Aditya Daftary MBBS, Presenter: Nothing to Disclose

John MacGillivray MD, Abstract Co-Author: Nothing to Disclose

David Altchek MD, Abstract Co-Author: Nothing to Disclose

Ronald Steven Adler MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the evolving sonographic (US) appearance of the post operative rotator cuff in asymptomatic subjects.

Long term retrospective US evaluation of patients who underwent rotator cuff repair (RCR) considered asymptomatic based on a standardized patient questionnaire was performed at multiple intervals. US images were interpreted by two musculoskeletal radiologists in consensus; and graded for continuity, morphology, bursal fluid and tendon margins.

27 patients (20 full thickness (FT) tears and 6 partial thickness (PT) tears) underwent RCR. US was performed 8m (±5m) and 1y 7m (±8m) following RCR. Mean study interval was 1 y (±5m). Initially, 18 (66.7%) RCR were continuous (CT); 3 (11.1%) had PT defects (mean 15.7±4mm2) and 6 (22.2%) had FT defects (mean 62.2±77.4mm2). One CT progressed to PT; 1 PT became CT, 1 PT improved slightly and 1 FT worsened. Morphology was normal in 3 (11.1%); abnormality was mild in 8 (29.6%), moderate in 14 (51.9%), severe in 2 (7.4%). It improved in 14 (51.9%) and was stable in 13 (48.1%). Subacromial/subdeltoid (SADB) bursa was normal/mildly thick in 19 (70.4%) and moderate/severely fluid distended in 8 (29.6%); it improved in 8 (29.6%), worsened in 4 (14.8%) and was stable in 15 (55.6%). Margins were poorly defined in 18 (66.7%), well defined in 9 (33.3%); improved in 12 (44.4%), were stable in 14 (51.9%) and worsened in 1 (3.7%). Two year follow up (mean 2y 2m±2m) was available in 4. Three were CT and stable; 1 FT grew. All 4 had mildly abnormal morphology; 3 were stable and 1 normalized. Normal/mildly thick SADB was stable in 2 subjects, worsened and improved in 1 each. Cuff margins improved at one year and were stable.

Long term US follow up of RCR may show defects, which may improve or worsen. Morphology, bursal fluid and margin definition improve or remain stable.

Asymptomatic RCR may appear discontinuous in up to a third of patients, and even worsen with time. Correlation with symptomatology is essential in determining its significance.

Daftary, A, MacGillivray, J, Altchek, D, Adler, R, Sonographic Appearance of Rotator Cuff Repair in Asymptomatic Patients: A Longitudinal Study.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5012143.html