Early postoperative repair status after rotator cuff repair cannot be accurately classified using questionnaires of patient function and isokinetic strength evaluation

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• 作者：Jessica Colliver ; BSc^a ; Allan Wang ; PhD ; FRACS^a ; ^b ; ^c ; Brendan Joss ; PhD^a ; Jay Ebert ; PhD^a ; ^{jay.ebert@uwa.edu.au" class="auth_mail" title="E-mail the corresponding author} ; Eamon Koh ; FRANZCR^d ; William Breidahl ; FRANZCR^e ; Timothy Ackland ; PhD^a
• 关键词：Basic Science Study ; Validation of Patient Reported Outcome Instruments
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：25
• 期：4
• 页码：536-542
• 全文大小：207 K

文摘

This study investigated if patients with an intact tendon repair or partial-thickness retear early after rotator cuff repair display differences in clinical evaluations and whether early tendon healing can be predicted using these assessments.

Methods

We prospectively evaluated 60 patients at 16 weeks after arthroscopic supraspinatus repair. Evaluation included the Oxford Shoulder Score, 11-item version of the Disabilities of the Arm, Shoulder and Hand, visual analog scale for pain, 12-item Short Form Health Survey, isokinetic strength, and magnetic resonance imaging (MRI). Independent t tests investigated clinical differences in patients based on the Sugaya MRI rotator cuff classification system (grades 1, 2, or 3). Discriminant analysis determined whether intact repairs (Sugaya grade 1) and partial-thickness retears (Sugaya grades 2 and 3) could be predicted.

Results

No differences (P < .05) existed in the clinical or strength measures. Although discriminant analysis revealed the 11-item version of the Disabilities of the Arm, Shoulder and Hand produced a 97% true-positive rate for predicting partial thickness retears, it also produced a 90% false-positive rate whereby it incorrectly predicted a retear in 90% of patients whose repair was intact. The ability to discriminate between groups was enhanced with up to 5 variables entered; however, only 87% of the partial-retear group and 36% of the intact-repair group were correctly classified.

Conclusions

No differences in clinical scores existed between patients stratified by the Sugaya MRI classification system at 16 weeks. An intact repair or partial-thickness retear could not be accurately predicted. Our results suggest that correct classification of healing in the early postoperative stages should involve imaging.