Pierre Métais1, David Gallinet2, Ludovic Labattut3, Arnaud Godenèche4, Johannes Barth5, Philippe Collin6, Nicolas Bonnevialle7, Jérôme Garret8, Philippe Clavert9. 1. Hôpital privé La Châtaigneraie, ELSAN, 63110 Beaumont, France. Electronic address: pierremetais@mac.com. 2. Centre épaule-main, 16, rue Madeleine Brès, 25000 Besançon, France. 3. Service de chirurgie orthopédique, CHU de Dijon, 14, rue PaulGaffarel, 21000 Dijon, France. 4. Ramsay Santé, hôpital privé Jean Mermoz, centre orthopédique Santy, 69008 Lyon, France. 5. Centre ostéo-articulaire des Cèdres, Parc Sud Galaxie, 5, rue des Tropiques, 38130 Échirolles, France. 6. CHP Saint-Grégoire, 35760 Saint-Grégoire, France. 7. Service de chirurgie orthopédique, CHU de Toulouse, place Baylac, 31059 Toulouse, France. 8. Clinique du Parc, 155, boulevard Stalingrad, 69006 Lyon, France. 9. Service de chirurgie de l'épaule et du coude, Hautepierre 2, CHRU de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
Abstract
INTRODUCTION: Acromioclavicular (AC) arthropathy can contribute to shoulder pain; it can be treated surgically by distal clavicle resection (DCR). The aim of this study was to determine whether increased T2 signal intensity in the clavicle on MRI is an argument in favour of AC resection arthroplasty by DCR during rotator cuff repair. METHODS: The MRI images from 107 shoulders in 107 patients were analysed. We looked for statistical relationships and correlations between shoulders with T2 hyperintensity (HI+) and those without (HI-) before surgery and then in shoulders with T2 hyperintensity (HI+) that underwent AC resection arthroplasty (AC+) and those who did not (AC-). RESULTS: On MRI, T2 hyperintensity in the AC joint was correlated with sex (more often found in men) and radiological signs of AC arthropathy. There was no statistical correlation before surgery, particularly with AC pain, or after surgery, with outcomes in shoulders undergoing DCR. CONCLUSION: When repairing rotator cuff tears, the presence of T2 hyperintensity on MRI in the distal clavicle is not a predictor of better clinical outcomes after AC resection arthroplasty is done. The AC pain may be related to the rotator cuff tear instead. LEVEL OF EVIDENCE: II, prospective randomised study.
INTRODUCTION: Acromioclavicular (AC) arthropathy can contribute to shoulder pain; it can be treated surgically by distal clavicle resection (DCR). The aim of this study was to determine whether increased T2 signal intensity in the clavicle on MRI is an argument in favour of AC resection arthroplasty by DCR during rotator cuff repair. METHODS: The MRI images from 107 shoulders in 107 patients were analysed. We looked for statistical relationships and correlations between shoulders with T2 hyperintensity (HI+) and those without (HI-) before surgery and then in shoulders with T2 hyperintensity (HI+) that underwent AC resection arthroplasty (AC+) and those who did not (AC-). RESULTS: On MRI, T2 hyperintensity in the AC joint was correlated with sex (more often found in men) and radiological signs of AC arthropathy. There was no statistical correlation before surgery, particularly with AC pain, or after surgery, with outcomes in shoulders undergoing DCR. CONCLUSION: When repairing rotator cuff tears, the presence of T2 hyperintensity on MRI in the distal clavicle is not a predictor of better clinical outcomes after AC resection arthroplasty is done. The AC pain may be related to the rotator cuff tear instead. LEVEL OF EVIDENCE: II, prospective randomised study.
Authors: Ayane Rossano; Nivethitha Manohar; Wouter J Veenendaal; Michel P J van den Bekerom; David Ring; Amirreza Fatehi Journal: J Orthop Date: 2022-05-20