Key result
Preoperative MRI findings of larger tear width, more tendon retraction, and more severe tendon degeneration were significantly associated with worse clinical outcome scores 1 year after repair (P<.05).
Why the study?
Investigation into using preoperative MRI to provide prognostic clinical outcome information after rotator cuff repair has been limited.
Do more severe rotator cuff tears on preoperative MRI predict worse postoperative DASH scores 1 year after repair?
Cohort (n=141)
Single-blind
No
Do more severe rotator cuff tears on preoperative MRI predict worse postoperative DASH scores 1 year after repair?
Effect estimate: estimate 3.52 for tear retraction; 2.05 for tear width; 1.59 for tendon degeneration
p-value: p=<.05
Larger rotator cuff tears, more tendon retraction, and more severe tendon degeneration on preoperative MRI are associated with worse clinical outcomes 1 year after repair.
May aid preoperative counseling on expected outcomes after rotator cuff repair; leaves open whether MRI should guide surgical indications.
Background Investigation of the use of preoperative MRI for providing prognostic information regarding clinical outcome following rotator cuff repair has been limited. Purpose To determine whether patients with more severe rotator cuff tears of the shoulder at preoperative MRI have a greater degree of residual pain and disability after rotator cuff repair. Materials and Methods This retrospective study included a cohort of 141 patients who underwent surgical repair of a full-thickness rotator cuff tear at a single institution between April 16, 2012, and September 3, 2015. The mean patient age was 56.8 years, and there were 100 men (mean age, 56.1 years) and 41 women (mean age, 56.3 years). Patients completed the Disabilities of the Arm, Shoulder, and Hand (DASH) survey (lower score indicates less pain and disability) before and 1 year after surgery. One musculoskeletal radiologist blinded to the DASH scores measured the maximal anterior-posterior width and medial-lateral retraction of the rotator cuff tear on the preoperative MRI and assessed tendon degeneration and composite muscle atrophy and fatty infiltration using categorical grading scales (grade 0 indicates no tendon degeneration or muscle atrophy and fatty infiltration, and higher grades indicate incrementally more severe tendon degeneration or muscle atrophy and fatty infiltration). Generalized estimating equation models were used to determine the association between preoperative MRI findings and the postoperative DASH score. Results There was a significant positive association (P < .05) between the measured tear width (estimate, 2.05), measured tear retraction (estimate, 3.52), and tendon degeneration grade (estimate, 1.59) and the postoperative DASH score. There was no significant association (P = .49) between the composite muscle atrophy and fatty infiltration grade (estimate, 0.31) and the postoperative DASH score. Conclusion Patients with larger rotator cuff tears, more tendon retraction, and more severe tendon degeneration have worse clinical outcome scores 1 year after rotator cuff repair.
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Kijowski et al. (2019) conducted a cohort in Full-thickness rotator cuff tear (n=141). Preoperative MRI findings of severe rotator cuff tears (tear width, retraction, tendon degeneration) vs. Less severe MRI findings was evaluated on Postoperative DASH score at 1 year (estimate 3.52 for tear retraction; 2.05 for tear width; 1.59 for tendon degeneration, p=<.05). Preoperative MRI findings of larger tear width, more tendon retraction, and more severe tendon degeneration were significantly associated with worse clinical outcome scores 1 year after repair (P<.05).
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