External rotation and active supination CT arthrography for the postoperative evaluation of type II superior labral anterior to posterior lesions

Kim, Sae Hoon; Choi, Ja Young; Yoo, Hye Jin; Hong, Sung Hwan

doi:10.1007/s00167-014-3350-5

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…CTA was chosen as an assessment tool based on a previous study that assessed failure after SLAP repair at least 1 year after surgery and on another study showing high sensitivity and specificity of CTA for failure of SLAP repair. 10 11) Furthermore, based on a study showing comparable diagnostic performance of CTA and magnetic resonance arthrography for labral lesions, we chose CTA due to its cost-effectiveness. 12) Imaging was done in 0° of abduction with neutral rotation of the shoulder and in 90° of abduction with external rotation of the shoulder.…”

Section: Methodsmentioning

confidence: 99%

Is Anatomical Healing Essential for Better Clinical Outcome in Type II SLAP Repair? Clinico-Radiological Outcome after Type II SLAP Repair

et al. 2018

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BackgroundWe hypothesized that anatomical healing in superior labrum anterior to posterior (SLAP) repair is associated with good clinical outcome. The purposes of this study were to assess the failure rate of anatomical healing after arthroscopic repair of SLAP lesions using computed tomography arthrography (CTA), investigate correlation of the rate with clinical outcomes, and identify prognostic factors for anatomical failure following SLAP repair.MethodsWe retrospectively evaluated the outcome of 43 patients at a minimum follow-up of 1 year after arthroscopic surgery for SLAP lesions or SLAP lesions associated with Bankart lesions. Twenty-eight patients underwent isolated SLAP repair and 15 patients underwent Bankart repair with SLAP repair. The anatomical outcome was assessed using CTA at 1 year after surgery. Clinical outcomes including visual analogue scale for pain and satisfaction and Constant score were assessed at the final follow-up. We investigated clinical failure that was defined as stiffness, loss of maximum rotation, deterioration of pain, and/or need for revision of surgery.ResultsAnatomical failure occurred in 32.6% of patients (14/43), whereas 16.3% of patients (7/43) had clinical failure. Clinicoradiological assessment revealed that clinical failure occurred only in 7.1% of patients (1/14) with unhealed SLAP lesions, whereas it occurred in 20.7% of patients (6/29) with healed SLAP lesions. Isolated SLAP repair resulted in a higher risk of anatomical failure (risk ratio, 7.0) than combined SLAP repair (p = 0.015). Nonoverhead activities were associated with higher risk of anatomical failure (risk ratio, 2.9; p = 0.041). Patients above 35 years of age had more risk of anatomical failure (risk ratio, 3.5; p = 0.010). Clinical outcomes significantly improved regardless of anatomical failure (p < 0.001) and were not significantly different between unhealed and healed repairs (all p > 0.05).ConclusionsSince patients with unhealed SLAP lesions had less clinical failure than patients with healed SLAP lesions, anatomical healing does not seem essential for better clinical outcome of SLAP II repair, especially in patients with higher healing failure risk (isolated SLAP repair, nonoverhead activities, and above 35 years of age). Therefore, we believe the indications of SLAP repair should be narrowed to avoid overtreatment.

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Section: Methodsmentioning

confidence: 99%

Is Anatomical Healing Essential for Better Clinical Outcome in Type II SLAP Repair? Clinico-Radiological Outcome after Type II SLAP Repair

et al. 2018

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“…The incidence of open tibial fracture as a part of isolated injury or polytrauma is on the rise due to increase in the incidence of motor vehicle accidents [1,2]. The outcomes for severe open fractures are still a great challenge for all the trauma surgeons in the treatment [3,4]. Especially, the soft tissue injury in open fractures still leads to various complications, such as infection, muscle necrosis, ischemia, and even limb loss [5,6].…”

Section: Introductionmentioning

confidence: 99%

A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

et al. 2019

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BackgroundThe outcomes for open tibial fractures with severe soft tissue injury are still a great challenge for all the trauma surgeons in the treatment. However, most of the existing open tibial fracture models can only provide minimal soft tissue injury which cannot meet the requirement of severe trauma research. Our goal is to investigate a novel tibial fracture model providing different fractures combined with soft tissue injury for better application in trauma research.MethodsA total of 144 Sprague-Dawley rats were randomly divided into 4 groups. With group 1 as control, the other groups sustained different right tibial fractures by the apparatus with buffer disc settings either 3 mm, 10 mm, or 15 mm. X-ray and computed tomography angiography (CTA) were performed at 6 h to evaluate the fracture patterns and vascular injuries. Peripheral blood and tibialis anterior muscle were harvested at 6 h, 1 day, 3 days, 7 days, 14 days, and 28 days for ELISA and histological analysis.ResultsX-ray and μCT results indicated that different fractures combined with soft tissue injuries could be successfully provided in this model. According to OTA and Gustilo classification, the fractures and soft tissue injuries were evaluated and defined: 36 type I in group 2, 34 type II in group 3, and 36 type III in group 4. The CTA confirmed no arterial injuries in groups 1 and 2, 2 arterial injuries in group 3, and 35 in group 4. ELISA indicated that the levels of pro-inflammatory cytokines TNF-α and IL-1β were significantly higher in group 4 than in other groups, and the levels of anti-inflammatory cytokines TGF-β and IL-10 were significantly higher in surgery groups than in group 1 in later stage or throughout the entire process. HE, Masson, and caspase-3 stains confirmed the most severe inflammatory cell infiltration and apoptosis in group 4 which lasted longer than that in groups 2 and 3.ConclusionsThe novel apparatus was valuable in performing different fractures combined with soft tissue injuries in a rat tibial fracture model with high reproducibility and providing a new selection for trauma research in the future.

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Besonderheiten der Magnetresonanztomographie nach operativer Schulterintervention

2017

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Even primary diagnostic evaluation of the shoulder is a challenge for radiologists. Many imaging findings that definitely indicate abnormal findings in the untreated shoulder should be evaluated carefully in postoperative patients. Artifacts caused by implants or metal abrasion pose considerable problems in postoperative magnetic resonance imaging (MRI). Classic approaches to minimizing artifacts caused by foreign bodies include using turbo spin echo sequences, increasing bandwidth, and reducing voxel size. In recent years, several vendors have developed dedicated pulse sequences for reducing metal artifacts. Different postoperative imaging findings will be encountered, depending on the kind of surgery done. This review article describes typical postoperative MRI findings, focusing on subacromial decompression, reconstruction of the rotator cuff, labrum procedures, and biceps tenodesis.

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External rotation and active supination CT arthrography for the postoperative evaluation of type II superior labral anterior to posterior lesions

Abstract: Case series, Level IV.

Cited by 3 publications

References 20 publications

Is Anatomical Healing Essential for Better Clinical Outcome in Type II SLAP Repair? Clinico-Radiological Outcome after Type II SLAP Repair

Is Anatomical Healing Essential for Better Clinical Outcome in Type II SLAP Repair? Clinico-Radiological Outcome after Type II SLAP Repair

A novel rat model of tibial fracture for trauma researches: a combination of different types of fractures and soft tissue injuries

Besonderheiten der Magnetresonanztomographie nach operativer Schulterintervention

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