Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

Huang, Tao; Liu, Jian; Ma, Yupeng; Zhou, Dongsheng; Chen, Liang; Liu, Fanxiao

doi:10.1186/s13018-019-1460-y

Cited by 21 publications

(18 citation statements)

References 54 publications

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“…22 Magnetic resonance arthrography has superior diagnostic value in terms of sensitivity and specificity for articular-sided PRCTs compared with ultrasonography and MRI, although similar diagnostic accuracy has not been found for bursal-sided tears. 23…”

Section: Figurementioning

confidence: 99%

Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review

Plancher

Shanmugam

Briggs

et al. 2021

J Am Acad Orthop Surg

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Partial thickness rotator cuff tears (PRCTs) are a challenging disease entity. Optimal management of PRCTs continues to be controversial. Although advances in magnetic resonance imaging and ultrasonography have aided in early diagnosis, arthroscopic evaluation remains the benchmark for diagnosis. Conservative treatment is often the first line of management for most patients; however, evidence suggests that surgical intervention may limit tear progression and the long-term sequelae. Surgical decision making is driven by factors such as age, arm dominance, etiology, activity level, tear thickness, and tear location. Many surgical options have been described in the literature to treat PRCTs including arthroscopic débridement, transosseous, in situ repair techniques, and tear completion and repair. Biologic supplements have also become an attractive alternative to aid in healing; however, the long-term efficacy of these modalities is largely unknown. This article will provide a detailed review of the etiology and natural history of PRCTs, as well as diagnosis, and current management to guide clinical decision-making and formulate an algorithm for management of PRCTs for the orthopaedic surgeon.

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Section: Figurementioning

confidence: 99%

Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review

Plancher

Shanmugam

Briggs

et al. 2021

J Am Acad Orthop Surg

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“…Based on the depth of the tears, rotator cuff tears are classified as either partial‐thickness rotator cuff tears (PTRCTs) or full‐thickness rotator cuff tears 3 . According to previous imaging and cadaveric studies, the prevalence of PTRCTs ranges from 13% to 37% 4,5 . Because the remaining intact tendon fibers are under greater tension than normal, PTRCTs sometimes cause more significant pain and dysfunction than full‐thickness rotator cuff tears 6 …”

Section: Introductionmentioning

confidence: 99%

“…3 According to previous imaging and cadaveric studies, the prevalence of PTRCTs ranges from 13% to 37%. 4,5 Because the remaining intact tendon fibers are under greater tension than normal, PTRCTs sometimes cause more significant pain and dysfunction than full-thickness rotator cuff tears. 6 PTRCTs can be further classified into articular-side, intratendinous, and bursal-side tears based on the specific location of the tears.…”

Section: Introductionmentioning

confidence: 99%

Functional and MRI Outcomes After In Situ Repair Versus Tear Completion Before Repair of Bursal‐Side Partial‐Thickness Rotator Cuff Tears

Zhuo

Pan

2023

Orthopaedic Surgery

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ObjectiveThe optimal repair method for bursal‐side partial‐thickness rotator cuff tears (PTRCTs) involving >50% of the thickness remains a controversial topic. The study was aimed to compare the functional and magnetic resonance imaging (MRI) outcomes after in situ repair or tear completion before repair of bursal‐side PTRCTs.MethodsA retrospective clinical study was conducted involving 58 patients who underwent in situ repair or tear completion before repair of bursal‐side PTRCTs between January 2019 and December 2020. These patients were divided into two groups: the in situ repair group and the tear completion before repair group. Functional assessment consisted of active range of motion (ROM), visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant–Murley score. The percentages of patients in each group achieving the minimal clinical important difference (MCID) of the functional scores were determined. The healing status of the rotator cuff was assessed by postoperative MRI.ResultsThere were no statistically significant differences between the two groups in terms of demographic data. The mean follow‐up period was 14.53 ± 2.64 months in the in situ repair group and 15.40 ± 2.66 months in the tear completion before repair group. At the final follow‐up, the forward elevation, external rotation, and internal rotation improved significantly in both groups. The VAS, ASES score, and Constant–Murley score improved significantly in the in situ repair group (5.17 ± 2.00 points to 0.11 ± 0.41 points, p = 0.001; 44.04 ± 17.40 points to 95.47 ± 4.32 points, p = 0.001; 49.50 ± 14.38 points to 93.50 ± 3.49 points, p = 0.001) and in the tear completion before repair group (5.43 ± 3.32 points to 0.03 ± 0.18 points, p = 0.001; 41.50 ± 19.59 points to 95.94 ± 2.68 points, p = 0.001; 47.54 ± 17.13 points to 93.97 ± 2.61 points, p = 0.001). Postoperative MRI revealed that the re‐tear rate was 7.1% (2/28) in the in situ repair group and 3.3% (1/30) in the tear completion before repair group. No significant differences were observed in terms of the functional scores, the percentages of patients achieving the MCID of the functional scores, and the re‐tear rate between the two groups (p > 0.05).ConclusionsBoth in situ repair and tear completion before repair yielded satisfactory clinical outcomes for patients with bursal‐side PTRCTs. No significant differences were observed in the functional and MRI outcomes between the two groups.

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“…Pain intensity is directly correlated with the presence of kinesiophobia. Recently, multiple studies [ 11 , 12 ] have focused on the shoulder pain caused by partial-thickness rotator cuff tears, and indicated that compared with interstitial and articular-sided partial-thickness RCTs, bursal-sided tears can result in more severe shoulder pain. However, the effect of kinesiophobia on postoperative function was not evaluated.…”

Section: Introductionmentioning

confidence: 99%

Kinesiophobia could affect shoulder function after repair of rotator cuff tears

Lyu

et al. 2022

BMC Musculoskelet Disord

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Purpose Kinesiophobia (fear of movement) is a major limiting factor in the return to pre-injury sport level after surgery of rotator cuff tears. The study aims to gain insights into how kinesiophobia affects shoulder pain and function after the repair of full-thickness rotator cuff tears. Methods A prospective study was conducted to evaluate patients who underwent rotator cuff repair between January 2019 and December 2019 in our institution. The patients were divided into a trial group with a high kinesiophobia (Tampa Scale for Kinesiophobia [TSK], TSK > 37) and a control group with a low kinesiophobia (TSK ≤ 37). The indicators of interest included the Constant-Murley scores, numerical rating scale (NRS), visual analogue scale (VAS), Oxford Shoulder Score (OSS), and the American shoulder and elbow score (ASES), shoulder function and strength, and range of motion (ROM) at 3 days, 6 weeks, and 12 months after repair of full-thickness rotator cuff tears. Results In total, 49 patients who underwent repair of full-thickness rotator cuff tears were enrolled, which was divided into a trial group involving 26 patients (mean TSK 52.54) and a control group involving 23 patients (mean TSK 33.43). There were no statistically significant differences in basic information such as age, gender, and length of stay in the two groups. The preoperative and early postoperative functional scores and the Tampa Scale for Kinesiophobia were statistically significant differences between the two groups. However, long-term postoperative follow-up showed no statistically significant difference in ASES, and Constant-Murley scores, OSS, and VAS scores between the two groups as the kinesiophobia changed from positive to negative. Conclusion Degree of kinesiophobia reduced during post-operative rehabilitation of rotator cuff repair patients, but high kinesiophobia is still present in a large portion of the patients after rotator cuff repair. Patients after rotator cuff repair will benefit from early recognition and prevention of kinesiophobia.

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Diagnostic accuracy of MRA and MRI for the bursal-sided partial-thickness rotator cuff tears: a meta-analysis

Cited by 21 publications

References 54 publications

Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review

Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review

Functional and MRI Outcomes After In Situ Repair Versus Tear Completion Before Repair of Bursal‐Side Partial‐Thickness Rotator Cuff Tears

Kinesiophobia could affect shoulder function after repair of rotator cuff tears

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