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http://dx.doi.org/10.3348/kjr.2015.16.2.363

Repaired Supraspinatus Tendons in Clinically Improving Patients: Early Postoperative Findings and Interval Changes on MRI  

Lee, Jung Eun (Department of Radiology, Kyung Hee University Hospital)
Park, Ji Seon (Department of Radiology, Kyung Hee University Hospital)
Ryu, Kyung Nam (Department of Radiology, Kyung Hee University Hospital)
Rhee, Yong Girl (Department of Orthopaedic Surgery, Kyung Hee University Hospital)
Yoon, So Hee (Department of Radiology, Kyung Hee University Hospital at Gangdong)
Park, So Young (Department of Radiology, Kyung Hee University Hospital at Gangdong)
Jin, Wook (Department of Radiology, Kyung Hee University Hospital at Gangdong)
Publication Information
Korean Journal of Radiology / v.16, no.2, 2015 , pp. 363-371 More about this Journal
Abstract
Objective: To demonstrate and further determine the incidences of repaired supraspinatus tendons on early postoperative magnetic resonance imaging (MRI) findings in clinically improving patients and to evaluate interval changes on follow-up MRIs. Materials and Methods: Fifty patients, who showed symptomatic and functional improvements after supraspinatus tendon repair surgery and who underwent postoperative MRI twice with a time interval, were included. The first and the second postoperative MRIs were obtained a mean of 4.4 and 11.5 months after surgery, respectively. The signal intensity (SI) patterns of the repaired tendon on T2-weighted images from the first MRI were classified into three types of heterogeneous high SI with fluid-like bright high foci (type I), heterogeneous high SI without fluid-like bright high foci (type II), and heterogeneous or homogeneous low SI (type III). Interval changes in the SI pattern, tendon thickness, and rotator cuff interval thickness between the two postoperative MRIs were evaluated. Results: The SI patterns on the first MRI were type I or II in 45 tendons (90%) and type III in five (10%). SI decreased significantly on the second MRI (p < 0.050). The mean thickness of repaired tendons and rotator cuff intervals also decreased significantly (p < 0.050). Conclusion: Repaired supraspinatus tendons exhibited high SI in 90% of clinically improving patients on MRI performed during the early postsurgical period. The increased SI and thickness of the repaired tendon decreased on the later MRI, suggesting a gradual healing process rather than a retear.
Keywords
Supraspinatus; Postoperative; MRI; Healing; Retear;
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1 Mohana-Borges AV, Chung CB, Resnick D. MR imaging and MR arthrography of the postoperative shoulder: spectrum of normal and abnormal findings. Radiographics 2004;24:69-85   DOI
2 Zlatkin MB. MRI of the postoperative shoulder. Skeletal Radiol 2002;31:63-80   DOI
3 Fealy S, Adler RS, Drakos MC, Kelly AM, Allen AA, Cordasco FA, et al. Patterns of vascular and anatomical response after rotator cuff repair. Am J Sports Med 2006;34:120-127   DOI
4 Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. Endresult study of factors influencing reconstruction. J Bone Joint Surg Am 1986;68:1136-1144   DOI
5 Owen RS, Iannotti JP, Kneeland JB, Dalinka MK, Deren JA, Oleaga L. Shoulder after surgery: MR imaging with surgical validation. Radiology 1993;186:443-447   DOI
6 Thomazeau H, Boukobza E, Morcet N, Chaperon J, Langlais F. Prediction of rotator cuff repair results by magnetic resonance imaging. Clin Orthop Relat Res 1997;(344):275-283
7 Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy 2009;25:30-39   DOI
8 Gaenslen ES, Satterlee CC, Hinson GW. Magnetic resonance imaging for evaluation of failed repairs of the rotator cuff. Relationship to operative findings. J Bone Joint Surg Am 1996;78:1391-1396   DOI
9 Bryant L, Shnier R, Bryant C, Murrell GA. A comparison of clinical estimation, ultrasonography, magnetic resonance imaging, and arthroscopy in determining the size of rotator cuff tears. J Shoulder Elbow Surg 2002;11:219-224   DOI
10 Schaefer O, Winterer J, Lohrmann C, Laubenberger J, Reichelt A, Langer M. Magnetic resonance imaging for supraspinatus muscle atrophy after cuff repair. Clin Orthop Relat Res 2002;(403):93-99
11 Torstensen ET, Hollinshead RM. Comparison of magnetic resonance imaging and arthroscopy in the evaluation of shoulder pathology. J Shoulder Elbow Surg 1999;8:42-45   DOI
12 Magee TH, Gaenslen ES, Seitz R, Hinson GA, Wetzel LH. MR imaging of the shoulder after surgery. AJR Am J Roentgenol 1997;168:925-928   DOI
13 Lafosse L, Brozska R, Toussaint B, Gobezie R. The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg Am 2007;89:1533-1541   DOI
14 Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 2005;87:1229-1240   DOI
15 Charousset C, Duranthon LD, Grimberg J, Bellaiche L. [Arthro- C-scan analysis of rotator cuff tears healing after arthroscopic repair: analysis of predictive factors in a consecutive series of 167 arthroscopic repairs]. Rev Chir Orthop Reparatrice Appar Mot 2006;92:223-233   DOI
16 Huijsmans PE, Pritchard MP, Berghs BM, van Rooyen KS, Wallace AL, de Beer JF. Arthroscopic rotator cuff repair with double-row fixation. J Bone Joint Surg Am 2007;89:1248-1257   DOI
17 Mellado JM, Calmet J, Olona M, Ballabriga J, Camins A, Perez del Palomar L, et al. MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture. Eur Radiol 2006;16:2186-2196   DOI
18 Klepps S, Bishop J, Lin J, Cahlon O, Strauss A, Hayes P, et al. Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med 2004;32:1716-1722   DOI
19 Spielmann AL, Forster BB, Kokan P, Hawkins RH, Janzen DL. Shoulder after rotator cuff repair: MR imaging findings in asymptomatic individuals--initial experience. Radiology 1999;213:705-708   DOI
20 Rand T, Freilinger W, Breitenseher M, Trattnig S, Garcia M, Landsiedl F, et al. Magnetic resonance arthrography (MRA) in the postoperative shoulder. Magn Reson Imaging 1999;17:843-850   DOI
21 Farley TE, Neumann CH, Steinbach LS, Jahnke AJ, Petersen SS. Full-thickness tears of the rotator cuff of the shoulder: diagnosis with MR imaging. AJR Am J Roentgenol 1992;158:347-351   DOI
22 Rand T, Trattnig S, Breitenseher M, Freilinger W, Cochole M, Imhof H. [MR arthrography of the shoulder joint in a postoperative patient sample]. Radiologe 1996;36:966-970   DOI
23 Jost B, Zumstein M, Pfirrmann CW, Gerber C. Long-term outcome after structural failure of rotator cuff repairs. J Bone Joint Surg Am 2006;88:472-479   DOI
24 Rafii M, Firooznia H, Golimbu C, Weinreb J. Magnetic resonance imaging of glenohumeral instability. Magn Reson Imaging Clin N Am 1993;1:87-104
25 Needell SD, Zlatkin MB, Sher JS, Murphy BJ, Uribe JW. MR imaging of the rotator cuff: peritendinous and bone abnormalities in an asymptomatic population. AJR Am J Roentgenol 1996;166:863-867   DOI
26 Harryman DT 2nd, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA 3rd. Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am 1991;73:982-989   DOI
27 Fujikawa A, Kyoto Y, Kawaguchi M, Naoi Y, Ukegawa Y. Achilles tendon after percutaneous surgical repair: serial MRI observation of uncomplicated healing. AJR Am J Roentgenol 2007;189:1169-1174   DOI
28 Crim J, Burks R, Manaster BJ, Hanrahan C, Hung M, Greis P. Temporal evolution of MRI findings after arthroscopic rotator cuff repair. AJR Am J Roentgenol 2010;195:1361-1366   DOI
29 Motamedi AR, Urrea LH, Hancock RE, Hawkins RJ, Ho C. Accuracy of magnetic resonance imaging in determining the presence and size of recurrent rotator cuff tears. J Shoulder Elbow Surg 2002;11:6-10   DOI
30 Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am 2007;89:953-960   DOI