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DOI: 10.1055/s-0041-1741445
A Comparison Between Preoperative and Intraoperative Measurement and Classification of the Size of Rotator Cuff Tears[*]
Article in several languages: português | English Financial Support The present RCT, from which this data was derived, was funded by the National Institute for Health Research (NIHR) Research for Patient Benefit programme (PB-PG-0816-20009). CL is supported by an NIHR Postdoctoral Fellowship, (PDF-2018-11-ST2-005). The views expressed are those of the author(s), and not necessarily those of the NIHR or the Department of Health and Social Care.
Abstract
Purpose To evaluate the agreement in tear size obtained through preoperative imaging and intraoperative measurement, and to determine the accuracy of preoperative imaging in the classification of tear size and identification of tears in each rotator cuff tendon.
Methods Data from 44 patients recruited to a randomized controlled trial were reviewed retrospectively. Size and location of the rotator cuff tears were confirmed by either ultrasound or magnetic resonance imaging scans preoperatively and evaluated during surgery. A t-test and Bland and Altman plot were used to determine the agreement between the preoperative and intraoperative measurements. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for tear size and involvement of the rotator cuff tendon.
Results There was good agreement in terms of the measurements (91%) and classification (89%) of the tear size preoperatively and during surgery. When classifying tear size, the sensitivity and PPV were high for medium-sized tears (100%) and lower for large tears (75%), reflecting that all medium-sized tears but not all large tears were identified preoperatively. For the preoperative identification of the tears, the sensitivity and PPV were highest for the supraspinatus (84%), with progressively lower sensitivities and PPV for the infraspinatus (57%), subscapularis (17%) and teres minor (0%).
Conclusions Through preoperative imaging, the measurement or classification of the tear size can be accurately performed. Where there is disagreement, it is unclear whether the tear size is either underestimated on the scan or overestimated during surgery. The high sensitivity demonstrates that a supraspinatus tear is usually detected by scan. The lower sensitivities for the infraspinatus and subscapularis indicate that the identification of tears in these tendons is less accurate.
* Study carried out by the Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
Publication History
Received: 18 May 2021
Accepted: 20 September 2021
Article published online:
09 February 2022
© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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