Elise Loock1, Aude Michelet2, Amaury D'Utruy3,4, Pierre Molinazzi5, Gerjon Hannink6, Simon Bertiaux5, Olivier Courage5. 1. Service de chirurgie orthopédique et traumatologique, CHRU de Lille, avenue du professeur Emile Laine, Lille, France. 2. ReSurg SA, Chemin de Vuarpilliere 35, 1260, Nyon, Switzerland. journals@resurg.com. 3. Hopital Privé de Versailles, Clinique des Franciscaines, Versailles, France. 4. Hôpital Européen Georges-Pompidou, Paris, France. 5. Ramsay Générale de Santé, Hôpital Privé de l'Estuaire, Le Havre, France. 6. Orthopaedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
PURPOSE: To evaluate the diagnostic accuracy between magnetic resonance arthrography (MRA) and arthroscopic examination for the assessment of pathologies of the long head of the biceps (LHB) prior to rotator cuff (RC) repair. The hypothesis was that MRA is suitable to identify biceps instabilities, due to improved visibility of the biceps pulley. METHODS: Sixty-six patients aged 58.5 ± 17.6 (range, 46-71) scheduled to have RC repair between 2016 and 2017 were prospectively enrolled. MRA images of the LHB were interpreted by one radiologist and two surgeons, then compared to arthroscopic findings. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated by comparing MRA axial readings to arthroscopic assessment in the neutral position (static instability), MRA sagittal readings to arthroscopic assessment in external rotation (dynamic s instability), MRA coronal and axial readings to arthroscopic assessment in the neutral position (tendinopathy). RESULTS: Among the three observers, the radiologist obtained the highest sensitivity and specificity for MRA, which were respectively: (1) for static instability, 62% (C.I. 35-85) and 77% (C.I. 63-88); (2) for dynamic instability, 50% (C.I. 29-71) and 62% (C.I. 46-77), and (3) for tendinopathy, 49% (C.I. 36-62) and 100% (C.I. 3-100). CONCLUSIONS: MRA is not suitable for the diagnosis of LHB lesions prior to arthroscopic rotator cuff repair. LEVEL OF EVIDENCE: Diagnostic study, Level I.
PURPOSE: To evaluate the diagnostic accuracy between magnetic resonance arthrography (MRA) and arthroscopic examination for the assessment of pathologies of the long head of the biceps (LHB) prior to rotator cuff (RC) repair. The hypothesis was that MRA is suitable to identify biceps instabilities, due to improved visibility of the biceps pulley. METHODS: Sixty-six patients aged 58.5 ± 17.6 (range, 46-71) scheduled to have RC repair between 2016 and 2017 were prospectively enrolled. MRA images of the LHB were interpreted by one radiologist and two surgeons, then compared to arthroscopic findings. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated by comparing MRA axial readings to arthroscopic assessment in the neutral position (static instability), MRA sagittal readings to arthroscopic assessment in external rotation (dynamic s instability), MRA coronal and axial readings to arthroscopic assessment in the neutral position (tendinopathy). RESULTS: Among the three observers, the radiologist obtained the highest sensitivity and specificity for MRA, which were respectively: (1) for static instability, 62% (C.I. 35-85) and 77% (C.I. 63-88); (2) for dynamic instability, 50% (C.I. 29-71) and 62% (C.I. 46-77), and (3) for tendinopathy, 49% (C.I. 36-62) and 100% (C.I. 3-100). CONCLUSIONS: MRA is not suitable for the diagnosis of LHB lesions prior to arthroscopic rotator cuff repair. LEVEL OF EVIDENCE: Diagnostic study, Level I.
Entities:
Keywords:
Arthroscopic rotator cuff repair; Diagnostic accuracy; Lesion of the long head of the biceps; Magnetic resonance arthrography
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