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Archives of Orthopaedic and Trauma Surgery

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01-05-2016 | Arthroscopy and Sports Medicine

Serial MRI evaluation following arthroscopic rotator cuff repair in double-row technique

Authors: Katharina Stahnke, Constanze Nikulka, Gerd Diederichs, Hendrik Haneveld, Markus Scheibel, Christian Gerhardt

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2016

Abstract

Introduction

So far, recurrent rotator cuff defects are described to occur in the early postoperative period after arthroscopic repair. The aim of this study was to evaluate the musculotendinous structure of the supraspinatus, as well as bone marrow edema or osteolysis after arthroscopic double-row repair. Therefore, magnetic resonance (MR) images were performed at defined intervals up to 2 years postoperatively.

Study design

Case series; Level of evidence, 3.

Materials and methods

MR imaging was performed within 7 days, 3, 6, 12, 26, 52 and 108 weeks after surgery. All patients were operated using an arthroscopic modified suture bridge technique. Tendon integrity, tendon retraction [“foot-print-coverage” (FPC)], muscular atrophy and fatty infiltration (signal intensity analysis) were measured at all time points. Furthermore, postoperative bone marrow edema and signs of osteolysis were assessed.

Results

MR images of 13 non-consecutive patients (6f/7m, ∅ age 61.05 ± 7.7 years) could be evaluated at all time points until ∅ 108 weeks postoperatively. 5/6 patients with recurrent defect at final follow-up displayed a time of failure between 12 and 24 months after surgery. Predominant mode of failure was medial cuff failures in 4/6 cases. The initial FPC increased significantly up to 2 years follow-up (p = 0.004). Evaluations of muscular atrophy or fatty infiltration were not significant different comparing the results of all time points (p > 0.05). Postoperative bone marrow edema disappeared completely at 6 months after surgery, whereas signs of osteolysis appeared at 3 months follow-up and increased to final follow-up.

Conclusions

Recurrent defects after arthroscopic reconstruction of supraspinatus tears in modified suture bridge technique seem to occur between 12 and 24 months after surgery. Serial MRI evaluation shows good muscle structure at all time points. Postoperative bone marrow edema disappears completely several months after surgery. Signs of osteolysis seem to appear caused by bio-absorbable anchor implantations.

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Title: Serial MRI evaluation following arthroscopic rotator cuff repair in double-row technique
Authors: Katharina Stahnke
Constanze Nikulka
Gerd Diederichs
Hendrik Haneveld
Markus Scheibel
Christian Gerhardt
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-016-2409-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Serial MRI evaluation following arthroscopic rotator cuff repair in double-row technique

Abstract

Introduction

Study design

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Study design

Materials and methods

Results

Conclusions

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