A high acromion-greater tuberosity impingement index increases the risk of retear after arthroscopic rotator cuff repair

Ling-hui, Xie; Xu, Xinxian; Ma, Baoxiang; Liu, Haixiao

doi:10.1177/10225536221092219

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…1,5,6,9,10,16,20,22,23 Multiple parameters from plain radiographs, such as critical shoulder angle, acromion index, and lateral acromial angle, showed no relationships with retears. 11,13,43 Studies of the usefulness of MRI-related factors, such as tear size, fatty infiltration, and muscle atrophy as prognostic indicators, have demonstrated relatively few discrepancies. 4,16,18,20,21,24,34 Compared with patient and plain radiograph factors, MRI-related factors are direct and more accurate indicators of tendon status.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Retear After Arthroscopic Rotator Cuff Repair Based on Intraoperative Arthroscopic Images Using Deep Learning

Cho

Kim

2023

Am J Sports Med

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Background: It is challenging to predict retear after arthroscopic rotator cuff repair (ARCR). The usefulness of arthroscopic intraoperative images as predictors of the ARCR prognosis has not been analyzed. Purpose: To evaluate the usefulness of arthroscopic images for the prediction of retear after ARCR using deep learning (DL) algorithms. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: In total, 1394 arthroscopic intraoperative images were retrospectively obtained from 580 patients. Repaired tendon integrity was evaluated using magnetic resonance imaging performed within 2 years after surgery. Images obtained immediately after ARCR were included. We used 3 DL architectures to predict retear based on arthroscopic images. Three pretrained DL algorithms (VGG16, DenseNet, and Xception) were used for transfer learning. Training and test sets were split into 8:2. Threefold stratified validation was used to fine-tune the hyperparameters using the training data set. The validation results of each fold were evaluated. The performance of each model in the test set was evaluated in terms of accuracy, area under the receiver operating characteristic curve (AUC), F1-score, sensitivity, and specificity. Results: In total, 1138 and 256 arthroscopic images were obtained from 514 patients and 66 patients in the nonretear and retear groups, respectively. The mean validation accuracy of each model was 83% for VGG16, 89% for Xception, and 91% for DenseNet. The accuracy for the test set was 76% for VGG16, 87% for Xception, and 91% for DenseNet. The AUC was highest for DenseNet (0.92); it was 0.83 for VGG16 and 0.91 for Xception. For the test set, the specificity and sensitivity were 0.93 and 0.84 for DenseNet, 0.89 and 0.84 for Xception, and 0.70 and 0.80 for VGG16, respectively. Conclusion: The application of DL algorithms to intraoperative arthroscopic images has demonstrated a high level of accuracy in predicting retear occurrences.

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Section: Discussionmentioning

confidence: 99%

Prediction of Retear After Arthroscopic Rotator Cuff Repair Based on Intraoperative Arthroscopic Images Using Deep Learning

Cho

Kim

2023

Am J Sports Med

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“…For instance, Xie et al . conducted a study suggesting that there is no statistically significant relationship between AI or LAA 56 . Consequently, further research is warranted to elucidate the precise nature of the relationship between LAA and AI.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Lateral Acromion Angle in Rotator Cuff Tear Patients with Acromioplasty

Hong,

Kong,

Zhang

et al. 2023

Orthopaedic Surgery

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BackgroundArthroscopic surgery has been established as an efficacious intervention for the treatment of rotator cuff tears. The primary aim of this study was to analyze the modifications in the lateral acromial angle (LAA) subsequent to rotator cuff repair surgery using single‐row rivet fixation and double‐row rivet fixation techniques. Furthermore, we sought to investigate the influence of LAA on the prognosis of rotator cuff repair surgery.MethodThis observational study retrospectively enrolled 105 patients diagnosed with degenerative rotator cuff tears who underwent arthroscopic rotator cuff repair between 2016 and 2019. Following the exclusion of two patients with subscapularis or superior labrum anterior and posterior (SLAP) tears, as well as three patients who were lost to follow‐up, a cohort of 100 patients was included for clinical and imaging evaluation. Among these individuals, 50 were assigned to the double‐row repair group, whereas the remaining 50 comprised the single‐row repair group. Bilateral shoulder magnetic resonance imaging (MRI) scans were conducted no less than 24 months post‐surgery. Experienced arthroscopic surgeons, blinded to the LAA measurements, assessed the rotator interval (RI) using a control MRI. Functional assessment was performed using the University of California, Los Angeles (UCLA) quick disability of the shoulder and arm, shoulder and hand (qDASH) score. The Wilcoxon signed‐rank test for dependent samples was employed to compare data between the pre‐ and post‐intervention groups. Pearson correlation coefficients were calculated to evaluate the relationship between different parameters.ResultsThe study population consisted of 73 female patients and 27 male patients, with a mean age of 58.32 ± 5.29 years and a mean follow‐up duration of 25.88 ± 8.11 months. Preoperatively, the mean LAA was 75.81° ± 11.28°, RI was 4.78 ± 0.62, UCLA score was 17.54 ± 2.44, and qDASH score was 2.45 ± 0.25. The average tear size was 8.95 ± 2.11 mm. A statistically significant difference in LAA was observed between the preoperative and postoperative measurements, with the double‐row repair group exhibiting a greater LAA than the single‐row repair group. Finally, a significant correlation was identified between LAA, RI, and qDASH scores after a 24‐month follow‐up period.ConclusionAccording to our findings, the utilization of double‐row rivet fixation has a greater LAA angle than single‐row rivet fixation. Moreover, this preservation of LAA is significantly associated with the functional recovery of the shoulder joint.

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In vivo shoulder kinematic changes and rotator cuff healing after surgical repair of large-to-massive rotator cuff tears

Tashiro,

Kozono,

Higaki

et al. 2024

J Orthop Surg Res

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Background Few studies have investigated the correlation between shoulder kinematics and clinical outcomes in patients undergoing rotator cuff repair using dynamic analysis. This study assessed shoulder kinematics before and after surgical repair in patients with rotator cuff tears (RCTs) and determined the relationship among shoulder kinematics and between shoulder kinematics and clinical outcomes. Methods Ten patients with large-to-massive RCTs and 10 control participants were included. In vivo shoulder kinematics during scapular plane abduction were measured preoperatively and 1 year postoperatively using validated image-registration techniques and compared among the control, preoperative, and postoperative groups. Mixed models were used to compare the effects of the groups on shoulder kinematics, followed by Tukey’s honest significant difference test. Pearson’s correlation coefficient was used to identify the correlations among shoulder kinematics and between each kinematic and clinical outcome. Results The scapula, tilted more anteriorly preoperatively, was not different from the control group postoperatively. Additionally, the change in scapular posterior tilt (PT) throughout dynamic abduction was 18.17° ± 3.59° in the postoperative group, greater than that in the control group (11.54° ± 2.29°; p = 0.0037). The postoperative change in PT significantly correlated with acromiohumeral distance (AHD) and rotator cuff integrity (Sugaya classification) (AHD: r = 0.71, p = 0.023; Sugaya classification: r = − 0.75, p = 0.013), but not preoperative change in PT. Functional score improved from preoperative to postoperative ( p < 0.0001). Abduction angle and functional score significantly correlated with Sugaya classification (abduction angle: r = − 0.67, p = 0.034; functional score: r = − 0.70, p = 0.025) but not with shoulder kinematics. Mean superior translation of the humeral head and AHD throughout abduction changed from 1.77 ± 1.34 to 0.61 ± 1.37 and 1.44 ± 1.59 to 2.71 ± 2.27 mm, respectively, from preoperative to postoperative (both p < 0.0001). Conclusions After the surgical repair of large-to-massive RCTs, glenohumeral stability normalized, and the more anteriorly tilted orientation of the scapula improved. Additionally, the preoperative increased scapular motion throughout dynamic abduction was further enhanced postoperatively. Interestingly, in postoperative patients, scapular motion toward PT during dynamic abduction correlated with minimum AHD and cuff healing.

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A high acromion-greater tuberosity impingement index increases the risk of retear after arthroscopic rotator cuff repair

Cited by 3 publications

References 35 publications

Prediction of Retear After Arthroscopic Rotator Cuff Repair Based on Intraoperative Arthroscopic Images Using Deep Learning

Prediction of Retear After Arthroscopic Rotator Cuff Repair Based on Intraoperative Arthroscopic Images Using Deep Learning

Changes in the Lateral Acromion Angle in Rotator Cuff Tear Patients with Acromioplasty

In vivo shoulder kinematic changes and rotator cuff healing after surgical repair of large-to-massive rotator cuff tears

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