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A Comparison Between Preoperative and Intraoperative Measurement and Classification of the Size of Rotator Cuff Tears

Authors :
Karl Peter Gill
Marcus Bateman
Bruno Mazuquin
Chris Littlewood
Source :
Revista Brasileira de Ortopedia, Vol 58, Iss 2, Pp 356-360 (2023)
Publication Year :
2023
Publisher :
Thieme Revinter Publicações Ltda., 2023.

Abstract

Abstract Purpose To evaluate the agreement in tear size obtained through preoperative imaging and intraoperative measurement, and to determine the accuracy of preoper-ative 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.

Details

Language :
English, Portuguese
ISSN :
19824378
Volume :
58
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Revista Brasileira de Ortopedia
Publication Type :
Academic Journal
Accession number :
edsdoj.7609956231344e23981fbc56cc5b2999
Document Type :
article
Full Text :
https://doi.org/10.1055/s-0041-1741445