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
ARTICLE HIGHLIGHTS
Research background

It is challenging to predict the reparability of a large and massive rotator cuff injury before surgery. Age, tendon retraction, tendon tear size, fatty infiltration, muscle atrophy, and superior humeral head migration are factors that influence whether or not large or massive rotator cuff tears can be repaired.

Research motivation

The better result and lower recurrent rate of complete rotator cuff repair, make the pre-operative evaluation much more important. If a complete repair is not possible, alternative salvage techniques with better results than partial rotator cuff repair should be considered.

Research objectives

The aim of the current study was to determine the accuracy of the rotator cuff reparability score.

Research methods

This was a retrospective cohort diagnostic study including all patients with large and massive rotator cuff tears between January 2013 and December 2019. All patients underwent an arthroscopic rotator cuff repair and were classified as having either complete or partial rotator cuff repair. The sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio were assessed. The receiver operating characteristic curve was analyzed to define the optimal cut-off level for the reparability of the rotator cuff tear.

Research results

Eighty patients were recruited for this study. The intra- and inter-observer reliabilities were good to excellent. The number of patients with 0, 1, 2, and 3 positive factors were 24, 33, 17, and 6 respectively. The complete repair was done in all patients without any positive factors. Two of 32 patients with one positive factor and seven of 17 patients with two positive factors were partially repaired. Only one of six patients with three positive factors was completely repaired. The area under the curve was 0.894. The optimal cut-off point was two with the sensitivity of 85.71% and the specificity of 83.33%.

Research conclusions

The optimal cut-off point for predicting the reparability of a large or massive rotator cuff tear is a rotator cuff reparability score of two. If the pre-operative score is two or more, the rotator cuff tear is likely to be irreparable.

Research perspectives

Further studies are required to validate the clinical utility of our rotator cuff reparability score in improving clinical outcomes and provide satisfactory results after long-term follow-up.