Ron Gilat1, Ehud Atoun2, Ornit Cohen3, Oren Tsvieli4, Ehud Rath5, Dror Lakstein6, Ofer Levy7. 1. Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel. 2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Barzilai Medical Center Campus, Ashkelon, Israel. Electronic address: dratoun@gmail.com. 3. Faculty of Health Sciences, Ben-Gurion University of the Negev, Barzilai Medical Center Campus, Ashkelon, Israel. 4. Mayanei Hayeshua Medical Center, Bnei Brak, Israel. 5. Department of Orthopedic Surgery, Tel Aviv Medical Center (Affiliated With Sackler Faculty of Medicine and Tel Aviv University), Tel Aviv, Israel. 6. Orthopedic Department, E. Wolfson Medical Center (Affiliated With Sackler Faculty of Medicine and Tel Aviv University), Tel Aviv, Israel. 7. Reading Shoulder Unit, Royal Berkshire Hospital, Reading, UK.
Abstract
BACKGROUND AND HYPOTHESIS: The diagnostic workup of the painful shoulder after rotator cuff repair (RCR) can be quite challenging. The aim of this study was to assess the reliability of ultrasonography (US) for the detection of recurrent rotator cuff tears in patients with shoulder pain after RCR. We hypothesized that US for the diagnosis of recurrent rotator cuff tear after RCR would not prove to be reliable when compared with surgical arthroscopic confirmation (gold standard). METHODS: In this cohort study (diagnosis), we retrospectively analyzed the data of 39 patients with shoulder pain after arthroscopic RCR who had subsequently undergone US, followed by revision arthroscopy. The rotator cuff was evaluated first using US for the presence of retears. Thereafter, revision arthroscopy was performed, and the diagnosis was either established or disproved. The sensitivity and specificity of US were assessed in reference to revision arthroscopy (gold standard). RESULTS: A rotator cuff retear was indicated by US in 21 patients (54%) and by revision arthroscopy in 26 patients (67%). US showed a sensitivity of 80.8% and specificity of 100% in the diagnosis of rotator cuff retears. Omission of partial rotator cuff retears resulted in a spike in sensitivity to 94.7%, with 100% specificity remaining. CONCLUSION: US imaging is a highly sensitive and specific test for the detection of recurrent rotator cuff tears, as confirmed by revision arthroscopy, in patients with a painful shoulder after primary RCR.
BACKGROUND AND HYPOTHESIS: The diagnostic workup of the painful shoulder after rotator cuff repair (RCR) can be quite challenging. The aim of this study was to assess the reliability of ultrasonography (US) for the detection of recurrent rotator cuff tears in patients with shoulder pain after RCR. We hypothesized that US for the diagnosis of recurrent rotator cuff tear after RCR would not prove to be reliable when compared with surgical arthroscopic confirmation (gold standard). METHODS: In this cohort study (diagnosis), we retrospectively analyzed the data of 39 patients with shoulder pain after arthroscopic RCR who had subsequently undergone US, followed by revision arthroscopy. The rotator cuff was evaluated first using US for the presence of retears. Thereafter, revision arthroscopy was performed, and the diagnosis was either established or disproved. The sensitivity and specificity of US were assessed in reference to revision arthroscopy (gold standard). RESULTS: A rotator cuff retear was indicated by US in 21 patients (54%) and by revision arthroscopy in 26 patients (67%). US showed a sensitivity of 80.8% and specificity of 100% in the diagnosis of rotator cuff retears. Omission of partial rotator cuff retears resulted in a spike in sensitivity to 94.7%, with 100% specificity remaining. CONCLUSION: US imaging is a highly sensitive and specific test for the detection of recurrent rotator cuff tears, as confirmed by revision arthroscopy, in patients with a painful shoulder after primary RCR.
Authors: Ali S Farooqi; Alexander Lee; David Novikov; Ann Marie Kelly; Xinning Li; John D Kelly; Robert L Parisien Journal: Orthop J Sports Med Date: 2021-10-11