In patients with rotator cuff tear, good outcome as judged by a Constant score of ≥80 corresponds to a JOA score cut-off of 84.0. Judgement of the treatment outcomes and evaluation of the surgical method may be more accurate when using clear cut-off values for the scoring system employed, such as those determined in our study.

PurposeThe Stump classification is significantly correlated with a retear after arthroscopic rotator cuff repair. However, no study has evaluated whether or not the stump classification is correlated with retear in the suture‐bridge or double‐row repair techniques. The aim of this study was to evaluate the relationship between a retear and the stump classification in the suture‐bridge and double‐row repair techniques. MethodsAmong 389 patients who underwent arthroscopic repairs of full‐thickness rotator cuff tears using suture‐bridge or double‐row repair techniques, 326 patients (median age 67.0 years; range 25–85) were included. There were 51 small, 172 medium, 83 large, and 20 massive tears. Two hundred forty patients were treated with the suture‐bridge technique, and 86 patients were treated with the double‐row technique. The following variables were analyzed: age, sex, the Cofield classification, anteroposterior and mediolateral tear size on preoperative MRI, global fatty degeneration index, and the stump classification. Cuff integrity was evaluated on magnetic resonance imaging at 6 months after surgery. The patients were divided into the intact and retear groups and the relationship between the variables and retear was evaluated by multivariate logistic regression analysis. ResultsThe overall retear rate was 10.1%. In the multivariate logistic regression analysis, the independent predictors of a retear were the stump classification type 3 (Odds ratio: 4.71, p = 0.0246), global fatty degeneration index (Odds ratio: 3.87, p = 0.0030), and anteroposterior tear size (Odds ratio: 1.07, p = 0.0077) in the suture bridge technique. In the double‐row technique, the independent predictors of retear were stump classification type 3 (Odds ratio: 7.82, p = 0.0348), and age (Odds ratio: 1.22, p = 0.0163). ConclusionThe stump classification was significantly correlated with retear in the suture‐bridge and double‐row repair technique. Stump classification type 3 was indicated to be an important risk factor for predicting retear. Level of evidenceIII

Background: In patients with rotator cuff tears, Shoulder36 (Sh36) was compared to the Simple Shoulder Test (SST) to determine a broader use of Sh36 worldwide. Methods: Sh36, SST, "Constant score," and the Japanese Orthopaedic Association score (JOA) were used to evaluate 230 patients (male, 116; female, 114) during the first visit, analyzed by staff blinded to the study. Pearson's correlation coefficient was used for the statistical analysis. Results: The correlation coefficient between the Constant score and each domain in Sh36 was as follows: r ¼ 0.68 (vs. pain, p < 0.01); r ¼ 0.69 (vs. range of motion, p < 0.01); r ¼ 0.74 (vs. muscle strength, p < 0.01); r ¼ 0.62 (vs. general health, p < 0.01); r ¼ 0.66 (vs. ability of daily living, p < 0.01); and r ¼ 0.65 (vs. ability for sports, p < 0.01). The correlation coefficient between the JOA and each domain in Sh36 was as follows: r ¼ 0.76 (vs. pain, p < 0.01); r ¼ 0.73 (vs. range of motion, p < 0.01); r ¼ 0.78 (vs. muscle strength, p < 0.01); r ¼ 0.68 (vs. general health, p < 0.01); r ¼ 0.71 (vs. ability of daily living, p < 0.01); and r ¼ 0.70 (vs. ability for sports, p < 0.01). The correlation coefficient between the SST and each domain in Sh36 was as follows: r ¼ 0.73 (vs. pain, p < 0.01); r ¼ 0.70 (vs. range of motion, p < 0.01); r ¼ 0.75 (vs. muscle strength, p < 0.01); r ¼ 0.67 (vs. general health, p < 0.01); r ¼ 0.69 (vs. ability of daily living, p < 0.01); and r ¼ 0.64 (vs. ability for sports, p < 0.01). Conclusion: A strong association exists between the SST and each domain in the Sh36, in patients with rotator cuff tears (r ¼ 0.64-0.73), suggesting the usefulness of Sh36 for patient-based scoring.

Conventional spin-echo (SE) and contrast-enhanced dynamic MR imaging were performed on a 1.5 T superconductive unit for evaluation of myometrial lesions in postmolar gestational trophoblastic disease (GTD) in 10 women. MR imaging was done at the time of the initial examination (n=10), during (n=6), and after repeated courses of chemotherapy (n=10). The T2-weighted SE image revealed an enlarged uterus (n=7), disappearance of zonal anatomy (n=6), and heterogeneous signal intensities (n=8) with prominent flow voids (n=7). However, these abnormalities remained after repeated courses of chemotherapy, when the S-β-HCG level returned to the normal range. Myometrial lesions characteristically had marked enhancement with areas of unenhancement on dynamic MR images in patients with highly elevated S-β-HCG. Areas of contrast enhancement correlated with changes in S-β-HCG level. The enhancement was reduced with decrease in S-β-HCG level after repeated courses of chemotherapy. Six of 8 masses seen on T2-weighted images proved to be active trophoblastic lesions and 2 masses proved to be hematoma or necrosis. In 2 patients, abnormal myometrial lesions were detected only on contrast-enhanced dynamic MR imaging. These preliminary data indicate that contrast-enhanced dynamic MR imaging more clearly demonstrates myometrial involvement of postmolar GTD than conventional SE imaging.

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