Magnetic resonance visualization of surgical classification of rotator cuff tear: comparison with three-dimensional shoulder magnetic resonance arthrography at 3.0 T

Background: It is estimated that more than 25% of general population more than 60 years old experience rotator cuff tear, acromial impingement syndrome is one of the most common causes. Morphology of acromion is an important extrinsic factor in the development of rotator cuff tear. The traditional classification of the acromion by Bigliani et al. based on supraspinatus outlet view has been widely used, but due to the high requirements for patients to obtain true supraspinatus outlet view and the poor inter-observer reliability, it brings lots of limitations to the clinical use of this classification. In our clinical work, we have noticed that the formation of acromial anterolateral spur on Rockwood tilt view has some relationship to a rotator cuff tear. Objectives: To develop a new classification of acromion based on the subacromial impingement theory and the Rockwood tilt view. And explore the application value of the new classification in the diagnosis and treatment of rotator cuff tear. Methods: From January 2017 to December 2017, 101 cases of shoulder arthroscopic surgeries for impingement syndrome or rotator cuff tear were retrospectively analyzed. We developed a new classification of the acromion based on the Rockwood tilt view as type I flat acromion, type II bump acromion and type III impingement acromion. The status of the supraspinatus tendon was also recorded as no tear, partial-thickness tear, and full-thickness tear. We tested the inter-observer and intra-observer reliability of the new classification system (Kappa value) and analyzed the correlation between the acromion morphology and the rupture of the supraspinatus tendon. Results: In all 101 cases, the most common type was the impingement acromion with 46 patients (45.5%), followed by bump acromion in 37 patients (36.6%), and the flat acromion in 18 patients (17.8%). The inter-observer reliability of the new classification system was significantly better than that of the traditional classification (0.826 vs. 0.281). The incidence of supraspinatus tendon tear in the patients with impingement acromion was significantly higher than that of the other two types of acromion (ϰ2 = 50.316,P < 0.05). Conclusion: The Rockwood tilt view can well demonstrate the exact architecture of the anterolateral acromion spur. The new classification based on Rockwood tilt view has high reliability and good reproducibility. The type III impingement acromion correlates highly with the supraspinatus tendon tear. Level of evidence: Level II.

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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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Analysis of glenohumeral morphological factors for anterior shoulder instability and rotator cuff tear by magnetic resonance imaging

Journal of Orthopaedic Surgery ◽

10.1177/2309499018768100 ◽

2018 ◽

Vol 26 (2) ◽

pp. 230949901876810 ◽

Cited By ~ 2

Author(s):

B Saygi ◽

N Karahan ◽

O Karakus ◽

AI Demir ◽

OC Ozkan ◽

...

Keyword(s):

Magnetic Resonance ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Shoulder Instability ◽

Normal Population ◽

Anterior Shoulder Instability ◽

Glenoid Version ◽

Glenohumeral Instability ◽

Cuff Tear ◽

Coronal Height

Objective: The aim of this study was to investigate whether there are glenohumeral morphological differences between normal population, glenohumeral instability, and rotator cuff pathology. Method: In this study, shoulder magnetic resonance (MR) images of 150 patients were evaluated. Patients included in the study were studied in three groups of 50 individuals: patients with anterior shoulder instability in group 1, patients with rotator cuff tear in group 2, and control subjects without shoulder pathology in group 3. Results: There were statistically significant differences between groups in evaluations for glenoid version, glenoid coronal height, glenoid coronal diameter, humeral axial and coronal diameters, and coracohumeral interval distances. Significant differences were observed between groups 2 and 3 in glenoid axial diameter, glenoid coronal height, glenoid depth, humeral coronal diameter, and coracohumeral distances. Conclusion: The results obtained in this study suggest that glenoid version, glenoid coronal height and diameter, humeral diameter, and coracohumeral interval parameters in glenohumeral morphology-related parameters in patients with anterior instability are different from those of normal population and patients with rotator cuff pathology. In cases where there is a clinically difficult diagnosis, these radiological measurements will be helpful to clinicians in diagnosis and treatment planning, especially in cases of treatment-resistant cases.

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