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Postoperative MRI signal intensity correlates functional outcomes after superior capsular reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Superior capsular reconstruction (SCR) using fascia lata autograft has been performed for irreparable rotator cuff tear recently. The signal-to-noise quotient (SNQ) of the graft on magnetic resonance imaging (MRI) may reflect the degree of graft maturity and healing. However, how SNQ changes with graft remodelling and time and whether this change correlates with postoperative clinical outcomes after SCR remain unknown. This study aimed to explore the correlation between SNQ of the fascia lata autograft and clinical functional outcomes after SCR.

Methods

Patients with irreparable posterosuperior rotator cuff tear undergoing SCR using fascia lata autograft between 2013 and 2017 were retrospectively analysed. For clinical outcomes, the American Shoulder and Elbow Surgeons (ASES) score, Constant–Murley score, Single Assessment Numeric Evaluation (SANE), and Visual Analogue Scale (VAS) for pain and range of motion (ROM; forward flexion and external rotation) were evaluated at postoperative 6 and 12 months. Signal intensity of the humeral, mid-substance, and glenoid sites and background were measured to calculate the SNQ values on follow-up MRI at 3 and 12 months. The correlations between clinical outcomes and SNQ at different time points were then analysed.

Results

A total of 15 patients were enrolled in the study. The mean postoperative VAS score significantly increased at postoperative 6 months and significantly decreased at postoperative 12 months. Except for forward flexion, all other functional outcomes were improved at postoperative 6 months. Analysis of MRI showed SNQ at the humeral (SNQh), mid-substance, and glenoid sites decreased from postoperative 3 to 12 months with a statistical significance detected in SNQh (P < 0.01). Correlation analyses showed that the SNQh values negatively correlated with VAS, ASES, Constant–Murley score, SANE, ROM (forward flexion), and ROM (external rotation) (all P < 0.05).

Conclusion

SNQ of the fascia lata autograft decreased with time in patients receiving SCR. SNQ at the humeral site was negatively correlated with clinical outcomes.

Level of evidence

III.

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Acknowledgements

The authors or their immediate families have not received any financial payment or benefits from any commercial company related to this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Hui Ben, Jun-Bum Lee, Sang-Pil So, Kyoung-Hwan Koh & In-Ho Jeon

  2. Department of Orthopedic Surgery, Faculty of Medicine, St. Carolus Hospital, Universitas Trisakti, Jakarta, Indonesia

    Erica Kholinne

  3. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Chu Hui Zeng

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  1. Hui Ben
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  2. Erica Kholinne
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Correspondence to In-Ho Jeon.

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S2022-0360-0001.

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Ben, H., Kholinne, E., Lee, JB. et al. Postoperative MRI signal intensity correlates functional outcomes after superior capsular reconstruction. Knee Surg Sports Traumatol Arthrosc 31, 1903–1909 (2023). https://doi.org/10.1007/s00167-022-07111-2

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  • DOI: https://doi.org/10.1007/s00167-022-07111-2

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