4.2 Article

Assessment of postoperative acromial and subacromial morphology after arthroscopic acromioplasty using magnetic resonance imaging

Journal

SKELETAL RADIOLOGY
Volume 50, Issue 4, Pages 761-770

Publisher

SPRINGER
DOI: 10.1007/s00256-020-03607-5

Keywords

Shoulder; Acromioplasty; Postoperative imaging; MRI

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The study found that there is a significant reduction in acromial thickness within approximately 1 year post arthroscopic acromioplasty, along with the development of loculated fluid collection in the subacromial bursal space. Changes in acromial morphology postoperatively were not significantly associated with clinical or radiological factors.
Objective To identify the morphological characteristics of the acromion and subacromial bursal space after arthroscopic acromioplasty using magnetic resonance imaging (MRI). Materials and methods One hundred patients who received arthroscopic rotator cuff repair and acromioplasty each received at least three MRI examinations (preoperative, first immediate postoperative, and second follow-up imaging between 8 months and 1 year postoperatively). Changes over time in the thickness and morphology of the postoperative acromion as well as the subacromial bursal space were assessed. Clinical and radiological parameters were also analyzed to identify any association with changes in acromial morphology. Results Despite minimal acromial thinning observed at the first immediate postoperative state, the acromions showed significant thinning at the second postoperative MRI, with a mean reduction of 32%. Along with acromial thinning, an exaggerated concave contour of the acromial undersurface was observed in some patients. In the subacromial space, a loculated fluid collection developed in 91% of the patients at the second postoperative follow-up. No statistically significant association was noted between postoperative acromial thickness change and clinical or radiological factors (Pvalue > 0.05). Conclusion A significant delayed reduction in acromial thickness within approximately 1 year of arthroscopic acromioplasty is thought to be a normal postoperative feature. The simultaneous collection of a loculated, cyst-like fluid in the subacromial bursal space may be an important associated factor of postoperative acromial thinning.

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