From the Guidelines
A CT scan is a valid option for imaging someone with surgical anchors in the right shoulder, as it can effectively visualize both bone and metal implants, and modern CT scanners have metal artifact reduction software to minimize artifacts. CT scans are particularly useful when there's a need to assess bone healing, potential anchor displacement, or complications around the implant site, such as periprosthetic lucency, osteolysis, hardware malposition, and component migration, as well as the degree of osseous incorporation along the glenoid 1. The use of newer metal reduction CT software has decreased the artifact-related limitations, improving evaluation, and dual-energy CT, employing virtual noncalcium software, may provide useful information regarding the presence of marrow edema 1.
Some considerations for using CT scans in this context include the potential for image degradation due to beam hardening artifact and other hardware-related artifacts, especially with older CT scanners 1. However, metal reduction protocols and modifications in patient positioning have greatly enhanced the ability of CT to evaluate for complications associated with shoulder arthroplasties 1. It's also important to note that the addition of intra-articular or IV contrast does not typically improve evaluation, and evaluation of bone graft resorption remains limited on CT because of metal artifact 1.
In terms of alternative imaging modalities, radiography is the first and main imaging modality utilized in the evaluation of shoulder arthroplasty, but it may not provide the same level of detail as CT scans for evaluating complications around the implant site 1. Ultimately, the choice of imaging modality will depend on the specific clinical question and the patient's individual circumstances. CT scans can provide valuable information for diagnosing and managing complications related to surgical anchors in the right shoulder, and their use should be considered on a case-by-case basis.
From the Research
Imaging Options for Surgical Anchors in the Right Shoulder
- Computed Tomography (CT) scans are a valid option for imaging patients with surgical anchors in place, as they provide detailed images of bone and soft tissue structures 2.
- However, the use of CT scans for imaging surgical anchors in the shoulder is not specifically discussed in the provided studies.
- Other imaging modalities, such as magnetic resonance imaging (MRI) and fluoroscopy, are also used for diagnostic and post-operative evaluation of shoulder injuries and surgeries 2, 3.
- MRI is used to assess the structural integrity of rotator cuff repairs and the rate of cyst formation in the greater tuberosity 4.
- Fluoroscopy is used for real-time evaluation of motility and esophageal disorders, as well as for post-operative cases where synergy with CT and endoscopy is apparent 3.
Considerations for Imaging Surgical Anchors
- The choice of imaging modality depends on the specific requirements of the surgical procedure and the nature of the intervention 2.
- Soft tissue reactions to copolymer and biocomposite materials, including all-suture anchors, have been reported, raising concerns over safety and clinical performance 5.
- The use of all-suture anchors in rotator cuff repair surgery has been shown to be safe and effective, with significant improvements in shoulder function outcome scores and minimal complications 4.
- Biomechanical studies have compared the force-resistance, displacement, and mode of failure of different fixation techniques, including screw and suture button-based fixation of glenoid bone blocks 6.