POSTOPERATIVE MR ARTHROGRAPHY OF THE SHOU LDER JOINT

Indications of MR arthrography were analyzed in this prospective study . The aim was to evaluate possible advantages over conventional MRI, e stablish diagnostic criteria and to analyze its meaning further for th e therapeutic management of postoperative patients. MR arthrography wa s performed in eight patients who had undergone surgical repair of rot ator cuff lesions (modified Neer acromio-plasty) and in six patients w ho had undergone arthroscopic therapy of recurrent unidirectional disl ocation of the shoulder by combined arthroscopic intra- and extracapsu lar repair. MR investigations were performed before and after applicat ion of a contrast solution (2 mmol Gd-DTPA). All patients suffered fro m chronic postoperative pain. In patients with rotator cuff lesions, a partial tear could be verified in one patient and excluded in all oth ers. In patients after arthroscopic therapy by combined intra- and ext racapsular repair, a radiologically patulous-appearing capsule correla ted with clinically recurrent dislocations. In all other patients diag nostic criteria, such as distribution of the intra-articular contrast solution, proliferation of scar tissue, nodular appearance of the glen ohumeral ligaments and capsule thickness, correlated with a regular po stoperative status. MR arthrography of the shoulder represents a promi sing method in the evaluation of the postoperative shoulder. It might further improve the evaluation of reactive capsule alterations, scar t issue proliferation, and the labroligamentous complex, as well as the ability to differentiate partial and complete rerupture from degenerat ive changes of the rotator cuff.