Abstract
Surgical treatment of sports injuries has become increasingly common. Patients who remain symptomatic or develop new symptoms following surgery may be referred for further imaging. In the postoperative setting, the radiologist needs to be able to distinguish between normal postsurgical change and pathology. This requires familiarity with the common surgical techniques, their potential complications and the normal postoperative morphological changes. Diagnostic imaging criteria normally used in the preoperative patient may need to be modified as it may be of limited utility following surgery. Imaging protocols may also need to be tailored to reduce hardware related artefacts. Postoperative appearances of the common surgical procedures are reviewed with an emphasis on the knee and the shoulder.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
White LM, Buckwalter KA (2002) Technical considerations: CT and MR imaging in the postoperative orthopedic patient. Semin Musculoskelet Radiol 6(1):5–17
Buckwalter KA, Rydberg J, Kopecky KK, Crow K, Yang EL (2001) Musculoskeletal imaging with multislice CT. AJR Am J Roentgenol 176(4):979–986
White LM, Kim JK, Mehta M et al (2000) Complications of total hip arthroplasty: MR imaging-initial experience. Radiology 215(1):254–262
Sofka CM, Potter HG (2002) MR imaging of joint arthroplasty. Semin Musculoskelet Radiol 6(1):79–85
Deutsch AL, Mink JH, Fox JM et al (1990) Peripheral meniscal tears: MR findings after conservative treatment or arthroscopic repair. Radiology 176(2):485–488
De Smet AA, Tuite MJ, Norris MA, Swan JS (1994) MR diagnosis of meniscal tears: analysis of causes of errors. AJR Am J Roentgenol 163(6):1419–1423
Farley TE, Howell SM, Love KF, Wolfe RD, Neumann CH (1991) Meniscal tears: MR and arthrographic findings after arthroscopic repair. Radiology 180(2):517–522
Lim PS, Schweitzer ME, Bhatia M et al (1999) Repeat tear of postoperative meniscus: potential MR imaging signs. Radiology 210(1):183–188
Applegate GR, Flannigan BD, Tolin BS, Fox JM, Del Pizzo W (1993) MR diagnosis of recurrent tears in the knee: value of intraarticular contrast material. AJR Am J Roentgenol 161(4):821–825
Arnoczky SP, Warren RF (1983) The microvasculature of the meniscus and its response to injury. An experimental study in the dog. Am J Sports Med 11(3):131–141
Smith DK, Totty WG (1990) The knee after partial meniscectomy: MR imaging features. Radiology 176(1):141–144
Mariani PP, Santori N, Adriani E, Mastantuono M (1996) Accelerated rehabilitation after arthroscopic meniscal repair: a clinical and magnetic resonance imaging evaluation. Arthroscopy 12(6):680–686
Sciulli RL, Boutin RD, Brown RR et al (1999) Evaluation of the postoperative meniscus of the knee: a study comparing conventional arthrography, conventional MR imaging, MR arthrography with iodinated contrast material, and MR arthrography with gadolinium-based contrast material. Skeletal Radiol 28(9):508–514
Magee T, Shapiro M, Rodriguez J, Williams D (2003) MR arthrography of postoperative knee: for which patients is it useful? Radiology 229(1):159–163
White LM, Schweitzer ME, Weishaupt D, Kramer J, Davis A, Marks PH (2002) Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. Radiology 222(2):421–429
Vives MJ, Homesley D, Ciccotti MG, Schweitzer ME (2003) Evaluation of recurring meniscal tears with gadolinium-enhanced magnetic resonance imaging: a randomized, prospective study. Am J Sports Med 31(6):868–873
Hantes ME, Zachos VC, Zibis AH et al (2004) Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol 50(3):231–237
Mutschler C, Vande Berg BC, Lecouvet FE et al (2003) Postoperative meniscus: assessment at dual-detector row spiral CT arthrography of the knee. Radiology 228(3):635–641
Trattnig S, Rand T, Czerny C et al (1999) Magnetic resonance imaging of the postoperative knee. Top Magn Reson Imaging 10(4):221–236
Howell SM, Clark JA, Blasier RD (1991) Serial magnetic resonance imaging of hamstring anterior cruciate ligament autografts during the first year of implantation. A preliminary study. Am J Sports Med 19(1):42–47
Boynton MD, Fadale PD (1993) The basic science of anterior cruciate ligament surgery. Orthop Rev 22(6):673–679
Vogl TJ, Schmitt J, Lubrich J et al (2001) Reconstructed anterior cruciate ligaments using patellar tendon ligament grafts: diagnostic value of contrast-enhanced MRI in a 2-year follow-up regimen. Eur Radiol 11(8):1450–1456
Cheung Y, Magee TH, Rosenberg ZS, Rose DJ (1992) MRI of anterior cruciate ligament reconstruction. J Comput Assist Tomogr 16(1):134–137
Howell SM, Knox KE, Farley TE, Taylor MA (1995) Revascularization of a human anterior cruciate ligament graft during the first two years of implantation. Am J Sports Med 23(1):42–49
Howell SM, Clark JA (1992) Tibial tunnel placement in anterior cruciate ligament reconstructions and graft impingement. Clin Orthop Relat Res (283):187–195
Saupe N, White LM, Chiavaras MM et al (2008) Anterior cruciate ligament reconstruction grafts: MR imaging features at long-term follow-up – correlation with functional and clinical evaluation. Radiology 249(2):581–590
Coupens SD, Yates CK, Sheldon C, Ward C (1992) Magnetic resonance imaging evaluation of the patellar tendon after use of its central one-third for anterior cruciate ligament reconstruction. Am J Sports Med 20(3):332–335
Simonian PT, Harrison SD, Cooley VJ, Escabedo EM, Deneka DA, Larson RV (1997) Assessment of morbidity of semitendinosus and gracilis tendon harvest for ACL reconstruction. Am J Knee Surg 10(2):54–59
Howell SM, Berns GS, Farley TE (1991) Unimpinged and impinged anterior cruciate ligament grafts: MR signal intensity measurements. Radiology 179(3):639–643
Simmons R, Howell SM, Hull ML (2003) Effect of the angle of the femoral and tibial tunnels in the coronal plane and incremental excision of the posterior cruciate ligament on tension of an anterior cruciate ligament graft: an in vitro study. J Bone Joint Surg Am 85-A(6):1018–1029
May DA, Snearly WN, Bents R, Jones R (1997) MR imaging findings in anterior cruciate ligament reconstruction: evaluation of notchplasty. AJR Am J Roentgenol 169(1):217–222
Watanabe BM, Howell SM (1995) Arthroscopic findings associated with roof impingement of an anterior cruciate ligament graft. Am J Sports Med 23(5):616–625
Recht MP, Piraino DW, Cohen MA, Parker RD, Bergfeld JA (1995) Localized anterior arthrofibrosis (cyclops lesion) after reconstruction of the anterior cruciate ligament: MR imaging findings. AJR Am J Roentgenol 165(2):383–385
Bradley DM, Bergman AG, Dillingham MF (2000) MR imaging of cyclops lesions. AJR Am J Roentgenol 174(3):719–726
Horton LK, Jacobson JA, Lin J, Hayes CW (2000) MR imaging of anterior cruciate ligament reconstruction graft. AJR Am J Roentgenol 175(4):1091–1097
Rak KM, Gillogly SD, Schaefer RA, Yakes WF, Liljedahl RR (1991) Anterior cruciate ligament reconstruction: evaluation with MR imaging. Radiology 178(2):553–556
McCauley TR, Elfar A, Moore A et al (2003) MR arthrography of anterior cruciate ligament reconstruction grafts. AJR Am J Roentgenol 181(5):1217–1223
van Trommel MF, Potter HG, Ernberg LA, Simonian PT, Wickiewicz TL (1998) The use of noncontrast magnetic resonance imaging in evaluating meniscal repair: comparison with conventional arthrography. Arthroscopy 14(1):2–8
White LM, Kramer J, Recht MP (2005) MR imaging evaluation of the postoperative knee: ligaments, menisci, and articular cartilage. Skeletal Radiol 34(8):431–452
Fanelli GC (1993) Posterior cruciate ligament injuries in trauma patients. Arthroscopy 9(3):291–294
Christel P (2003) Basic principles for surgical reconstruction of the PCL in chronic posterior knee instability. Knee Surg Sports Traumatol Arthrosc 11(5):289–296
Sherman PM, Sanders TG, Morrison WB, Schweitzer ME, Leis HT, Nusser CA (2001) MR imaging of the posterior cruciate ligament graft: initial experience in 15 patients with clinical correlation. Radiology 221(1):191–198
Cooper JM, McAndrews PT, LaPrade RF (2006) Posterolateral corner injuries of the knee: anatomy, diagnosis, and treatment. Sports Med Arthrosc 14(4):213–220
Steadman JR, Rodkey WG, Briggs KK, Rodrigo JJ (1999) The microfracture technic in the management of complete cartilage defects in the knee joint. Orthopade 28(1):26–32
Alparslan L, Winalski CS, Boutin RD, Minas T (2001) Postoperative magnetic resonance imaging of articular cartilage repair. Semin Musculoskelet Radiol 5(4):345–363
Matsusue Y, Yamamuro T, Hama H (1993) Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy 9(3):318–321
Minas T, Chiu R (2000) Autologous chondrocyte implantation. Am J Knee Surg 13(1):41–50
Alparslan L, Minas T, Winalski CS (2001) Magnetic resonance imaging of autologous chondrocyte implantation. Semin Ultrasound CT MR 22(4):341–351
Spielmann AL, Forster BB, Kokan P, Hawkins RH, Janzen DL (1999) Shoulder after rotator cuff repair: MR imaging findings in asymptomatic individuals – initial experience. Radiology 213(3):705–708
Zanetti M, Jost B, Hodler J, Gerber C (2000) MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects. Skeletal Radiol 29(6):314–319
Ryu RK, Burkhart SS, Parten PM, Gross RM (2002) Complex topics in arthroscopic subacromial space and rotator cuff surgery. Arthroscopy 18(2 Suppl 1):51–64
Owen RS, Iannotti JP, Kneeland JB, Dalinka MK, Deren JA, Oleaga L (1993) Shoulder after surgery: MR imaging with surgical validation. Radiology 186(2):443–447
Magee TH, Gaenslen ES, Seitz R, Hinson GA, Wetzel LH (1997) MR imaging of the shoulder after surgery. AJR Am J Roentgenol 168(4):925–928
Rand T, Trattnig S, Breitenseher M, Wurnig C, Marschner B, Imhof H (1999) The postoperative shoulder. Top Magn Reson Imaging 10(4):203–213
Gaenslen ES, Satterlee CC, Hinson GW (1996) Magnetic resonance imaging for evaluation of failed repairs of the rotator cuff. J Bone Joint Surg Am 78(9):1391–1396
Duc SR, Mengiardi B, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2006) Diagnostic performance of MR arthrography after rotator cuff repair. AJR Am J Roentgenol 186(1):237–241
Zlatkin MB (2002) MRI of the postoperative shoulder. Skeletal Radiol 31(2):63–80
Prickett WD, Teefey SA, Galatz LM, Calfee RP, Middleton WD, Yamaguchi K (2003) Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively. J Bone Joint Surg Am 85-A(6):1084–1089
Kim SH, Yoo JC, Ahn JM (2005) Arthroscopically repaired Bankart lesions and the effect of two different arm positions on immediate postoperative evaluation with magnetic resonance arthrography. Arthroscopy 21(7):867–874
Probyn LJ, White LM, Salonen DC, Tomlinson G, Boynton EL (2007) Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment – correlation with second-look surgical evaluation. Radiology 245(3):814–823
Wagner SC, Schweitzer ME, Morrison WB, Fenlin JM Jr, Bartolozzi AR (2002) Shoulder instability: accuracy of MR imaging performed after surgery in depicting recurrent injury – initial findings. Radiology 222(1):196–203
Rand T, Freilinger W, Breitenseher M et al (1999) Magnetic resonance arthrography (MRA) in the postoperative shoulder. Magn Reson Imaging 17(6):843–850
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Naraghi, A., White, L.M. (2010). Postoperative Imaging in Sports Medicine. In: Robinson, P. (eds) Essential Radiology for Sports Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5973-7_8
Download citation
DOI: https://doi.org/10.1007/978-1-4419-5973-7_8
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-5972-0
Online ISBN: 978-1-4419-5973-7
eBook Packages: MedicineMedicine (R0)