Relationship between preoperative size of rotator cuff tears measured using radial-slice magnetic resonance images and postoperative rotator cuff integrity: a prospective case-control study

Shibayama, Yuki; Hirose, Tomoko; Sugi, Akira; Mizushima, Emi; Watanabe, Yuto; Tomii, Rira; Iba, Kouske; Yamashita, Toshihiko

doi:10.1016/j.jseint.2021.11.005

Cited by 4 publications

(3 citation statements)

References 49 publications

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“…They proposed a geometric classification system based on the width and length of a tear [42]. Shibayama et al [39] reported that the tear area measured using radial-slice MRI was the independent factor that most significantly affected rotator cuff integrity. Recently, Guo et al [11] reported that their modified Patte stage III tendon retraction, a tendon medial to the glenoid rim in two sections, was an independent factor for reparability and retear.…”

Section: Discussionmentioning

confidence: 99%

A modified Patte classification system for rotator cuff tendon retraction to predict reparability and tendon healing in arthroscopic rotator cuff repair

Takeda,

Fujii,

Suzue

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe purpose of this study was to propose a modified Patte classification system for tendon retraction, including the cut‐off points for predicting reparability and rotator cuff healing after arthroscopic rotator cuff repair (ARCR) and assess its prediction accuracy and measurement reliability.MethodsThis retrospective study included 463 consecutive patients scheduled to undergo ARCR for full‐thickness supraspinatus tears. Receiver operating characteristic (ROC) curve analysis was used to determine the cut‐off points for predicting reparability and tendon healing. The modified Patte classification system, in which these cut‐off points were combined with the original Patte classification, classified the tendon retraction as stages I–V. The prediction accuracy of reparability and tendon healing was assessed using the area under the curve (AUC). Measurement reliability was determined using Cohen's κ statistics.ResultsOf the 402 included patients, 32 rotator cuff tears were irreparable and 71 of the remaining 370 were diagnosed with healing failure. ROC analysis determined the cut‐off point of reparability at the medial one‐fifth and that of tendon healing at the medial one‐third of the humeral head. The AUC of the modified Patte classification for predicting reparability and tendon healing was 0.897 (excellent) and 0.768 (acceptable), respectively. Intra‐rater reliability was almost perfect (mean κ value: 0.875), and inter‐rater reliability was substantial (0.797).ConclusionDiagnostic performance of the modified Patte classification system was excellent for reparability and acceptable for rotator cuff healing, with high measurement reliability. The modified Patte classification system can be easily implemented in clinical practice for planning surgical procedures and counselling patients in the day‐by‐day clinical work.Level of EvidenceLevel III.

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Section: Discussionmentioning

confidence: 99%

A modified Patte classification system for rotator cuff tendon retraction to predict reparability and tendon healing in arthroscopic rotator cuff repair

Takeda,

Fujii,

Suzue

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…Radially reformatted images obtained from a 3D dataset offer the possibility to further improve shoulder MRI diagnostics by reducing image distortion and by minimizing volume averaging (13). A few reports have demonstrated the utility of radial-slice MRI to visualize RCTs using fatsuppressed T2-weighted imaging (14,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of a 3D double-echo steady-state sequence at 3 T using radial reformats for detecting and grading rotator cuff tears: a pilot diagnostic accuracy study with magnetic resonance imaging and arthroscopic correlation

Osterholt,

Link,

Abrar

et al. 2023

Acta Radiol

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Background In diagnosing rotator cuff tears (RCTs), magnetic resonance imaging (MRI) is the imaging modality of choice, and its accuracy is improving constantly. Purpose To evaluate the diagnostic performance of a high-resolution 3D double-echo steady-state (DESS) sequence with radial and paracoronal 3-T MRI regarding the grading of RCTs in correlation with conventional 2D MRI and arthroscopic findings. Material and Methods We retrospectively compared arthroscopic findings of RCTs with preoperative MRI, including conventional 2D sequences and radial and paracoronal DESS images in 20 patients. Two observers evaluated supraspinatus (SSP), infraspinatus (ISP), and subscapularis (SSC) tendon tears using a grading system. For statistical analysis, arthroscopy was used as the reference standard. Results Inter-observer agreement for detecting and grading SSP, ISP, and SSC tendon tears on radial and paracoronal sliced 3D DESS MRI was excellent (intraclass-correlation [ICC] = 0.92–0.98; all P < 0.001). Regarding the detection of SSP lesions, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 93.8%, 50%, 88.2%, and 66.7% for both radial and paracoronal DESS imaging. A sensitivity of 100%, specificity of 61.1%, PPV of 22.2%, and NPV of 100% were noted for detecting ISP tendon tears using radially reformatted DESS images. Regarding detecting SSC tendon tears using radially reformatted DESS images, sensitivity, specificity, PPV, and NPV were 100%, 81.3%, 50%, and 100%, respectively. The results with standard 2D MRI were similar. Conclusion The DESS technique with radially reformatted images provided excellent sensitivity and high inter-observer agreement in detecting RCTs. It showed a moderate to high correlation between MRI and arthroscopy for diagnosing SSP and SSC tendon tears.

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“…19,33,44,47,50 For a posterosuperior rotator cuff (PSRC) tear, preoperative magnetic resonance imaging (MRI) scans to determine findings such as tear size, extent of retraction, and tear configuration in addition to extent of fatty infiltration can be used to assess the possibility of repair. 4,25,39,41 However, since the retraction of a torn subscapularis tendon is less common than tears of the supraspinatus tendon, given the position of the transverse humeral ligament over the bicipital groove, the tear size or extent of retraction is difficult to accurately evaluate by MRI. 22,23,51,52 Thus, the use of MRI to assess the extent of muscle atrophy or fatty infiltration can predict the reparability of a tear, and it is imperative to accurately evaluate the degree of fatty infiltration in the subscapularis muscle.…”

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confidence: 99%

Comparison of the Goutallier Classification of Fatty Infiltration for the Subscapularis With a Novel Modified Classification

Yoon

Kim

Choi

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Fatty infiltration in the subscapularis muscle extends to the upper portion of the muscle first and then to the lower portion only after some degree of fatty change has taken place in the upper region. Although the Goutallier classification is the most widely used method to categorize fatty infiltration, how to accurately and reliably determine the extent of infiltration is controversial. Purpose: To examine a modified classification that is more reliable in (1) assessing fatty infiltration of the subscapularis muscle and (2) predicting the structural integrity of the repaired tendon by identifying cutoff points for retear. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: This study retrospectively examined the records of 545 patients who underwent arthroscopic repair for a subscapularis tear. Two shoulder surgeons reviewed the preoperative magnetic resonance imaging scans of all enrolled patients and evaluated the fatty infiltration of the subscapularis muscle based on the original Goutallier classification, as well as a novel modified Goutallier classification designed to measure the proportion of fat and muscle in the upper and lower portions of the muscle separately. Intra- and interobserver agreement of the reviewers was calculated using κ statistics. Using receiver operating characteristic curve analysis, we determined the cutoff point for the particular fatty infiltration grade related to the occurrence of retear for each classification scheme. Results: The κ values for interobserver reliability were 0.743 and 0.856 for the original and modified Goutallier classifications, respectively, with the modified classification having significantly higher reliability ( Z = 4.064; P < .001). Cutoff points for the fatty infiltration grade associated with retear were 2.5 for the original Goutallier classification (sensitivity, 65.3%; specificity, 95.6%; accuracy, 87.8%) and 3.5 for the modified classification (sensitivity, 52.5%; specificity, 97.8%; accuracy, 89.7%). Conclusion: In assessing fatty infiltration of the subscapularis muscle, the modified Goutallier classification showed higher reliability than the original Goutallier classification. The cutoff point for potential retear (grade 3.5) was at a point where the fatty infiltration extended to the lower portion of the subscapularis muscle.

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Relationship between preoperative size of rotator cuff tears measured using radial-slice magnetic resonance images and postoperative rotator cuff integrity: a prospective case-control study

Cited by 4 publications

References 49 publications

A modified Patte classification system for rotator cuff tendon retraction to predict reparability and tendon healing in arthroscopic rotator cuff repair

A modified Patte classification system for rotator cuff tendon retraction to predict reparability and tendon healing in arthroscopic rotator cuff repair

Diagnostic performance of a 3D double-echo steady-state sequence at 3 T using radial reformats for detecting and grading rotator cuff tears: a pilot diagnostic accuracy study with magnetic resonance imaging and arthroscopic correlation

Comparison of the Goutallier Classification of Fatty Infiltration for the Subscapularis With a Novel Modified Classification

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