Inter-Rater Agreement of the Goutallier, Patte, and Warner Classification Scores Using Preoperative Magnetic Resonance Imaging in Patients With Rotator Cuff Tears

Background: Numerous studies have shown preoperative fatty infiltration of rotator cuff muscles to be strongly negatively correlated with the successful repair of massive rotator cuff tears (RCTs). Purpose: To assess the association between factors identified on preoperative magnetic resonance imaging (MRI), especially infraspinatus fatty infiltration, and the reparability of massive RCTs. Study Design: Case-control study; Level of evidence, 3. Methods: We analyzed a total of 105 patients with massive RCTs for whom MRI was performed ≤6 months before arthroscopic procedures. The mean age of the patients was 62.7 years (range, 46-83 years), and 46 were men. Among them, complete repair was possible in 50 patients (48%) and not possible in 55 patients (52%). The tangent sign, fatty infiltration of the rotator cuff, and Patte classification were evaluated as predictors of reparability. Using the receiver operating characteristic curve and the area under the curve (AUC), the prediction accuracy of each variable and combinations of variables were measured. Results: Reparability was associated with fatty infiltration of the supraspinatus ( P = .0045) and infraspinatus ( P < .001) muscles, the tangent sign ( P = .0033), and the Patte classification ( P < .001) but not with fatty infiltration of the subscapularis and teres minor ( P = .425 and .132, respectively). The cut-off values for supraspinatus and infraspinatus fatty infiltration were grade >3 and grade >2, respectively. The examination of single variables revealed that infraspinatus fatty infiltration showed the highest AUC value (0.812; sensitivity: 0.86; specificity: 0.76), while the tangent sign showed the lowest AUC value (0.626; sensitivity: 0.38; specificity: 0.87). Among 2-variable combinations, the combination of infraspinatus fatty infiltration and the Patte classification showed the highest AUC value (0.874; sensitivity: 0.54; specificity: 0.96). The combination of 4 variables, that is, infraspinatus and supraspinatus fatty infiltration, the tangent sign, and the Patte classification, had an AUC of 0.866 (sensitivity: 0.28; specificity: 0.98), which was lower than the highest AUC value (0.874; sensitivity: 0.54; specificity: 0.96) among the 2-variable combinations. Conclusion: The tangent sign or Patte classification alone was not a predictive indicator of the reparability of massive RCTs. Among single variables, infraspinatus fatty infiltration was the most effective in predicting reparability, while the combination of Goutallier classification <3 of the infraspinatus and Patte classification ≤2 of the rotator cuff muscles was the most predictive among the combinations of variables. This information may help predict the reparability of massive RCTs.

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Arthroscopic Repair: Ability of Large to Massive Rotator Cuff Tears and Correlation With Preoperative Magnetic Resonance Imaging Measurements (SS-41)

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2008.04.041 ◽

2008 ◽

Vol 24 (6) ◽

pp. e23

Author(s):

Jae Chul Yoo ◽

Kyung Chung Kang ◽

Jin Hwan Ahn

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Arthroscopic Repair ◽

Preoperative Magnetic Resonance Imaging ◽

Rotator Cuff Tears ◽

Resonance Imaging ◽

Massive Rotator Cuff Tears ◽

Repair Ability ◽

Preoperative Magnetic Resonance

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Assessment of Tendon Retraction in Large to Massive Rotator Cuff Tears: A Modified Patte Classification Based on 2 Coronal Sections on Preoperative Magnetic Resonance Imaging With Higher Specificity on Predicting Reparability

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2020.06.023 ◽

2020 ◽

Vol 36 (11) ◽

pp. 2822-2830 ◽

Cited By ~ 1

Author(s):

Siyi Guo ◽

Yiming Zhu ◽

Guanyang Song ◽

Chunyan Jiang

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Preoperative Magnetic Resonance Imaging ◽

Rotator Cuff Tears ◽

Resonance Imaging ◽

Massive Rotator Cuff Tears ◽

Preoperative Magnetic Resonance ◽

Tendon Retraction

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Correlation of Arthroscopic Repairability of Large to Massive Rotator Cuff Tears With Preoperative Magnetic Resonance Imaging Scans

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2008.12.015 ◽

2009 ◽

Vol 25 (6) ◽

pp. 573-582 ◽

Cited By ~ 73

Author(s):

Jae Chul Yoo ◽

Jin Hwan Ahn ◽

Jae Hyuk Yang ◽

Kyoung Hwan Koh ◽

Sang Hee Choi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Preoperative Magnetic Resonance Imaging ◽

Rotator Cuff Tears ◽

Resonance Imaging ◽

Massive Rotator Cuff Tears ◽

Preoperative Magnetic Resonance

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Use of preoperative magnetic resonance imaging to predict rotator cuff tear pattern and method of repair (SS-78)

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2004.02.074 ◽

2004 ◽

Vol 20 ◽

pp. e37 ◽

Cited By ~ 1

Author(s):

J.F.James Davidson ◽

Stephen S. Burkhart ◽

David P. Richards ◽

Scot E. Campbell

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Preoperative Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Cuff Tear ◽

Tear Pattern ◽

Preoperative Magnetic Resonance

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Prediction of primary reparability of massive tears of the rotator cuff on preoperative magnetic resonance imaging

Journal of Shoulder and Elbow Surgery ◽

10.1016/s1058-2746(02)86888-4 ◽

2003 ◽

Vol 12 (3) ◽

pp. 222-225 ◽

Cited By ~ 58

Author(s):

Takayuki Sugihara ◽

Teruhiko Nakagawa ◽

Masamitsu Tsuchiya ◽

Masafumi Ishizuki

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Preoperative Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Preoperative Magnetic Resonance ◽

Massive Tears

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Concordância interobservador na avaliação de lesões do tendão subescapular usando imagens de Ressonância Nuclear Magnética

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v8i1.3821 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Aleixo Abreu Tanure ◽

Roberto Barreto Maia ◽

Thiago Alencar Fortaleza ◽

Luis Guilherme Rosifini Alves Rezende ◽

Adriana Vieira Pedreira Cabral ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Mr Imaging ◽

Interobserver Agreement ◽

Preoperative Magnetic Resonance Imaging ◽

Subscapularis Tendon ◽

Resonance Imaging ◽

Preoperative Magnetic Resonance ◽

Tendon Tears

Introdução: As lesões do tendão musculo subescapular (TMSE) do manguito rotador passaram a ter aumento de sua incidência com as avançadas técnicas de diagnostico por imagem e artroscópicas. A Ressonância Nuclear Magnética (RM) apresenta boa sensibilidade e especificidade permitindo adequada acurácia diagnóstico. Objetivo: avaliação da concordância interobservador da RM para Lesões do TMSE comparada à artroscopia. Métodologia: 49 pacientes sintomáticos foram submetidos à RM para diagnóstico de lesão do TMSE e avaliação da Classificação de Lafosse, tendo sua concordância avaliada através da Artroscopia diagnostica. Resultados: A acurácia global foi 68% para concordância diagnóstica da Lesão do TMSE e 57,1% para concordância na classificação de Lafosse. Discussão: obteve-se concordância para o diagnóstico de Lesão ou ausência de Lesão do TMSE de 0,49 e a concordância para a Classificação de Lafosse foi de 0,30. Conclusão: o diagnóstico da lesão do TMSE através da RM é de difícil realização.Descritores: Manguito Rotador; Artroscopia; Imagem por Ressonância Magnética.ReferênciasTicker JB, Warner JJ. Single-tendon tears of the rotator cuff: evaluation and treatment of subscapularis tears and principles of treatment for supraspinatus tears. Orthop Clin North Am. 1997; 28(1):99-116.  Codman EA. Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. The Shoulder. 2nd Ed. Boston: Thomas Todd; 1934. p. 262-312.  Deutsch A, Altchek DW, Veltri DM, Potter HG, Warren RF. Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med. 1997;25(1):13-22.Li XX, Schweitzer ME, Bifano JA, Lerman J, Manton GL, El-Noueam KI. MR evaluation of subscapularis tears. J Comput Assist Tomogr. 1999;23(5):713-17.  Adams CR, Schoolfield JD, Burkhart SS. Accuracy of preoperative magnetic resonance imaging in predicting a subscapularis tendon tear based on arthroscopy. Arthroscopy. 2010;26(11):1427-33.Adams CR, Brady PC, Koo SS, Narbona P, Arrigoni P, Karnes GJ et al. A systematic approach for diagnosing subscapularis tendon tears with preoperative magnetic resonance imaging scans. Arthroscopy. 2012; 28(11):1592-600.Pfirrmann CWA, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: Detection and grading at MR ar- thrography. Radiology. 1999; 213:709-714.Yoon JP, Chung SW, Kim SH, Oh JH. Diagnostic value of four clinical tests for the evaluation of subscapularis integrity. J Shoulder Elbow Surg. 2013;22(9):1186-92.Beltran J. The use of magnetic resonance imaging about the shoulder. J Shoulder Elbow Surg. 1992; 1(6):321-33.Houtz CG, Schwartzberg RS, Barry JA, Reuss BL, Papa L. Shoulder MRI accuracy in the community setting. J Shoulder Elbow Surg. 2011; 20(4):537-42.Burks RT, Crim J, Brown N, Fink B, Greis PE. A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med. 2009;37(4):674-82. Gyftopoulos S, O' Donnell J, Shah NP, Goss J, Babb J, Recht MP. Correlation of MRI with arthroscopy for the evaluation of the subscapularis tendon: a musculoskeletal division’s experience. Skeletal Radiol. 2013;42(9):1269-75.Pfirrmann CW1, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: detection and grading at MR arthrography. Radiology. 1999;213(3):709-14.Spencer EE Jr, Dunn WR, Wright RW, Wolf BR, Spindler KP, McCarty E et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sports Med. 2008;36(1):99-103.Toussaint B, Barth J, Charousset C, Godeneche A, Joudet T, Lefebvre Y et al. New endoscopic classification for subscapularis lesions. Orthop Traumatol Surg Res. 2012;98(8 Suppl):S186-92.Lafosse L, Jost B, Reiland Y, Audebert S, Tousaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subescapularis tears. J Bone Joint Surg Am. 2007;89(6):1184-93.Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74.Balich SM, Sheley RC, Brown TR, Sauser DD, Quinn SF. MR imaging of the rotator cuff tendon: interobserver agreement and analysis of interpretive errors. Radiology. 1997; 204(1):191-94.Robertson PL, Schweitzer ME, Mitchell DG, Schlesinger F, Epstein RE, Frieman BG et al. Rotator cuff disor- ders: interobserver and intraobserver variation in diagnosis with MR imaging. Radiology. 1995;194(3):831-35.Singson RD, Hoang T, Dan S, Friedman M. MR evaluation of rotator cuff pathology using T2-weighted fast spin-echo technique with and without fat suppression. AJR Am J Roentgenol. 1996; 166:1061-65.Szymanski C1, Staquet V, Deladerrière JY, Vervoort T, Audebert S, Maynou C. Reproducibility and reliability of subscapularis tendon assessment using CT-arthrography. Orthop Traumatol Surg Res. 2013;99(1):2-9.

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