Assessment of postoperative acromial and subacromial morphology after arthroscopic acromioplasty using magnetic resonanc
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SCIENTIFIC ARTICLE
Assessment of postoperative acromial and subacromial morphology after arthroscopic acromioplasty using magnetic resonance imaging Hye Jin Kang 1 & Ji Seon Park 1 & Kyung Nam Ryu 1 & Yong Girl Rhee 2 & Wook Jin 3 & So Young Park 3 Received: 29 June 2020 / Revised: 7 September 2020 / Accepted: 10 September 2020 # ISS 2020
Abstract Objective To identify the morphological characteristics of the acromion and subacromial bursal space after arthroscopic acromioplasty using magnetic resonance imaging (MRI). Materials and methods One hundred patients who received arthroscopic rotator cuff repair and acromioplasty each received at least three MRI examinations (preoperative, first immediate postoperative, and second follow-up imaging between 8 months and 1 year postoperatively). Changes over time in the thickness and morphology of the postoperative acromion as well as the subacromial bursal space were assessed. Clinical and radiological parameters were also analyzed to identify any association with changes in acromial morphology. Results Despite minimal acromial thinning observed at the first immediate postoperative state, the acromions showed significant thinning at the second postoperative MRI, with a mean reduction of 32%. Along with acromial thinning, an exaggerated concave contour of the acromial undersurface was observed in some patients. In the subacromial space, a loculated fluid collection developed in 91% of the patients at the second postoperative follow-up. No statistically significant association was noted between postoperative acromial thickness change and clinical or radiological factors (P value > 0.05). Conclusion A significant delayed reduction in acromial thickness within approximately 1 year of arthroscopic acromioplasty is thought to be a normal postoperative feature. The simultaneous collection of a loculated, cyst-like fluid in the subacromial bursal space may be an important associated factor of postoperative acromial thinning. Keywords Shoulder . Acromioplasty . Postoperative imaging . MRI
Introduction After back and knee pain, shoulder pain is the third most common musculoskeletal symptom encountered in clinical practice [1, 2]. Rotator cuff disease is the leading cause of shoulder pain and disability, with subacromial impingement * Ji Seon Park [email protected] 1
Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea
2
Department of Orthopedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
3
Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
playing an important role [3, 4]. “Intrinsic impingement” may be caused by tension overload and overuse, leading to degeneration of the cuff tendons [5, 6]. “Extrinsic impingement” results from mechanical compression of the subacromial contents through structures external to the t
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