Repaired Supraspinatus Tendons in Clinically Improving Patients: Early Postoperative Findings and Interval Changes on MRI

Abstract

ObjectiveTo demonstrate and further determine the incidences of repaired supraspinatus tendons on early postoperative magnetic resonance imaging (MRI) findings in clinically improving patients and to evaluate interval changes on follow-up MRIs.Materials and MethodsFifty patients, who showed symptomatic and functional improvements after supraspinatus tendon repair surgery and who underwent postoperative MRI twice with a time interval, were included. The first and the second postoperative MRIs were obtained a mean of 4.4 and 11.5 months after surgery, respectively. The signal intensity (SI) patterns of the repaired tendon on T2-weighted images from the first MRI were classified into three types of heterogeneous high SI with fluid-like bright high foci (type I), heterogeneous high SI without fluid-like bright high foci (type II), and heterogeneous or homogeneous low SI (type III). Interval changes in the SI pattern, tendon thickness, and rotator cuff interval thickness between the two postoperative MRIs were evaluated.ResultsThe SI patterns on the first MRI were type I or II in 45 tendons (90%) and type III in five (10%). SI decreased significantly on the second MRI (p < 0.050). The mean thickness of repaired tendons and rotator cuff intervals also decreased significantly (p < 0.050).ConclusionRepaired supraspinatus tendons exhibited high SI in 90% of clinically improving patients on MRI performed during the early postsurgical period. The increased SI and thickness of the repaired tendon decreased on the later MRI, suggesting a gradual healing process rather than a retear.

Large Critical Shoulder Angle Has Higher Risk of Tendon Retear After Arthroscopic Rotator Cuff Repair

“…During the first year after repair, supraspinatus tendons exhibited high signal intensity on MRI in 90% of clinically improving patients, and the increased signal intensity and thickness of the repaired tendon decreased, suggesting a gradual healing process rather than a retear. 21 Recurrent defects after arthroscopic reconstruction of supraspinatus tears in a modified suture bridge technique seem to occur between 12 and 24 months after surgery. 36 Thus, it is proper to evaluate the MRI appearance of the repaired tendon at 2 years after rotator cuff repair.…”

Postoperative residual pain is associated with a high magnetic resonance imaging (MRI)-based signal intensity of the repaired supraspinatus tendon

“…It was suggested that during the first postoperative year, it is not prudent to consider the tendon repair as failed according to tendon irregularity, thinning, or increased signal intensity. Given that the repaired tendon had a gradual healing process during the first year after surgery [25], it is interesting to know if the residual pain is still related with the rotator cuff tendon quality.…”

A Long Preoperative Duration of Symptoms Is Associated With Worse Functional Outcomes After 1-Stage Arthroscopic Treatment of Rotator Cuff Tears With Shoulder Stiffness

“…1,21,35 Furthermore, the most confusing changes on postoperative MRI elicited by the surgical intervention vanish by the end of the first year after surgery. 8,23 Fourth, we did not evaluate preoperative fatty degeneration, muscle atrophy, or postoperative glenohumeral osteoarthritis, which are related to the DOS. 16,19 Last but not least, because patients with partial or massive rotator cuff tears were excluded from the present study, our conclusions may not be applicable to these patients.…”