Quantitative magnetic resonance imaging vs. perioperative arthroscopy to measure stage 1 ruptures of the supraspinatus tendon for surgical planning.

ABSTRACT

BACKGROUND: Accurate preoperative assessment of supraspinatus tendon tear (STT) size is important for surgical planning. Our aims were to evaluate the correlation between stage 1 STT size measured preoperatively by quantitative magnetic resonance imaging (qMRI) and size measured perioperatively by arthroscopy. The concordance between preoperative tear size and the surgical plan was also assessed. METHODS: This prospective, nonrandomized, noncontrolled, interventional study was carried out in patients with a stable stage 1 STT. Three months before surgery, STT size was measured in the sagittal and coronal planes by a radiologist by qMRI (1.5 T). Three months later, the surgeon measured the size of the tear again on the same qMRI scans and decided on the most appropriate surgical plan. During arthroscopy, the surgeon measured the size of the tear again using a graduated sensor hook and carried out the repair. STT size measured preoperatively was compared to that measured by arthroscopy and the concordance between preoperative STT size and the surgical plan was determined. RESULTS: Sixty-seven patients were included (mean age 59.5 ± 8.9 years; 58.2% female). There was good concordance between STT size measured by qMRI vs. arthroscopy in the coronal plane (concordance correlation coefficient = 0.36 [95% confidence interval (CI) 0.16-0.53]; Pearson's correlation coefficient = 0.42 [95% CI 0.2-0.6]; P = .0004) and in the sagittal plane (concordance correlation coefficient = 0.51 [95% CI 0.33-0.65]; Pearson's correlation coefficient = 0.57 [95% CI 0.38-0.71]; P < .0001). Preoperative STT size concurred with the surgical plan in 85% of patients. CONCLUSION: There was good concordance between STT size measured by qMRI and that measured perioperatively by arthroscopy. However, preoperative STT size measured by qMRI did not concur with the surgical plan in 15% of patients and in these patients the surgical procedure had to be revised during surgery.