title: Serial MRI evaluation following arthroscopic rotator cuff repair in double-row technique.
abstract: BACKGROUND
  So far, recurrent rotator cuff defects are described to occur in the early postoperative period after arthroscopic repair. The aim of this study was to evaluate the musculotendinous structure of the supraspinatus, as well as bone marrow edema or osteolysis after arthroscopic double-row repair. Therefore, magnetic resonance (MR) images were performed at defined intervals up to 2 years postoperatively.
  
  
  METHODS
  Case series; Level of evidence, 3.
  
  
  METHODS
  MR imaging was performed within 7 days, 3, 6, 12, 26, 52 and 108 weeks after surgery. All patients were operated using an arthroscopic modified suture bridge technique. Tendon integrity, tendon retraction ["foot-print-coverage" (FPC)], muscular atrophy and fatty infiltration (signal intensity analysis) were measured at all time points. Furthermore, postoperative bone marrow edema and signs of osteolysis were assessed.
  
  
  RESULTS
  MR images of 13 non-consecutive patients (6f/7m, ∅ age 61.05 ± 7.7 years) could be evaluated at all time points until ∅ 108 weeks postoperatively. 5/6 patients with recurrent defect at final follow-up displayed a time of failure between 12 and 24 months after surgery. Predominant mode of failure was medial cuff failures in 4/6 cases. The initial FPC increased significantly up to 2 years follow-up (p = 0.004). Evaluations of muscular atrophy or fatty infiltration were not significant different comparing the results of all time points (p > 0.05). Postoperative bone marrow edema disappeared completely at 6 months after surgery, whereas signs of osteolysis appeared at 3 months follow-up and increased to final follow-up.
  
  
  CONCLUSIONS
  Recurrent defects after arthroscopic reconstruction of supraspinatus tears in modified suture bridge technique seem to occur between 12 and 24 months after surgery. Serial MRI evaluation shows good muscle structure at all time points. Postoperative bone marrow edema disappears completely several months after surgery. Signs of osteolysis seem to appear caused by bio-absorbable anchor implantations.
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Stahnke
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Constanze
authors.initials: C
authors.lastname: Nikulka
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Diederichs
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Haneveld
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Scheibel
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. christian.gerhardt@charite.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerhardt
mesh_terms: D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001853:Bone Marrow / Q000473:pathology; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000209:etiology; D010014:Osteolysis / Q000209:etiology; D011183:Postoperative Complications; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D053441:Suture Anchors / Q000009:adverse effects; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Magnetic resonance imaging; Rotator cuff tear; Suture bridge technique; Time of failure