques are available to reduce image degradation secondary to surgical distortions of native anatomy and implant-related artefacts and to define complications after rotator cuff surgery. A useful approach to image the shoulder after surgery is the standard radiography, followed by MRI/MRA for patients with low "metal presence" and CT for patients who have a higher metal presence. However, for the assessment of patients who have undergone surgery for rotator cuff injuries, imaging findings should always be correlated with the clinical presentation because post-operative imaging abnormalities do not necessarily correlate with symptoms.The complexity of the anatomy and function of the rotator cuff makes the rotator cuff tendons vulnerable to considerable morbidity, often necessitating surgical intervention. Optimal management of rotator cuff abnormalities depends on a variety of factors, such as the presence and severity of an impingement, the degree of tendon damage and individual functional demands.1 The goals of rotator cuff surgery are to reduce pain, while simultaneously improving the function. The latter is accomplished by two main types of surgical procedures: (1) subacromial decompression surgery alone, typically with an acromioplasty and/or Mumford procedure (distal clavicular resection); and (2) repair of the rotator cuff tear (open or arthroscopic), which is almost always accompanied by a subacromial decompression.Post-operative imaging is performed when pain or disability occurs after a surgical procedure. Often, however, postoperative imaging is degraded by surgical distortions of the native anatomy and metallic artefacts related to implants. Nevertheless, it is imperative that clinicians have an accurate anatomical delineation of the operative site. It is also important for the radiologist to accurately diagnose complications that might occur after rotator cuff surgery to guide optimal treatment. Mansat et al 2 examined 40 articles reporting the results of open rotator cuff repairs and determined that the overall mean complication rate was 10.5%.The article addresses complications that occur after rotator cuff surgery and expected post-operative imaging findings, with a focus on MRI, MR arthrography (MRA) and CT arthrography (CTA). Because not all post-operative imaging findings result in disability or pain for the patient, we also emphasize our approach and experience regarding how best to define imaging abnormalities after rotator cuff surgery. IMAGING APPROACHA protocol for the imaging of the post-operative shoulder always begins with radiography of the shoulder. The purpose of the radiograph is not only to detect obvious osseous complications, but also to identify the type of surgical procedure performed ...

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Shoulder after Rotator Cuff Repair: MR Imaging Findings in Asymptomatic Individuals—Initial Experience

Cited by 111 publications

References 21 publications

Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial

Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial

What We Should Know Before Using Tissue Engineering Techniques to Repair Injured Tendons: A Developmental Biology Perspective

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

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