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Serial structural MRI evaluation of arthroscopy rotator cuff repair: does Sugaya’s classification correlate with the postoperative clinical outcomes?

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Sugaya’s classification is the most commonly used for postoperative evaluation of rotator cuff repairs. However, the correlation between this classification and clinical outcomes after supraspinatus tendon repair were not performed with serial MRI examinations in standardized time intervals.

Materials and methods

This prospective case series involved 54 patients undergoing repair of the supraspinatus tendon tear. Magnetic resonance imaging (MRI, 1.5 T) was used to determine the Sugaya’s classifications at 3, 6, and 12 months, and these data were correlated with the visual analog scale for pain (VAS), Constant and University of California at Los Angeles (UCLA) assessments.

Results

Patients with types I, II, and ≥III of Sugaya’s classification experienced pain of 1.27 ± 1.95, 1.00 ± 1.40, and 3.43 ± 3.36, respectively (p = 0.010), according to the VAS. The Constant and UCLA scales did not differ significantly. Type II predominated, though their percentage decreased over time (from 77.8 to 66.7 %), whereas type I became more frequent (from 1.9 to 20.4 %).

Conclusions

The pain was more intense in patients classified as types III, IV, or V of Sugaya’s classification. The postoperative appearance of the supraspinatus tendon was not correlated with the Constant and UCLA scales. The occurrence of type II, the most prevalent, decreased over time, whereas the occurrence of type I increased; these differences were not significant.

Level de evidence: prospective cohort evaluation—level III.

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References

  1. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A:219–224

    PubMed  Google Scholar 

  2. Cole BJ, McCarty LP 3rd, Kang RW, Alford W, Lewis PB, Hayden JK (2007) Arthroscopic rotator cuff repair: prospective functional outcome and repair integrity at minimum 2-year follow-up. J Shoulder Elbow Surg 16:579–585

    Article  PubMed  Google Scholar 

  3. Lafosse L, Brozska R, Toussaint B, Gobezie R (2007) The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg Am 89:1533–1541

    Article  PubMed  Google Scholar 

  4. Sugaya H, Maeda K, Matsuki K, Moriishi J (2007) Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair: a prospective outcome study. J Bone Joint Surg Am 89:953–960

    Article  PubMed  Google Scholar 

  5. Burks RT, Crim J, Brown N, Fink B, Greis PE (2009) A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med 37:674–682

    Article  PubMed  Google Scholar 

  6. Malavolta EA, Gracitelli M, Neto A, Assunção JH, Bordalo-Rodrigues M, de Camargo OP (2014) Platelet-rich plasma in rotator cuff repair:a prospective randomized study. Am J Sports Med 42:2446–2454

    Article  PubMed  Google Scholar 

  7. Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87:1229–1240

    Article  PubMed  Google Scholar 

  8. Deutsch A, Kroll DG, Hasapes J, Staewen RS, Pham C, Tait C (2008) Repair integrity and clinical outcome after arthroscopic rotator cuff repair using single-row anchor fixation: a prospective study of single-tendon and two-tendon tears. J Shoulder Elbow Surg 17:845–852

    Article  PubMed  Google Scholar 

  9. Gulotta LV, Rodeo SA (2009) Growth factors for rotator cuff repair. Clin Sports Med 28:13–23

    Article  PubMed  Google Scholar 

  10. Frank JB, ElAttrache NS, Dines JS, Blackburn A, Crues J, Tibone JE (2008) Repair site integrity after arthroscopic transosseous-equivalent suture-bridge rotator cuff repair. Am J Sports Med 36:1496–1503

    Article  PubMed  Google Scholar 

  11. Iannotti JP, Deutsch A, Green A, Rudicel S, Christensen J, Marraffino S et al (2013) Time to failure after rotator cuff repair a prospective imaging study. J Bone Joint Surg Am 95:965–971

    Article  PubMed  Google Scholar 

  12. Crim J, Burks R, Manaster BJ, Hanrahan C, Hung M, Greis P (2010) Temporal evolution of MRI findings after arthroscopic rotator cuff repair. Am J Roentgenol 195:1361–1366

    Article  Google Scholar 

  13. Koh KH, Laddha MS, Lim TK, Park JH, Yoo JC (2012) Serial structural and functional assessments of rotator cuff repairs: do they differ at 6 and 19 months postoperatively? J Shoulder Elbow Surg 21:859–866

    Article  PubMed  Google Scholar 

  14. Mihata T, Watanabe C, Fukunishi K, Ohue M, Tsujimura T, Fujiwara K et al (2011) Functional and structural outcomes of single-row versus double-row versus combined double-row and suture-bridge repair for rotator cuff tears. Am J Sports Med 39:2091–2098

    Article  PubMed  Google Scholar 

  15. Jo CH, Shin JS (2013) Cross-sectional area of the supraspinatus muscle after rotator cuff repair: an anatomic measure of outcome. J Bone Joint Surg Am 95:1785–1791

    Article  PubMed  Google Scholar 

  16. Sugaya H, Maeda K, Matsuki K, Moriishi J (2005) Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy 21:1307–1316

    Article  PubMed  Google Scholar 

  17. Saccomanno MF, Cazzato G, Fodale M, Sircana G, Milano G (2015) Magnetic resonance imaging criteria for the assessment of the rotator cuff after repair: a systematic review. Knee Surg Sports Traumatol Arthrosc 23:423–442

    Article  PubMed  Google Scholar 

  18. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 8:599–605

    Article  CAS  PubMed  Google Scholar 

  19. Constant C, Murley A (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  20. Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff—end-result study of factors influencing reconstruction. J Bone Joint Surg Am 68:1136–1144

    CAS  PubMed  Google Scholar 

  21. Miller BS, Downie BK, Kohen RB, Kijek T, Lesniak B, Jacobson JA et al (2011) When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med 39:2064–2070

    Article  PubMed  Google Scholar 

  22. Russell RD, Knight JR, Mulligan E, Khazzam MS (2014) Structural integrity after rotator cuff repair does not correlate with patient function and pain: a meta-analysis. J Bone Joint Surg Am 96:265–271

    Article  PubMed  Google Scholar 

  23. Smith TO, Daniell H, Geere J-A, Toms AP, Hing CB (2012) The diagnostic accuracy of MRI for the detection of partial- and full-thickness rotator cuff tears in adults. Magn Reson Imaging 30:336–346

    Article  PubMed  Google Scholar 

  24. De Jesus JO, Parker L, Frangos AJ, Nazarian LN (2009) Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol 192:1701–1707

    Article  PubMed  Google Scholar 

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Acknowledgments

We acknowledge Carolina PB Gracitelli for the statistical analysis.

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Correspondence to Jorge Henrique Assunção.

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Malavolta, E.A., Assunção, J.H., Ramos, F.F. et al. Serial structural MRI evaluation of arthroscopy rotator cuff repair: does Sugaya’s classification correlate with the postoperative clinical outcomes?. Arch Orthop Trauma Surg 136, 791–797 (2016). https://doi.org/10.1007/s00402-016-2429-5

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  • DOI: https://doi.org/10.1007/s00402-016-2429-5

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