A Novel Reparability Assessment Scoring System for Full-Thickness Rotator Cuff Tears
- 주제(키워드) rotator cuff tear , reparability , partial repair , assessment score , arthroscopy
- 주제(기타) Orthopedics
- 주제(기타) Sport Sciences
- 설명문(일반) [Park, In; Kang, Jun-Seok; Lee, Hye-Ah; Jo, Yoon-Geol; Shin, Sang-Jin] Ewha Womans Univ, Seoul Hosp, Seoul, South Korea; [Park, In; Kang, Jun-Seok; Jo, Yoon-Geol; Shin, Sang-Jin] Ewha Womans Univ, Seoul Hosp, Coll Med, Dept Orthoped Surg, 260 Gonghang Daero, Seoul 07804, South Korea; [Lee, Hye-Ah] Ewha Womans Univ, Mokdong Hosp, Clin Trial Ctr, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 SAGE PUBLICATIONS INC
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000174576
- 본문언어 영어
- Published As http://dx.doi.org/10.1177/2325967120940979
- PubMed https://pubmed.ncbi.nlm.nih.gov/32844101
초록/요약
Background: It is difficult to predict the arthroscopic reparability of rotator cuff tears preoperatively when the repair is challenging. This can result in unsatisfactory outcomes and a high retear rate. Purpose: To develop an assessment score reflecting factors in rotator cuff tears that can predict reparability before surgery. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively enrolled 170 patients with rotator cuff tears larger than 2 cm who underwent arthroscopic repair. Patients were categorized into "complete repair" and "partial repair" groups based on the area of the exposed footprint after arthroscopic rotator cuff repair. In each group, preoperative magnetic resonance imaging factors (tear size, fatty infiltration, remnant tendon length, atrophy), clinical factors (range of motion, American Shoulder and Elbow Surgeons score, Constant score), and patient demographics were evaluated. Receiver operating characteristic curve analysis was used to choose the optimal cutoff value. A reparability assessment score was formulated through stepwise selection using variables that showed significant between-group differences on univariate analysis. We selected 4 variables and assigned a relative score for each variable based on estimated coefficient values. The sum of the scores for each factor ranged from 0 to 5. Results: The average rotator cuff tear size was 28 x 26 mm. The torn rotator cuff was repaired completely in 74 patients (43.5%) and partially in 96 patients (56.5%). The following factors were chosen for the reparability assessment score: positive tangent sign (odds ratio [OR], 5.969;P= .001), fatty infiltration of the infraspinatus of grade <= 2 (OR, 3.537;P= .001), coronal tear size >= 26 mm (OR, 3.315;P= .002), and remnant tendon length <15 mm (OR, 2.584;P= .017). Complete repair was possible if the sum of the scores was <3 (area under curve, 0.803; 95% CI, 0.739-0.867; sensitivity, 51.0%; specificity, 95.9%). Conclusion: In patients with a score of <3 on the novel reparability assessment score, complete repair was obtainable, whereas in patients with a score of >= 3, complete repair was difficult and other methods such as biologic grafts or arthroplasty had to be considered for a favorable prognosis.
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