Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2022; 13(12): 1038-1046
Published online Dec 18, 2022. doi: 10.5312/wjo.v13.i12.1038
Accuracy of the rotator cuff reparability score
Niti Prasathaporn, Vanasiri Kuptniratsaikul, Napatpong Thamrongskulsiri, Thun Itthipanichpong
Niti Prasathaporn, Department of Orthopaedics, Ramkhamhaeng Hospital, Bangkok 10240, Thailand
Vanasiri Kuptniratsaikul, Napatpong Thamrongskulsiri, Thun Itthipanichpong, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Napatpong Thamrongskulsiri, Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Prasathaporn N designed and performed the research and supervised the report; Kuptniratsaikul V designed the study and contributed to the analysis; Thamrongskulsiri N wrote the manuscript; Itthipanichpong T contributed to the analysis and wrote the manuscript and supervised the study; All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Research and Ethics Committee Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand (Approval No. IRB026/2561).
Informed consent statement: Patients were not required to give informed consent to the study as the study analysis used anonymous clinical data obtained after each patient had agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Thun Itthipanichpong, MD, Doctor, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, 1873 Rama IV Rd, Khwaeng Pathum Wan, Khet Pathum Wan, Krung Thep Maha Nakhon, Bangkok 10330, Thailand. thun.i@chula.ac.th
Received: July 25, 2022
Peer-review started: July 25, 2022
First decision: October 17, 2022
Revised: October 22, 2022
Accepted: November 30, 2022
Article in press: November 30, 2022
Published online: December 18, 2022
Processing time: 143 Days and 21.1 Hours
Abstract
BACKGROUND

The reparability of large or massive rotator cuff tears is difficult to determine pre-operatively. We previously identified age ≥ 65 years, acromiohumeral interval ≤ 6 mm, and anteroposterior tear size ≥ 22 mm as risk factors for rotator cuff repair failure. We therefore developed a rotator cuff reparability score where each of the above risk factors is assigned a score of one point.

AIM

To determine the accuracy of a rotator cuff reparability score.

METHODS

This was a retrospective cohort study of recruited patients with large or massive rotator cuff tears treated at our institution between January 2013 and December 2019. Exclusion criteria were revision surgery and patients with contraindications for surgery. All patients underwent arthroscopic rotator cuff repair and were categorized into either complete or partial rotator cuff repair. Rotator cuff reparability scores were calculated for each patient. The sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio were assessed. A receiver operating characteristic curve was plotted to determine the optimal cut-off rotator cuff reparability score.

RESULTS

Eighty patients (mean age, 61 years; range, 25–84 years; 41 females and 39 males) were recruited. Intra- and inter-observer reliabilities were good to excellent. The number of patients with 0, 1, 2, and 3 risk factors for rotator cuff repair failure were 24, 33, 17, and 6, respectively. Complete repair was performed in all patients without risk factors. Two of the 33 patients with one risk factor and seven of the 17 patients with two risk factors underwent partial repair. One of the six patients with three risk factors underwent complete repair. The area under the curve was 0.894. The optimal cut-off score was two points with a sensitivity of 85.71% and a specificity of 83.33%.

CONCLUSION

A rotator cuff reparability score of two was determined to be the optimal cut-off score for predicting the reparability of large or massive rotator cuff tears.

Keywords: Rotator cuff tear; Reparability; Prognostic factors; Rotator cuff reparability score

Core Tip: This is retrospective study to evaluate the accuracy of a novel rotator cuff reparability score. In large or massive rotator cuff tears, arthroscopic rotator cuff repair is not always feasible. The reparability of large or massive rotator cuff tears can be more accurately determined after intra-operative arthroscopy. The identification of pre-operative risk factors for rotator cuff tear repair failure may facilitate improvements in management and provide patients with more accurate treatment information. Accordingly, we developed a novel scoring system to predict the likelihood of rotator cuff repair failure.