Contrast-enhanced ultrasound characterization of the vascularity of the repaired rotator cuff tendon: Short-term and intermediate-term follow-up

Edwin R. Cadet, Ronald S. Adler, Robert Gallo, Seth C. Gamradt, Russell F. Warren, Frank A. Cordasco, Stephen Fealy

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The objectives of this study were to characterize and compare the vascularity of arthroscopically repaired rotator cuff tendons at short-term and intermediate-term follow-up. Materials and methods: Nineteen patients who underwent arthroscopic rotator cuff repair were prospectively monitored for an average of 21.2 months. Initial baseline, grayscale ultrasound images of the operated-on shoulder were obtained on all patients at 3 months and at a minimum of 10 months postoperatively. Perflutren-lipid microsphere contrast (DEFINITY, Lantheus Medical Imaging, North Billerica, MA, USA) was injected after baseline grayscale images and after exercise to obtain contrast-enhanced images of the repair. Three regions of interest-supraspinatus tendon, peribursal tissue, and bone anchor site-were evaluated before and after rotator cuff-specific exercises. Results: The peribursal tissue demonstrated the greatest blood flow, followed by the bone anchor site and tendon, in pre-exercise and postexercise states. Significantly less blood flow was observed in all regions of interest before exercise (P < .05) and only at the bone anchor site after exercise (P < .001) at latest follow-up compared with the 3-month values. Intratendinous blood flow remained relatively low at both evaluation points after surgical repair. Conclusion: Preliminary findings suggest that the peribursal tissue and bone anchor site are the main conduits of blood flow for the rotator cuff tendon after arthroscopic repair, with the supraspinatus tendon being relatively avascular. Blood flow of the repaired rotator cuff tendon decreases with time. Furthermore, exercise significantly enhances blood flow to the repaired rotator cuff.

Original languageEnglish (US)
Pages (from-to)597-603
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Volume21
Issue number5
DOIs
StatePublished - May 1 2012

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Rotator Cuff
Tendons
Suture Anchors
Exercise
perflutren
Diagnostic Imaging
Microspheres
Lipids

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Cadet, Edwin R. ; Adler, Ronald S. ; Gallo, Robert ; Gamradt, Seth C. ; Warren, Russell F. ; Cordasco, Frank A. ; Fealy, Stephen. / Contrast-enhanced ultrasound characterization of the vascularity of the repaired rotator cuff tendon : Short-term and intermediate-term follow-up. In: Journal of Shoulder and Elbow Surgery. 2012 ; Vol. 21, No. 5. pp. 597-603.
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Contrast-enhanced ultrasound characterization of the vascularity of the repaired rotator cuff tendon : Short-term and intermediate-term follow-up. / Cadet, Edwin R.; Adler, Ronald S.; Gallo, Robert; Gamradt, Seth C.; Warren, Russell F.; Cordasco, Frank A.; Fealy, Stephen.

In: Journal of Shoulder and Elbow Surgery, Vol. 21, No. 5, 01.05.2012, p. 597-603.

Research output: Contribution to journalArticle

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AU - Cadet, Edwin R.

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N2 - Background: The objectives of this study were to characterize and compare the vascularity of arthroscopically repaired rotator cuff tendons at short-term and intermediate-term follow-up. Materials and methods: Nineteen patients who underwent arthroscopic rotator cuff repair were prospectively monitored for an average of 21.2 months. Initial baseline, grayscale ultrasound images of the operated-on shoulder were obtained on all patients at 3 months and at a minimum of 10 months postoperatively. Perflutren-lipid microsphere contrast (DEFINITY, Lantheus Medical Imaging, North Billerica, MA, USA) was injected after baseline grayscale images and after exercise to obtain contrast-enhanced images of the repair. Three regions of interest-supraspinatus tendon, peribursal tissue, and bone anchor site-were evaluated before and after rotator cuff-specific exercises. Results: The peribursal tissue demonstrated the greatest blood flow, followed by the bone anchor site and tendon, in pre-exercise and postexercise states. Significantly less blood flow was observed in all regions of interest before exercise (P < .05) and only at the bone anchor site after exercise (P < .001) at latest follow-up compared with the 3-month values. Intratendinous blood flow remained relatively low at both evaluation points after surgical repair. Conclusion: Preliminary findings suggest that the peribursal tissue and bone anchor site are the main conduits of blood flow for the rotator cuff tendon after arthroscopic repair, with the supraspinatus tendon being relatively avascular. Blood flow of the repaired rotator cuff tendon decreases with time. Furthermore, exercise significantly enhances blood flow to the repaired rotator cuff.

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