Changes in Perianchor Cyst Formation Over Time After Rotator Cuff Repair: Influential Factors and Outcomes

Chung, Seok Won; Lee, Yong-Soo; Kim, Ja-Yeon; Lee, Jung-Ho; Ki, Se‐Young; Oh, Kyung-Soo; Yoon, Jong Pil; Kim, Joon Yub

doi:10.1177/0363546518810517

Cited by 16 publications

(22 citation statements)

References 27 publications

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“…These were comparable in terms of failed healing rate (13.2% vs. 15.0%), perianchor cyst formation (60.5% vs. 60.0%), and major anchor-related complications evaluated by radiology at 6.3 ± 0.9 and 7.8 ± 1.2 postoperative months, respectively. In the follow-up study, the formation of perianchor cyst decreased with time and was observed only in 7 patients (18.4%) at 18 months after surgery [ 25 , 27 ] On the other hand, Shin et al reported that the bony ingrowth into PEEK anchors occurred two times faster than biocomposite anchors [ 28 ]. The PEEK anchor used in the study was newly developed and open-vented to facilitate bony ingrowth.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

Lee

2020

JCM

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The aim of the current study was to evaluate the functional and radiologic outcomes of biocompatible non-absorbable PEEK (polyetheretherketone) and biocomposite (poly-L-lactic acid/poly(lactic-co-glycolic acid) 70% + β-tricalcium phosphate) anchors, especially in terms of perianchor cyst formation during the first six months postoperatively. We prospectively analysed 29 patients who underwent arthroscopic rotator cuff repair between March and May 2019. Both PEEK and biocomposite suture anchors were used as lateral anchors in one body. Clinical outcomes were assessed using the shoulder range of motion (ROM), visual analogue scale (VAS) for pain and satisfactory score, American Shoulder and Elbow Surgeons (ASES) score, and Simple Shoulder Test (SST). All these were obtained in patients preoperatively at 3 and 6 months after surgery. The imaging evaluation included perianchor cyst formation, anchor absorption, repaired cuff integrity, and retear pattern. All functional outcomes significantly improved over time. The biocomposite anchor had a statistically significant tendency to form higher grades of fluid collection at 3 months after surgery. However, the perianchor cyst reduced by the sixth postoperative month. Six months postoperatively, the functional outcomes were improved after rotator cuff repair and similar degrees of perianchor cyst formation were observed, regardless of the suture anchor material used.

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Section: Discussionmentioning

confidence: 99%

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

Lee

2020

JCM

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“…The findings of Ro et al 5 are similar to those of other studies in that perianchor cysts do not negatively affect clinical outcomes. 6,8,9 Reported rates of cyst appearance vary widely among studies (10.8%-56.6%). 5,6,8,9 This is probably because of the different definitions of perianchor cysts and different methods of detecting the cysts (plain radiographs, computed tomography, and magnetic resonance imaging).…”

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confidence: 99%

“…6,8,9 Reported rates of cyst appearance vary widely among studies (10.8%-56.6%). 5,6,8,9 This is probably because of the different definitions of perianchor cysts and different methods of detecting the cysts (plain radiographs, computed tomography, and magnetic resonance imaging). There are hypotheses regarding why cysts occur around the anchors, including foreign-body reaction, synovitis, and inflammation.…”

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confidence: 99%

“…The authors' conclusion differs from that of other studies that found no association between retears and perianchor cysts. 6,8,9 Perhaps the difference is due to the fact that Ro et al used a single-row repair technique whereas other studies used a transosseous-equivalent double-row technique. Or perhaps the finding that larger cysts are associated with retears was confounded by the fact that larger tears are also associated with larger cysts.…”

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confidence: 99%

“…Or perhaps the finding that larger cysts are associated with retears was confounded by the fact that larger tears are also associated with larger cysts. The larger tear sizes might be the standalone factor that is associated with retears, not cyst size 9 (like the old coffeeesmokingeheart disease conundrum).…”

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confidence: 99%

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Editorial Commentary: Perianchor Cysts—We Need More Worries After Rotator Cuff Repair Like We Need Holes in the Head

Jang

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Postoperative bone marrow edema lasts no more than 6 months after uncomplicated arthroscopic double-row rotator cuff repair with PEEK anchors

Chen

He²,

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To assess the natural evolution of the osseous reaction following arthroscopic double-row rotator cuf repair with PEEK anchors and to analyze its correlation with clinical shoulder function. Methods Between 2015 and 2017, 159 patients received arthroscopic double-row rotator cuf repair with PEEK anchors and underwent serial clinical and radiological follow-up (3, 6, 12, and 24 months). Radiological results were analyzed by tendon integrity, bone marrow edema, and peri-implant osteolysis. Clinical shoulder function was evaluated with the Constant score. Results One-hundred and seventeen patients were enrolled; among them, 63% demonstrated bone marrow edema around the anchors on postoperative 3-month MRI. The edema area percentage was 41% ± 7%. At 6 months, edema was only seen in 12% of cases, with an area percentage of 18% ± 5%. At 12 and 24 months, edema was rarely present. Fluid signals around the anchor were observed in 17.6%, 42.7%, 33.3%, and 21.0% of patients at 3, 6, 12, and 24 months, respectively; the tunnel widening values were 1.1 ± 0.4 mm, 1.8 ± 0.5 mm, 2.3 ± 0.6 mm, and 2.2 ± 0.7 mm at each follow-up, respectively. The sign of osteolysis was signiicantly more obvious around the lateral anchor than around the medial anchor. The presence of an osseous reaction was not correlated with worse clinical outcome. Conclusion Osseous reactions following arthroscopic rotator cuf repair are common and signiicant even with PEEK anchors. Bone marrow edema does not last more than 6 months in patients without complications. Peri-implant osteolysis is more evident around the lateral anchor than around the medial anchor and improves gradually over time. The sign of osteolysis is not correlated with clinical shoulder function. Based on these indings, surgeons should be cautious about bone marrow edema lasting more than 6 months following arthroscopic rotator cuf repair. Level of evidence Level IV.

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Changes in Perianchor Cyst Formation Over Time After Rotator Cuff Repair: Influential Factors and Outcomes

Cited by 16 publications

References 27 publications

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

Editorial Commentary: Perianchor Cysts—We Need More Worries After Rotator Cuff Repair Like We Need Holes in the Head

Postoperative bone marrow edema lasts no more than 6 months after uncomplicated arthroscopic double-row rotator cuff repair with PEEK anchors

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