Table 3.
Post-operative findings (expected) and complications after rotator cuff surgery
| Parameter | Imaging modality | Appearance on imaging |
|---|---|---|
| Expected post-operative finding | ||
| Presence of metal implants | Radiographs/CT | Identification of implants and sutures |
| Osseous changes of subacromial decompression | Radiographs/CT/MRI | Distal clavicle resection |
| Acromioplasty: flattened acromial undersurface with loss of the anterior acromion | ||
| Superior subluxation of humeral head | ||
| Bursectomy | CT/MRI | Absence of subacromial peribursal fat |
| Persistent fluid in subacromial bursal region | ||
| Expected post-operative rotator cuff tendon appearance | MRI | Foci of intermediate (less the fluid or intra-articular contrast) intensity in tissue secondary to granulation tissue |
| Tendon-to-bone repair | Radiographs/CT/MRI | Surgical trough in humeral head |
| Suture anchors at tendon–bone interface | ||
| Tendon-to-tendon repair | Radiographs/CT/MRI | Suture placement within tendons |
| Expected post-operative muscle changes | CT/MRI | Apparent muscle enlargement on parasagittal images as muscle pulled laterally during reconstruction |
| Muscle fatty infiltration/atrophy if present before surgery | ||
| Post-operative complication | ||
| Recurrent rotator cuff tear | MRI | Signal similar to fluid in tendon substance, usually at the tendon–bone interface or 1.5 cm medial to re-attachment site |
| MRA/CTA | Definite gap in tendon with signal similar to intra-articular contrast | |
| Suture displacement | Radiographs/CT/MRI | Suture anchor displacement into unexpected position |
| Subacromial spur reformation | Radiographs/CT/MRI | Subacromial spur evidence, best on sagittal and coronal views |
| Infection | MRI | Joint effusion, synovial thickening, adjacent soft-tissue oedema |
| Adhesive capsulitis | MRI/MRA | Loss of normal fat signal in subcoracoid triangle, thickening of inferior glenohumeral ligament |
| Deltoid detachment | MRI | Retraction of deltoid with fluid filling the defect, muscle atrophy with fatty infiltration |
| Heterotopic ossification | Radiographs/CT/MRI | Mature ossification in deltoid better assessed by CT |
| Acromial fracture | Radiographs/CT | Fracture line well shown on axillary view or axial CT |
| MRI | Increased fluid signal in acromion | |
CTA, CT angiography; MRA, MR arthrography.