Early Postoperative MRI Evaluation of a Fascia Lata Autograft With and Without Polypropylene Mesh Augmentation After Superior Capsular Reconstruction.

Autor:	Ben, Hui, Kholinne, Erica, Zeng, Chu Hui, So, Sang-Pil, Lee, Jun-Bum, Sun, Yucheng, Koh, Kyoung-Hwan, Jeon, In-Ho
Předmět:	FASCIAE surgery SHOULDER joint surgery KRUSKAL-Wallis Test SHOULDER injuries MAGNETIC resonance imaging POLYENES PLASTIC surgery SURGERY PATIENTS RETROSPECTIVE studies MANN Whitney U Test AUTOGRAFTS TREATMENT effectiveness POSTOPERATIVE period SURGICAL meshes CHI-squared test DATA analysis software LONGITUDINAL method
Zdroj:	American Journal of Sports Medicine; Mar2023, Vol. 51 Issue 4, p912-918, 7p
Abstrakt:	Background: Recently, a polypropylene mesh has been introduced and reported to improve clinical outcomes after superior capsular reconstruction (SCR) using a fascia lata autograft (FLA). However, mesh-related events such as a foreign body response may trigger inflammation, which might affect graft healing and remodeling. Purpose/Hypothesis: The aim was to investigate whether the healing and remodeling of an FLA were affected by the use of a mesh by comparing the signal intensity of an FLA-alone group vs an FLA + Mesh group on postoperative magnetic resonance imaging (MRI). The hypothesis was that the use of a mesh would decrease the MRI signal intensity of FLA during the early postoperative phase. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who had undergone SCR using an FLA with or without a mesh between March 2013 and August 2021 were retrospectively analyzed. Follow-up MRI was performed at 3 months. A total of 78 patients (24 in the FLA group and 54 in the FLA + Mesh group) with intact grafts were included. Graft remodeling was evaluated by analyzing the signal-to-noise quotient (SNQ) at the humeral, mid-substance, and glenoid sites. Theoretically, lower SNQ ratios indicate higher strength and better healing of the graft. Results: The mean SNQ was 30.603 (range, 11.790-72.710) in the FLA group and 18.367 (range, 4.464-69.500) in the FLA + Mesh group (P <.001). Furthermore, significant differences were found between the 2 groups at the humeral and mid-substance sites (37.863 [range, 5.092-81.187] vs 15.512 [range, 1.814-80.869], P <.001; and 29.168 [range, 6.103-73.900] vs 16.878 [range, 2.454-92.416], P =.003; respectively). However, there was no difference between the 2 groups at the glenoid site (25.346 [range, 7.565-86.353] vs 20.354 [range, 3.732-88.468], P =.057). Conclusion: At the 3-month follow-up, the FLA + Mesh group showed a lower MRI signal intensity than the FLA group. The healing and remodeling of an FLA may be enhanced when a mesh is used. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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