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- Title
In Vivo Vascularity Alterations in Repaired Rotator Cuffs Determined by Contrast-Enhanced Ultrasound.
- Authors
Funakoshi, Tadanao; Iwasaki, Norimasa; Kamishima, Tamotsu; Nishida, Mutsumi; Ito, Yoichi; Nishida, Kinya; Motomiya, Makoto; Suenaga, Naoki; Minami, Akio
- Abstract
Background: The alterations in blood flow after rotator cuff repair remain unclear. Visualization of vascular patterns could clarify basic and clinical investigations.Purpose: To assess longitudinal blood flow inside the repaired cuff and the surrounding tissue after rotator cuff repair, using contrast-enhanced ultrasonography.Study Design: Descriptive laboratory study.Methods: Fifteen patients (7 men and 8 women; mean age, 65.0 ± 9.8 years) consented to participate. The patients underwent an ultrasound scan before and 1, 2, and 3 months after surgery. Enhanced ultrasound images were recorded for 1 minute after intravenous injection of contrast reagent. Four regions of interest inside the cuff and 2 regions in the anchor hole and subacromial bursa were superimposed on the obtained images. Calculated areas under the time-intensity curves were expressed in acoustic units (AU).Results: We found area-dependent differences in patterns of alteration and magnitude of blood flow inside the repaired cuff and peritendinous tissues. Vascularity in the articular distal and bursal distal region of the repaired cuff at 1 month postoperatively increased significantly compared with that at the preoperative baseline (76 vs 5 AU, P = .0037; 92 vs 7 AU, P = .043). The vascularity peaked at 1 month after surgery in the bursal area within the cuff but at 2 months in the articular area. The vascularity in the articular proximal region of the repaired cuff was significantly lower than that in the bursal proximal (P = .0046), bursal distal (P = .0183), and articular distal regions (P = .0163) 1 month after surgery.Conclusion: Enhancement patterns in intratendinous tissue increased at 1 or 2 months postoperatively and decreased at 3 months. We found area-dependent differences in enhancement patterns inside the repaired cuff and peritendinous tissue.Clinical Relevance: Visualization of vascularization using contrast-enhanced ultrasound could help in deciding on an appropriate repair technique or on the form of postoperative rehabilitation after rotator cuff repair.
- Subjects
JAPAN; ANALYSIS of variance; BLOOD circulation; COMPARATIVE studies; RANGE of motion of joints; LONGITUDINAL method; MAGNETIC resonance imaging; RESEARCH methodology; HEALTH outcome assessment; REGRESSION analysis; RESEARCH evaluation; RESEARCH funding; ROTATIONAL motion; ROTATOR cuff; ROTATOR cuff injuries; STATISTICAL hypothesis testing; STATISTICS; T-test (Statistics); STATISTICAL power analysis; TREATMENT effectiveness; INTER-observer reliability; CONTRAST media; DATA analysis software
- Publication
American Journal of Sports Medicine, 2011, Vol 39, Issue 12, p2640
- ISSN
0363-5465
- Publication type
Article
- DOI
10.1177/0363546511420077