L Niglis1, P Collin2, J-C Dosch3, N Meyer4, J-F Kempf5. 1. Service de chirurgie orthopédique du membre supérieur, CCOM, 10, avenue Achille-Baumann, 67400 Illkirch, France. Electronic address: lucas.niglis@chru-strasbourg.fr. 2. CHP Saint-Grégoire, 6, avenue de la Boutière, 35760 Saint-Grégoire, France. 3. Service de radiologie, CCOM, 10, avenue Achille-Baumann, 67400 Illkirch, France. 4. Laboratoire de biostatistique, hôpital civil, 1, place de l'Hôpital, 67000 Strasbourg, France. 5. Service de chirurgie orthopédique du membre supérieur, CCOM, 10, avenue Achille-Baumann, 67400 Illkirch, France.
Abstract
BACKGROUND: The long-term outcomes of rotator cuff repair are unclear. Recurrent tears are common, although their reported frequency varies depending on the type and interpretation challenges of the imaging method used. The primary objective of this study was to assess the intra- and inter-observer reproducibility of the MRI assessment of rotator cuff repair using the Sugaya classification 10years after surgery. The secondary objective was to determine whether poor reproducibility, if found, could be improved by using a simplified yet clinically relevant classification. HYPOTHESIS: Our hypothesis was that reproducibility was limited but could be improved by simplifying the classification. MATERIAL AND METHOD: In a retrospective study, we assessed intra- and inter-observer agreement in interpreting 49 magnetic resonance imaging (MRI) scans performed 10years after rotator cuff repair. These 49 scans were taken at random among 609 cases that underwent re-evaluation, with imaging, for the 2015 SoFCOT symposium on 10-year and 20-year clinical and anatomical outcomes of rotator cuff repair for full-thickness tears. Each of three observers read each of the 49 scans on two separate occasions. At each reading, they assessed the supra-spinatus tendon according to the Sugaya classification in five types. RESULTS: Intra-observer agreement for the Sugaya type was substantial (κ=0.64) but inter-observer agreement was only fair (κ=0.39). Agreement improved when the five Sugaya types were collapsed into two categories (1-2-3 and 4-5) (intra-observer κ=0.74 and inter-observer κ=0.68). CONCLUSION: Using the Sugaya classification to assess post-operative rotator cuff healing was associated with substantial intra-observer and fair inter-observer agreement. A simpler classification into two categories improved agreement while remaining clinically relevant. LEVEL OF EVIDENCE: II, prospective randomised low-power study.
BACKGROUND: The long-term outcomes of rotator cuff repair are unclear. Recurrent tears are common, although their reported frequency varies depending on the type and interpretation challenges of the imaging method used. The primary objective of this study was to assess the intra- and inter-observer reproducibility of the MRI assessment of rotator cuff repair using the Sugaya classification 10years after surgery. The secondary objective was to determine whether poor reproducibility, if found, could be improved by using a simplified yet clinically relevant classification. HYPOTHESIS: Our hypothesis was that reproducibility was limited but could be improved by simplifying the classification. MATERIAL AND METHOD: In a retrospective study, we assessed intra- and inter-observer agreement in interpreting 49 magnetic resonance imaging (MRI) scans performed 10years after rotator cuff repair. These 49 scans were taken at random among 609 cases that underwent re-evaluation, with imaging, for the 2015 SoFCOT symposium on 10-year and 20-year clinical and anatomical outcomes of rotator cuff repair for full-thickness tears. Each of three observers read each of the 49 scans on two separate occasions. At each reading, they assessed the supra-spinatus tendon according to the Sugaya classification in five types. RESULTS: Intra-observer agreement for the Sugaya type was substantial (κ=0.64) but inter-observer agreement was only fair (κ=0.39). Agreement improved when the five Sugaya types were collapsed into two categories (1-2-3 and 4-5) (intra-observer κ=0.74 and inter-observer κ=0.68). CONCLUSION: Using the Sugaya classification to assess post-operative rotator cuff healing was associated with substantial intra-observer and fair inter-observer agreement. A simpler classification into two categories improved agreement while remaining clinically relevant. LEVEL OF EVIDENCE: II, prospective randomised low-power study.
Authors: Alexandre Lädermann; Philippe Collin; George S Athwal; Markus Scheibel; Matthias A Zumstein; Geoffroy Nourissat Journal: EFORT Open Rev Date: 2018-05-21
Authors: Bong-Jae Jun; Sambit Sahoo; Peter B Imrey; Andrew R Baker; Ahmet Erdemir; Yuxuan Jin; Joseph P Iannotti; Vahid Entezari; Eric T Ricchetti; Michael J Bey; Kathleen A Derwin Journal: JSES Int Date: 2020-09-12