Key result
Fatty infiltration 1 year after rotator cuff repair progressed significantly when measured relative to an immediate postoperative baseline (p<0.001), but not relative to a preoperative baseline.
Why the study?
Does using an immediate postoperative MRI baseline compared to a preoperative baseline change the assessment of fatty infiltration progression in patients after arthroscopic rotator cuff repair?
Observational (n=77)
Does using an immediate postoperative MRI baseline compared to a preoperative baseline change the assessment of fatty infiltration progression in patients after arthroscopic rotator cuff repair?
Using an immediate postoperative MRI baseline rather than a preoperative baseline reveals that fatty infiltration progresses after rotator cuff repair, suggesting it is a more accurate baseline for monitoring true changes.
Answers are grounded in this paper and cite their sources.
Immediate postoperative MRI baseline detects post-repair fatty infiltration progression missed preoperatively; leaves open optimal serial imaging timing in rotator cuff repair.
PURPOSE: Fatty infiltration (FI) is known to be an irreversible change which continues degeneration after rotator cuff repair. Previous studies evaluated postoperative changes in FI using a preoperative baseline. This study aimed to investigate the changes in FI using an immediate postoperative baseline. We hypothesized that FI was progressed more when measured relative to an immediate postoperative baseline than to a preoperative baseline. METHODS: From 2008 to 2010, 77 patients who met the following criteria were included in this study: arthroscopic rotator cuff repair of a full-thickness rotator cuff tear and presence of preoperative (approximately 1 month before surgery), immediate postoperative (approximately 3 days after surgery), and 1-year postoperative (at least 9 months to 1 year after surgery) magnetic resonance imaging (MRI) undertaken. The exclusion criteria were: absence of any of the three MRIs, isolated subscapularis repair, and rotator cuff repair with margin convergence only. The MRIs were examined to assess the Goutallier grade of the rotator cuff muscles for the assessment of FI. Structural integrity was evaluated using the Sugaya classification. Measurements 1 year after surgery were compared with those at the preoperative and immediate postoperative time points according to the integrity. RESULTS: In the total and retear group, FI in the supraspinatus and infraspinatus 1 year after surgery did not change significantly relative to the preoperative baseline (all n.s.), but progressed compared to the immediate postoperative baseline (all p < 0.001). In the retear group, FI in the supraspinatus and infraspinatus reduced for seven and two of 20 patients, respectively, compared with the preoperative baseline; however, no patients showed a reduced FI compared with the immediate postoperative baseline. CONCLUSIONS: The results of the study showed that the changes in FI reduced, remained or progressed in accordance with the baseline and structural integrity. FI progressed when compared with the immediate postoperative baseline than with the preoperative baseline. The immediate postoperative time point would be considered as the baseline to monitor the true changes of FI after repair. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
No takes yet. Share an insight, caveat, or question.
Park et al. (2017) conducted an observational in Full-thickness rotator cuff tear (n=77). Immediate postoperative baseline MRI vs. Preoperative baseline MRI was evaluated on Progression of fatty infiltration in the supraspinatus and infraspinatus 1 year after surgery (p=<0.001). Fatty infiltration 1 year after rotator cuff repair progressed significantly when measured relative to an immediate postoperative baseline (p<0.001), but not relative to a preoperative baseline.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: