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Rotator Cuff Postoperative Repair
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Anterior subacromial decompression (ASAD)
            • Full-thickness rotator cuff tear (FTRCT)
            • Acromioclavicular (AC) joint
            • Glenohumeral (GH) joint
            • Subacromial/subdeltoid (SA/SD) bursa
          • Synonyms

            • Cuff debridement used for partial tears
            • Retear = rerupture
          • Definitions

            • Debridement or repair of rotator cuff tear
              • Usually with coracoacromial arch decompression
              • Arthroscopic, miniopen, or open repairs
            • Standard surgical procedures
              • Debridement of shallow partial-thickness tears (< 1/2 to 2/3 thickness of cuff)
              • Repair of full-thickness or deep partial-thickness tears
                • Bone trough (transosseous)
                • Suture anchors
                • Bioabsorbable tacks
              • ASAD (acromioplasty)
              • AC joint resection (Mumford procedure)
              • Coracoacromial ligament resection
            • Postop integrity of cuff does not necessarily equate to lack of symptoms

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Barth J et al: Ultrasonic evaluation of the repair integrity can predict functional outcomes after arthroscopic double-row rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 23(2):376-85, 2015
                                        2. Lee JE et al: Repaired supraspinatus tendons in clinically improving patients: early postoperative findings and interval changes on MRI. Korean J Radiol. 16(2):363-71, 2015
                                        3. Saccomanno MF et al: Magnetic resonance imaging criteria for the assessment of the rotator cuff after repair: a systematic review. Knee Surg Sports Traumatol Arthrosc. 23(2):423-42, 2015
                                        4. Codsi MJ et al: Assessment of rotator cuff repair integrity using ultrasound and magnetic resonance imaging in a multicenter study. J Shoulder Elbow Surg. 23(10):1468-72, 2014
                                        5. Thakkar RS et al: Complications of rotator cuff surgery-the role of post-operative imaging in patient care. Br J Radiol. 87(1039):20130630, 2014
                                        6. Crim J et al: Temporal evolution of MRI findings after arthroscopic rotator cuff repair. AJR Am J Roentgenol. 195(6):1361-6, 2010
                                        7. McMenamin D et al: Imaging of the shoulder after surgery. Eur J Radiol. 68(1):106-19, 2008
                                        8. Liem D et al: Magnetic resonance imaging of arthroscopic supraspinatus tendon repair. J Bone Joint Surg Am. 89(8):1770-6, 2007
                                        9. Potter HG et al: Imaging of the rotator cuff following repair: human and animal models. J Shoulder Elbow Surg. 16(5 Suppl):S134-9, 2007
                                        10. Woertler K: Multimodality imaging of the postoperative shoulder. Eur Radiol. 17(12):3038-55, 2007
                                        11. Duc SR et al: Diagnostic performance of MR arthrography after rotator cuff repair. AJR Am J Roentgenol. 186(1):237-41, 2006
                                        12. Mellado JM et al: MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture. Eur Radiol. 16(10):2186-96, 2006
                                        13. Ruzek KA et al: Postoperative imaging of the shoulder. Radiol Clin North Am. 44(3):331-41, 2006
                                        14. Wu J et al: MRI of the postoperative shoulder. Clin Sports Med. 25(3):445-64, vi, 2006
                                        15. Zanetti M et al: MR imaging of the shoulder after surgery. Radiol Clin North Am. 44(4):537-51, viii, 2006
                                        16. Mellado JM et al: Surgically repaired massive rotator cuff tears: MRI of tendon integrity, muscle fatty degeneration, and muscle atrophy correlated with intraoperative and clinical findings. AJR Am J Roentgenol. 184(5):1456-63, 2005
                                        17. Mohana-Borges AV et al: MR imaging and MR arthrography of the postoperative shoulder: spectrum of normal and abnormal findings. Radiographics. 24(1):69-85, 2004
                                        18. Prickett WD et al: Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively. J Bone Joint Surg Am. 85-A(6):1084-9, 2003
                                        19. Zlatkin MB: MRI of the postoperative shoulder. Skeletal Radiol. 31(2):63-80, 2002
                                        20. Zanetti M et al: MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects. Skeletal Radiol. 29(6):314-9, 2000
                                        21. Rand T et al: The postoperative shoulder. Top Magn Reson Imaging. 10(4):203-13, 1999
                                        22. Spielmann AL et al: Shoulder after rotator cuff repair: MR imaging findings in asymptomatic individuals--initial experience. Radiology. 213(3):705-8, 1999
                                        23. Gusmer PB et al: MR imaging of the shoulder after rotator cuff repair. AJR Am J Roentgenol. 168(2):559-63, 1997
                                        24. Longobardi RS et al: MR imaging of the postoperative shoulder. Magn Reson Imaging Clin N Am. 5(4):841-59, 1997
                                        25. Magee TH et al: MR imaging of the shoulder after surgery. AJR Am J Roentgenol. 168(4):925-8, 1997
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Anterior subacromial decompression (ASAD)
                                                  • Full-thickness rotator cuff tear (FTRCT)
                                                  • Acromioclavicular (AC) joint
                                                  • Glenohumeral (GH) joint
                                                  • Subacromial/subdeltoid (SA/SD) bursa
                                                • Synonyms

                                                  • Cuff debridement used for partial tears
                                                  • Retear = rerupture
                                                • Definitions

                                                  • Debridement or repair of rotator cuff tear
                                                    • Usually with coracoacromial arch decompression
                                                    • Arthroscopic, miniopen, or open repairs
                                                  • Standard surgical procedures
                                                    • Debridement of shallow partial-thickness tears (< 1/2 to 2/3 thickness of cuff)
                                                    • Repair of full-thickness or deep partial-thickness tears
                                                      • Bone trough (transosseous)
                                                      • Suture anchors
                                                      • Bioabsorbable tacks
                                                    • ASAD (acromioplasty)
                                                    • AC joint resection (Mumford procedure)
                                                    • Coracoacromial ligament resection
                                                  • Postop integrity of cuff does not necessarily equate to lack of symptoms

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Barth J et al: Ultrasonic evaluation of the repair integrity can predict functional outcomes after arthroscopic double-row rotator cuff repair. Knee Surg Sports Traumatol Arthrosc. 23(2):376-85, 2015
                                                                              2. Lee JE et al: Repaired supraspinatus tendons in clinically improving patients: early postoperative findings and interval changes on MRI. Korean J Radiol. 16(2):363-71, 2015
                                                                              3. Saccomanno MF et al: Magnetic resonance imaging criteria for the assessment of the rotator cuff after repair: a systematic review. Knee Surg Sports Traumatol Arthrosc. 23(2):423-42, 2015
                                                                              4. Codsi MJ et al: Assessment of rotator cuff repair integrity using ultrasound and magnetic resonance imaging in a multicenter study. J Shoulder Elbow Surg. 23(10):1468-72, 2014
                                                                              5. Thakkar RS et al: Complications of rotator cuff surgery-the role of post-operative imaging in patient care. Br J Radiol. 87(1039):20130630, 2014
                                                                              6. Crim J et al: Temporal evolution of MRI findings after arthroscopic rotator cuff repair. AJR Am J Roentgenol. 195(6):1361-6, 2010
                                                                              7. McMenamin D et al: Imaging of the shoulder after surgery. Eur J Radiol. 68(1):106-19, 2008
                                                                              8. Liem D et al: Magnetic resonance imaging of arthroscopic supraspinatus tendon repair. J Bone Joint Surg Am. 89(8):1770-6, 2007
                                                                              9. Potter HG et al: Imaging of the rotator cuff following repair: human and animal models. J Shoulder Elbow Surg. 16(5 Suppl):S134-9, 2007
                                                                              10. Woertler K: Multimodality imaging of the postoperative shoulder. Eur Radiol. 17(12):3038-55, 2007
                                                                              11. Duc SR et al: Diagnostic performance of MR arthrography after rotator cuff repair. AJR Am J Roentgenol. 186(1):237-41, 2006
                                                                              12. Mellado JM et al: MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture. Eur Radiol. 16(10):2186-96, 2006
                                                                              13. Ruzek KA et al: Postoperative imaging of the shoulder. Radiol Clin North Am. 44(3):331-41, 2006
                                                                              14. Wu J et al: MRI of the postoperative shoulder. Clin Sports Med. 25(3):445-64, vi, 2006
                                                                              15. Zanetti M et al: MR imaging of the shoulder after surgery. Radiol Clin North Am. 44(4):537-51, viii, 2006
                                                                              16. Mellado JM et al: Surgically repaired massive rotator cuff tears: MRI of tendon integrity, muscle fatty degeneration, and muscle atrophy correlated with intraoperative and clinical findings. AJR Am J Roentgenol. 184(5):1456-63, 2005
                                                                              17. Mohana-Borges AV et al: MR imaging and MR arthrography of the postoperative shoulder: spectrum of normal and abnormal findings. Radiographics. 24(1):69-85, 2004
                                                                              18. Prickett WD et al: Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively. J Bone Joint Surg Am. 85-A(6):1084-9, 2003
                                                                              19. Zlatkin MB: MRI of the postoperative shoulder. Skeletal Radiol. 31(2):63-80, 2002
                                                                              20. Zanetti M et al: MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects. Skeletal Radiol. 29(6):314-9, 2000
                                                                              21. Rand T et al: The postoperative shoulder. Top Magn Reson Imaging. 10(4):203-13, 1999
                                                                              22. Spielmann AL et al: Shoulder after rotator cuff repair: MR imaging findings in asymptomatic individuals--initial experience. Radiology. 213(3):705-8, 1999
                                                                              23. Gusmer PB et al: MR imaging of the shoulder after rotator cuff repair. AJR Am J Roentgenol. 168(2):559-63, 1997
                                                                              24. Longobardi RS et al: MR imaging of the postoperative shoulder. Magn Reson Imaging Clin N Am. 5(4):841-59, 1997
                                                                              25. Magee TH et al: MR imaging of the shoulder after surgery. AJR Am J Roentgenol. 168(4):925-8, 1997