Michael J Codsi1, Scott A Rodeo2, Jason J Scalise3, Tara McDonnell Moorehead4, C Benjamin Ma5. 1. The Everett Clinic, Everett, WA, USA. Electronic address: mikecodsi@gmail.com. 2. Hospital for Special Surgery, New York, NY, USA. 3. The CORE Institute, Phoenix, AZ, USA. 4. inVentiv Health Clinical, contracted to Pfizer Inc, Cambridge, MA, USA. 5. University of California San Francisco, Orthopedic Surgery, San Francisco, CA, USA.
Abstract
BACKGROUND: This study compared ultrasound and magnetic resonance imaging (MRI) evaluation of the repaired rotator cuff to determine concordance between these imaging studies. METHODS: We performed a concordance study using the data from a prospective nonrandomized multicenter study at 13 centers. A suture bridge technique was used to repair 113 rotator cuff tears that were between 1 and 4 cm wide. Repairs were evaluated with MRI and ultrasound at multiple time points after surgery. The MRI scans were read by a central radiologist and the surgeon, and the ultrasounds were read by a local radiologist or the surgeon who performed the ultrasound. RESULTS: The concordance between the central radiologist's MRI reading and the investigator's MRI readings at all time points was 89%, with a κ coefficient of 0.60. The concordance between the central radiologist's MRI and ultrasound readings at all time points was 85%, with a κ coefficient of 0.40. The concordance between the investigator's MRI and ultrasound readings was 92%, with a κ coefficient of 0.70. CONCLUSIONS: In the community setting, ultrasound may be used to evaluate the integrity of a repaired rotator cuff tendon and constitutes a comparable alternative to MRI when evaluating the integrity of a rotator cuff repair. Clinical investigators should compare their postoperative ultrasound results with their postoperative MRI results for a certain time period to establish the accuracy of ultrasound before relying solely on ultrasound imaging to evaluate the integrity of their rotator cuff repairs.
BACKGROUND: This study compared ultrasound and magnetic resonance imaging (MRI) evaluation of the repaired rotator cuff to determine concordance between these imaging studies. METHODS: We performed a concordance study using the data from a prospective nonrandomized multicenter study at 13 centers. A suture bridge technique was used to repair 113 rotator cuff tears that were between 1 and 4 cm wide. Repairs were evaluated with MRI and ultrasound at multiple time points after surgery. The MRI scans were read by a central radiologist and the surgeon, and the ultrasounds were read by a local radiologist or the surgeon who performed the ultrasound. RESULTS: The concordance between the central radiologist's MRI reading and the investigator's MRI readings at all time points was 89%, with a κ coefficient of 0.60. The concordance between the central radiologist's MRI and ultrasound readings at all time points was 85%, with a κ coefficient of 0.40. The concordance between the investigator's MRI and ultrasound readings was 92%, with a κ coefficient of 0.70. CONCLUSIONS: In the community setting, ultrasound may be used to evaluate the integrity of a repaired rotator cuff tendon and constitutes a comparable alternative to MRI when evaluating the integrity of a rotator cuff repair. Clinical investigators should compare their postoperative ultrasound results with their postoperative MRI results for a certain time period to establish the accuracy of ultrasound before relying solely on ultrasound imaging to evaluate the integrity of their rotator cuff repairs.
Authors: Richard M Hinds; Nicole Montero-Lopez; Kenneth Brock; Ronald Adler; Anthony Sapienza; John T Capo; Nader Paksima Journal: Hand (N Y) Date: 2018-07-13