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Postoperative Findings After Rotator Cuff Surgery
Julia R. Crim, MD
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Rotator cuff repair
            • Distal tendon tears are reattached to humeral head, more proximal tears are sutured end to end
            • Usually performed arthroscopically, rarely open
              • Arthroscopic surgery reattaches with sutures and metal or bioabsorbable suture anchors
              • Open procedure splits deltoid for access and tends to cause atrophy
            • If tear large, tendon attachment is often medialized on humeral head
            • Humeral head recontoured medial to footprint for attachment of tendon
              • Trough can mimic Hill-Sachs deformity
            • Semisynthetic grafts may be used to cover large defect ("graft jacket")
          • Acromioplasty: Resection of inferior bony prominence of acromion
            • Performed for treatment of rotator cuff impingement
          • Mumford procedure: Resection of distal clavicle
            • Performed for treatment of rotator cuff impingement
            • < 1 cm should be removed to preserve coracoclavicular ligaments
          • Biceps tenotomy/tenodesis
            • Performed for tendinopathy or tear of long head biceps
            • Tenotomy: Tendon cut, allowed to retract distally
            • Tenodesis: Tendon cut, reattached to biceps groove
            • May be placed either at top of groove or on humeral shaft deep to pectoralis major

        IMAGING

        • General Features

          • Imaging Recommendations

            PATHOLOGY

            • General Features

              CLINICAL ISSUES

              • Natural History & Prognosis

                Selected References

                1. Park YB et al: Reversibility of supraspinatus muscle atrophy in tendon-bone healing after arthroscopic rotator cuff repair. Am J Sports Med. 44(4):981-8, 2016
                2. Pierce JL et al: Postoperative shoulder imaging: rotator cuff, labrum, and biceps tendon. Radiographics. 36(6):1648-1671, 2016
                3. Crim J et al: Temporal evolution of MRI findings after arthroscopic rotator cuff repair. AJR Am J Roentgenol. 195(6):1361-6, 2010
                4. Sanders TG et al: Chondrolysis of the glenohumeral joint after arthroscopy: findings on radiography and low-field-strength MRI. AJR Am J Roentgenol. 188(4):1094-8, 2007
                5. Duc SR et al: Diagnostic performance of MR arthrography after rotator cuff repair. AJR Am J Roentgenol. 186(1):237-41, 2006
                Related Anatomy
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                References
                Tables

                Tables

                KEY FACTS

                • Imaging

                  • Pathology

                    • Clinical Issues

                      TERMINOLOGY

                      • Definitions

                        • Rotator cuff repair
                          • Distal tendon tears are reattached to humeral head, more proximal tears are sutured end to end
                          • Usually performed arthroscopically, rarely open
                            • Arthroscopic surgery reattaches with sutures and metal or bioabsorbable suture anchors
                            • Open procedure splits deltoid for access and tends to cause atrophy
                          • If tear large, tendon attachment is often medialized on humeral head
                          • Humeral head recontoured medial to footprint for attachment of tendon
                            • Trough can mimic Hill-Sachs deformity
                          • Semisynthetic grafts may be used to cover large defect ("graft jacket")
                        • Acromioplasty: Resection of inferior bony prominence of acromion
                          • Performed for treatment of rotator cuff impingement
                        • Mumford procedure: Resection of distal clavicle
                          • Performed for treatment of rotator cuff impingement
                          • < 1 cm should be removed to preserve coracoclavicular ligaments
                        • Biceps tenotomy/tenodesis
                          • Performed for tendinopathy or tear of long head biceps
                          • Tenotomy: Tendon cut, allowed to retract distally
                          • Tenodesis: Tendon cut, reattached to biceps groove
                          • May be placed either at top of groove or on humeral shaft deep to pectoralis major

                      IMAGING

                      • General Features

                        • Imaging Recommendations

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Natural History & Prognosis

                              Selected References

                              1. Park YB et al: Reversibility of supraspinatus muscle atrophy in tendon-bone healing after arthroscopic rotator cuff repair. Am J Sports Med. 44(4):981-8, 2016
                              2. Pierce JL et al: Postoperative shoulder imaging: rotator cuff, labrum, and biceps tendon. Radiographics. 36(6):1648-1671, 2016
                              3. Crim J et al: Temporal evolution of MRI findings after arthroscopic rotator cuff repair. AJR Am J Roentgenol. 195(6):1361-6, 2010
                              4. Sanders TG et al: Chondrolysis of the glenohumeral joint after arthroscopy: findings on radiography and low-field-strength MRI. AJR Am J Roentgenol. 188(4):1094-8, 2007
                              5. Duc SR et al: Diagnostic performance of MR arthrography after rotator cuff repair. AJR Am J Roentgenol. 186(1):237-41, 2006