ABSTRACT
Imaging plays an important role in evaluation of the shoulder after surgery. In addition
to being familiar with the underlying pathologic condition that leads to surgery,
it is just as important to have a general understanding of the surgical procedure
because it explains the expected postoperative imaging findings. Identification of
postoperative complications with imaging is also improved with this information. This
article reviews some of the more common surgeries of the shoulder, including rotator
cuff repair, acromioplasty, labral repair, Hill-Sachs impaction fracture and glenoid
bone augmentation, acromioclavicular joint repair, and shoulder arthroplasty. Each
respective surgical technique is briefly reviewed, followed by discussion and examples
of normal postoperative appearances and common postoperative complications. Knowledge
of these common procedures and their expected postoperative imaging findings will
allow an accurate assessment of complications.
KEYWORDS
Shoulder - postoperative - MRI - CT - ultrasound
REFERENCES
- 1
Matsen III F A.
Clinical practice. Rotator-cuff failure.
N Engl J Med.
2008;
358
(20)
2138-2147
- 2
Morag Y, Jacobson J A, Miller B, De Maeseneer M, Girish G, Jamadar D.
MR imaging of rotator cuff injury: what the clinician needs to know.
Radiographics.
2006;
26
(4)
1045-1065
- 3
Vinson E N, Helms C A, Higgins L D.
Rim-rent tear of the rotator cuff: a common and easily overlooked partial tear.
AJR Am J Roentgenol.
2007;
189
(4)
943-946
- 4
Millstein E S, Snyder S J.
Arthroscopic management of partial, full-thickness, and complex rotator cuff tears:
indications, techniques, and complications.
Arthroscopy.
2003;
19
(Suppl 1)
189-199
- 5
Kamath G, Galatz L M, Keener J D, Teefey S, Middleton W, Yamaguchi K.
Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness
supraspinatus tears.
J Bone Joint Surg Am.
2009;
91
(5)
1055-1062
- 6
Mohana-Borges A V, Chung C B, Resnick D.
MR imaging and MR arthrography of the postoperative shoulder: spectrum of normal and
abnormal findings.
Radiographics.
2004;
24
(1)
69-85
- 7
Huijsmans P E, Pritchard M P, Berghs B M, van Rooyen K S, Wallace A L, de Beer J F.
Arthroscopic rotator cuff repair with double-row fixation.
J Bone Joint Surg Am.
2007;
89
(6)
1248-1257
- 8
Morse K, Davis A D, Afra R, Kaye E K, Schepsis A, Voloshin I.
Arthroscopic versus mini-open rotator cuff repair: a comprehensive review and meta-analysis.
Am J Sports Med.
2008;
36
(9)
1824-1828
- 9
Mohtadi N G, Hollinshead R M, Sasyniuk T M, Fletcher J A, Chan D S, Li F X.
A randomized clinical trial comparing open to arthroscopic acromioplasty with mini-open
rotator cuff repair for full-thickness rotator cuff tears: disease-specific quality
of life outcome at an average 2-year follow-up.
Am J Sports Med.
2008;
36
(6)
1043-1051
- 10
Woertler K.
Multimodality imaging of the postoperative shoulder.
Eur Radiol.
2007;
17
(12)
3038-3055
- 11
Duc S R, Mengiardi B, Pfirrmann C W, Jost B, Hodler J, Zanetti M.
Diagnostic performance of MR arthrography after rotator cuff repair.
AJR Am J Roentgenol.
2006;
186
(1)
237-241
- 12
Fealy S, Adler R S, Drakos M C et al..
Patterns of vascular and anatomical response after rotator cuff repair.
Am J Sports Med.
2006;
34
(1)
120-127
- 13
Prickett W D, Teefey S A, Galatz L M, Calfee R P, Middleton W D, Yamaguchi K.
Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively.
J Bone Joint Surg Am.
2003;
85-A
(6)
1084-1089
- 14
Magee T H, Gaenslen E S, Seitz R, Hinson G A, Wetzel L H.
MR imaging of the shoulder after surgery.
AJR Am J Roentgenol.
1997;
168
(4)
925-928
- 15
Magee T, Shapiro M, Hewell G, Williams D.
Complications of rotator cuff surgery in which bioabsorbable anchors are used.
AJR Am J Roentgenol.
2003;
181
(5)
1227-1231
- 16
Gumina S, Di Giorgio G, Perugia D, Postacchini F.
Deltoid detachment consequent to open surgical repair of massive rotator cuff tears.
Int Orthop.
2008;
32
(1)
81-84
- 17
Bevernage C, Geusens E, Nijs S.
Case report: a gossypiboma in the shoulder.
Emerg Radiol.
2006;
12
(5)
231-233
- 18
Steinbach L S.
Magnetic resonance imaging of glenohumeral joint instability.
Semin Musculoskelet Radiol.
2005;
9
(1)
44-55
- 19
VandenBerghe G, Hoenecke H R, Fronek J.
Glenohumeral joint instability: the orthopedic approach.
Semin Musculoskelet Radiol.
2005;
9
(1)
34-43
- 20
Rafii M.
Non-contrast MR imaging of the glenohumeral joint. Part II Glenohumeral instability
and labrum tears.
Skeletal Radiol.
2004;
33
(11)
617-626
- 21
Keener J D, Brophy R H.
Superior labral tears of the shoulder: pathogenesis, evaluation, and treatment.
J Am Acad Orthop Surg.
2009;
17
(10)
627-637
- 22
Morgan C D, Burkhart S S, Palmeri M, Gillespie M.
Type II SLAP lesions: three subtypes and their relationships to superior instability
and rotator cuff tears.
Arthroscopy.
1998;
14
(6)
553-565
- 23
Tuite M J, Cirillo R L, De Smet A A, Orwin J F.
Superior labrum anterior-posterior (SLAP) tears: evaluation of three MR signs on T2-weighted
images.
Radiology.
2000;
215
(3)
841-845
- 24
Mohana-Borges A V, Chung C B, Resnick D.
Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography.
AJR Am J Roentgenol.
2003;
181
(6)
1449-1462
- 25
Beltran J, Rosenberg Z S, Chandnani V P, Cuomo F, Beltran S, Rokito A.
Glenohumeral instability: evaluation with MR arthrography.
Radiographics.
1997;
17
(3)
657-673
- 26
Ly J Q, Beall D P, Sanders T G.
MR imaging of glenohumeral instability.
AJR Am J Roentgenol.
2003;
181
(1)
203-213
- 27
Harper K W, Helms C A, Haystead C M, Higgins L D.
Glenoid dysplasia: incidence and association with posterior labral tears as evaluated
on MRI.
AJR Am J Roentgenol.
2005;
184
(3)
984-988
- 28
Shah N, Tung G A.
Imaging signs of posterior glenohumeral instability.
AJR Am J Roentgenol.
2009;
192
(3)
730-735
- 29
Tirman P F, Feller J F, Janzen D L, Peterfy C G, Bergman A G.
Association of glenoid labral cysts with labral tears and glenohumeral instability:
radiologic findings and clinical significance.
Radiology.
1994;
190
(3)
653-658
- 30
Sugimoto H, Suzuki K, Mihara K, Kubota H, Tsutsui H.
MR arthrography of shoulders after suture-anchor Bankart repair.
Radiology.
2002;
224
(1)
105-111
- 31
Lynch J R, Clinton J M, Dewing C B, Warme W J, Matsen III F A.
Treatment of osseous defects associated with anterior shoulder instability.
J Shoulder Elbow Surg.
2009;
18
(2)
317-328
- 32
Griffith J F, Antonio G E, Yung P S et al..
Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation:
CT analysis of 218 patients.
AJR Am J Roentgenol.
2008;
190
(5)
1247-1254
- 33
Probyn L J, White L M, Salonen D C, Tomlinson G, Boynton E L.
Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment—correlation
with second-look surgical evaluation.
Radiology.
2007;
245
(3)
814-823
- 34
Lecouvet F E, Simoni P, Koutaïssoff S, Vande Berg B C, Malghem J, Dubuc J E.
Multidetector spiral CT arthrography of the shoulder. Clinical applications and limits,
with MR arthrography and arthroscopic correlations.
Eur J Radiol.
2008;
68
(1)
120-136
- 35
Major N M, Banks M C.
MR imaging of complications of loose surgical tacks in the shoulder.
AJR Am J Roentgenol.
2003;
180
(2)
377-380
- 36
Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner J J.
Acromioclavicular joint injuries: diagnosis and management.
J Am Acad Orthop Surg.
2009;
17
(4)
207-219
- 37
Nuber G W, Bowen M K.
Acromioclavicular joint injuries and distal clavicle fractures.
J Am Acad Orthop Surg.
1997;
5
(1)
11-18
- 38
Wiater J M, Fabing M H.
Shoulder arthroplasty: prosthetic options and indications.
J Am Acad Orthop Surg.
2009;
17
(7)
415-425
- 39
Feldman F.
Radiology of shoulder prostheses.
Semin Musculoskelet Radiol.
2006;
10
(1)
5-21
- 40
Burgess D L, McGrath M S, Bonutti P M, Marker D R, Delanois R E, Mont M A.
Shoulder resurfacing.
J Bone Joint Surg Am.
2009;
91
(5)
1228-1238
- 41
Roberts C C, Ekelund A L, Renfree K J, Liu P T, Chew F S.
Radiologic assessment of reverse shoulder arthroplasty.
Radiographics.
2007;
27
(1)
223-235
- 42
Sofka C M, Adler R S.
Original report. Sonographic evaluation of shoulder arthroplasty.
AJR Am J Roentgenol.
2003;
180
(4)
1117-1120
Jon A JacobsonM.D.
Department of Radiology, University of Michigan
1500 East Medical Center Dr. TC-2910L, Ann Arbor, MI 48109-0326
Email: jjacobsn@umich.edu
