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External rotation and active supination CT arthrography for the postoperative evaluation of type II superior labral anterior to posterior lesions

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate the effectiveness of external rotation and active supination CT arthrography in postoperative evaluation by comparing it with neutral CT arthrography and analyzing its agreement with postoperative clinical results after the repair of type II superior labral anterior to posterior (SLAP) lesions.

Materials and methods

A total of 25 patients who had undergone CT arthrography in neutral, external rotation and active supination position at least 1 year after the arthroscopic repair of SLAP lesions were enrolled. Two radiologists independently evaluated the status of the repaired SLAP lesions with neutral CT arthrography and then with external rotation and active supination CT arthrography.

Results

Five patients had residual symptoms and positive findings upon SLAP-specific examinations. Agreements between the presence of symptoms and radiologic diagnoses based on neutral CT arthrography were insignificant for reader 1 (κ = 0.138, p = n.s.) and significant for reader 2 (κ = 0.328, p = 0.027). However, agreements were highly significant in the analysis following the evaluation of external rotation and active supination CT arthrography for both readers (κ = 0.694, p < 0.001 in reader 1; κ = 0.783, p < 0.001 in reader 2).

Conclusions

The presence of contrast-filled gaps between the labrum and glenoid on neutral CT arthrography after SLAP repair is frequent with satisfactory clinical outcomes. Gaps without additional widening upon external rotation and active supination CT arthrography may suggest postoperatively stable biceps anchors, so this new method could minimize the overdiagnosis of recurrent SLAP lesions. Additional gap widening on external rotation and active supination CT arthrography could be related to a true recurrent SLAP lesion and the symptoms of the patients.

Level of evidence

Case series, Level IV.

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Conflict of interest

There is no disclosure and no conflict of interest in this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

    Sae Hoon Kim

  2. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Ja-Young Choi, Hye Jin Yoo & Sung Hwan Hong

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  1. Sae Hoon Kim
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  2. Ja-Young Choi
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Correspondence to Ja-Young Choi.

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Kim, S.H., Choi, JY., Yoo, H.J. et al. External rotation and active supination CT arthrography for the postoperative evaluation of type II superior labral anterior to posterior lesions. Knee Surg Sports Traumatol Arthrosc 24, 134–140 (2016). https://doi.org/10.1007/s00167-014-3350-5

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  • DOI: https://doi.org/10.1007/s00167-014-3350-5

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