Kitridis D, Alaseirlis D, Malliaropoulos N, Chalidis B, McMahon P, Debski R, Givissis P. Assessing the accuracy of arthroscopic and open measurements of the size of rotator cuff tears: A simulation-based study. World J Orthop 2021; 12(12): 983-990 [PMID: 35036340 DOI: 10.5312/wjo.v12.i12.983]
Corresponding Author of This Article
Dimitrios Kitridis, MD, MSc, Surgeon, 1st Orthopaedic Department, Aristotle University of Thessaloniki, School of Medicine, Agiou Dimitriou Street, Thessaloniki 54124, Greece. dkitridis@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Dec 18, 2021; 12(12): 983-990 Published online Dec 18, 2021. doi: 10.5312/wjo.v12.i12.983
Assessing the accuracy of arthroscopic and open measurements of the size of rotator cuff tears: A simulation-based study
Dimitrios Kitridis, Dimosthenis Alaseirlis, Nikolaos Malliaropoulos, Byron Chalidis, Patrick McMahon, Richard Debski, Panagiotis Givissis
Dimitrios Kitridis, Dimosthenis Alaseirlis, Byron Chalidis, Panagiotis Givissis, 1st Orthopaedic Department, Aristotle University of Thessaloniki, School of Medicine, Thessaloniki 54124, Greece
Nikolaos Malliaropoulos, William Harvey Research Institute, Centre for Sports and Exercise, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London EC1M 6BQ, United Kingdom
Patrick McMahon, McMahon Orthopedics and Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15203, United States
Richard Debski, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15219, United States
Author contributions: Kitridis D wrote the manuscript and conducted the statistical analysis; Alaseirlis D designed and coordinated the study; Malliaropoulos N interpreted the data; Chalidis B conducted the literature search; McMahon P and Debski R performed the experiments, acquired and analyzed data; Givissis P supervised the paper; all authors read and approved the final manuscript.
Institutional review board statement: Not Applicable for the current simulation-based study. No patients or animals were involved.
Conflict-of-interest statement: All authors have nothing to disclose.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios Kitridis, MD, MSc, Surgeon, 1st Orthopaedic Department, Aristotle University of Thessaloniki, School of Medicine, Agiou Dimitriou Street, Thessaloniki 54124, Greece. dkitridis@gmail.com
Received: March 21, 2021 Peer-review started: March 21, 2021 First decision: May 3, 2021 Revised: May 30, 2021 Accepted: October 27, 2021 Article in press: October 27, 2021 Published online: December 18, 2021
ARTICLE HIGHLIGHTS
Research background
Arthroscopic procedures are commonly performed for rotator cuff pathology. The intraoperative evaluation of the tear size and pattern contributes to the choice and completion of the technique and the prognosis of the repair.
Research motivation
The accuracy of common arthroscopic instruments to evaluate the dimensions of different types of rotator cuff tears is not yet evaluated.
Research objectives
The purpose of the current study was to compare the arthroscopic and open measurements with the real dimensions of three different patterns of simulated rotator cuff tears of known size using a plastic shoulder model.
Research methods
Three sizes and patterns of simulated supraspinatus tears on a plastic shoulder model (small and large U-shaped, oval-shaped) were created. Six orthopaedic surgeons with three levels of experience measured the dimensions of the tears arthroscopically, using a 5 mm probe, repeating the procedure three times, and then using a ruler (open technique). Arthroscopic, open and computerized measurements were compared.
Research results
A constant underestimation of specific dimensions of the tears was found when measured with an arthroscope, compared to both the open and computerized measurements. No differences were observed between the open and computerized measurements. The accuracy of arthroscopic and open measurements was 90.5% and 98.5%, respectively. When comparing between levels of experience, senior residents reported smaller tear dimensions when compared both to staff surgeons and fellows.
Research conclusions
This study suggests that arthroscopic measurements of full-thickness rotator cuff tears constantly underestimate the dimensions of the tears. This underestimation could lead to false documentation during surgery, unreliable prognostic suggestions, and even postoperative failures.
Research perspectives
Development of more precise arthroscopic techniques or tools for the evaluation of the size and type of rotator cuff tears are necessary.
