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

Yuji Shibayama; Toshiaki Hirose; Akira Sugi; Emi Mizushima; Yuto Watanabe; Rira Tomii; Kousuke Iba; Toshihiko Yamashita

doi:10.1016/j.jseint.2021.11.005

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

JSES Int. 2021 Dec 17;6(2):279-286. doi: 10.1016/j.jseint.2021.11.005. eCollection 2022 Mar.

Authors

Yuji Shibayama¹, Toshiaki Hirose², Akira Sugi¹, Emi Mizushima¹, Yuto Watanabe¹, Rira Tomii¹, Kousuke Iba¹, Toshihiko Yamashita¹

Affiliations

¹ Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
² Asabu Orthopaedic Hospital, Sapporo, Hokkaido, Japan.

Abstract

Background: Magnetic resonance imaging (MRI) is useful for diagnosing shoulder diseases preoperatively. However, preoperative risk factors for retears have not been previously reported using a radial-slice MRI. Here, we investigated the relationship between the preoperative tear area of the rotator cuff evaluated using radial-slice MRI and the postoperative rotator cuff integrity. Our hypothesis is that larger tear area of the rotator cuff measured using radial-slice MRI would be associated with increased retear rates.

Methods: From June 2010 to October 2015, we treated 102 consecutive patients who underwent shoulder arthroscopy for reparable rotator cuff tears. The patient demographics, medical comorbidities, radiologic factors, tear size, fatty infiltration, muscle atrophy measured using oblique coronal and oblique sagittal MRI, and the tear area calculated using radial-slice MRI were assessed to compare the intact and retear groups in univariate and multivariate logistic regression analyses. The cutoff values of the independent factors were obtained using the receiver operating characteristic curve.

Results: Retears occurred in 15 of 102 (14.7%) patients. In the univariate analysis, significant differences were found between the two groups for tear size, fatty infiltration of the supraspinatus and infraspinatus, muscle atrophy, and tear area. In the multivariate analysis, the tear area was the independent factor that significantly affected the rate of retear. A tear area of 6.3 cm² was the strongest predictor of retear with an area under the curve of 0.965, sensitivity of 86.7%, and specificity of 96.6%.

Conclusion: The tear area was the independent factor that most significantly affected the rate of retear and showed excellent accuracy with a cutoff value of 6.3 cm². Radial-slice MRI may be a valuable diagnostic tool for assessing the postoperative rotator cuff integrity.

Keywords: Cuff integrity; Prognostic factors; Radial magnetic resonance imaging; Retear; Risk factor; Rotator cuff tear.