Michael J Kissenberth1, Gabriel J Rulewicz2, Stephen C Hamilton3, Hannah E Bruch4, Richard J Hawkins3. 1. Steadman Hawkins Clinic of the Carolinas, Greenville Hospital System, Greenville, SC, USA. Electronic address: mkissenberth@ghs.org. 2. North Mississippi Sports Medicine and Orthopaedic Clinic, Tupelo, MS, USA. 3. Steadman Hawkins Clinic of the Carolinas, Greenville Hospital System, Greenville, SC, USA. 4. Hawkins Foundation, Greenville, SC, USA.
Abstract
HYPOTHESIS: We hypothesize that patients with a positive tangent sign will have rotator cuff tears that are not able to be repaired primarily. METHODS: We performed a retrospective review of the charts of patients who had undergone surgery for repair of a rotator cuff tear. The operative note was reviewed to determine whether the cuff tear was primarily repaired. The magnetic resonance imaging study of each patient was reviewed to assess for a positive or negative tangent sign. The reviewer was blinded to the result of each measurement. RESULTS: Eighty-one patients met the inclusion criteria. Of the 79 included in our analyses, 17 had a positive tangent sign and 62 had a negative tangent sign. There was only 1 patient with a negative tangent sign who had an irreparable rotator cuff tear. There were 3 patients with a positive tangent sign who had a repairable rotator cuff. With a pretest prevalence of irreparable tears of 18.9%, a positive finding suggested a post-test probability of 82.3% with a positive tangent sign and a post-test probability of only 1.6% when the tangent sign was negative. CONCLUSION: Our results showed decision-making value in both a negative tangent sign and a positive tangent sign. The tangent sign is an easily performed and reproducible tool with good intraobserver and interobserver reliability that is a powerful predictor of whether a rotator cuff tear will be repairable.
HYPOTHESIS: We hypothesize that patients with a positive tangent sign will have rotator cuff tears that are not able to be repaired primarily. METHODS: We performed a retrospective review of the charts of patients who had undergone surgery for repair of a rotator cuff tear. The operative note was reviewed to determine whether the cuff tear was primarily repaired. The magnetic resonance imaging study of each patient was reviewed to assess for a positive or negative tangent sign. The reviewer was blinded to the result of each measurement. RESULTS: Eighty-one patients met the inclusion criteria. Of the 79 included in our analyses, 17 had a positive tangent sign and 62 had a negative tangent sign. There was only 1 patient with a negative tangent sign who had an irreparable rotator cuff tear. There were 3 patients with a positive tangent sign who had a repairable rotator cuff. With a pretest prevalence of irreparable tears of 18.9%, a positive finding suggested a post-test probability of 82.3% with a positive tangent sign and a post-test probability of only 1.6% when the tangent sign was negative. CONCLUSION: Our results showed decision-making value in both a negative tangent sign and a positive tangent sign. The tangent sign is an easily performed and reproducible tool with good intraobserver and interobserver reliability that is a powerful predictor of whether a rotator cuff tear will be repairable.
Authors: Alexandre Lädermann; Stephen S Burkhart; Pierre Hoffmeyer; Lionel Neyton; Philippe Collin; Evan Yates; Patrick J Denard Journal: EFORT Open Rev Date: 2017-03-13
Authors: Alexandre Lädermann; Philippe Collin; George S Athwal; Markus Scheibel; Matthias A Zumstein; Geoffroy Nourissat Journal: EFORT Open Rev Date: 2018-05-21
Authors: Micah Naimark; Thai Trinh; Christopher Robbins; Bridger Rodoni; James Carpenter; Asheesh Bedi; Bruce Miller Journal: Orthop J Sports Med Date: 2019-08-05