Purpose
To investigate the intra- and inter-rater agreement of magnetic resonance imaging
(MRI) evaluations of rotator cuff integrity at 6 and 24 months after arthroscopic
rotator cuff repair (ARCR).
Methods
Three shoulder surgeons reviewed 68 MRI scans from 34 patients who had undergone ARCR
and MRI examination at both 6 and 24 months after surgery. Postoperative rotator cuff
integrity was investigated by using Owen, Sugaya, and Hayashida classifications to
determine whether the rotator cuff was intact or whether there was a partial-thickness
retear or full-thickness retear and Burks score to assess tendon appearance. Multirater
kappa statistics were used to measure intra- and inter-rater agreement. Kappa values
were interpreted according to guidelines adapted from the work of Landis and Koch.
Results
All classifications had similar intra- and inter-rater agreement (κ = 0.14 to 0.67,
0.23 to 0.60, respectively), but no intra- or inter-rater agreement scored “excellent.”
Inter-rater agreement after ARCR was higher at 24 months (κ = 0.31 to 0.60) than at
6 months (κ = 0.23 to 0.44) in all evaluations. Reviewers identified full-thickness
retears with a moderate to good degree of inter-rater agreement in all evaluations,
at both 6 months (κ = 0.42 to 0.73) and 24 months (κ = 0.61 to 0.80) after ARCR. However,
poor inter-rater agreement (κ = 0.13 to 0.19) was found in the identification of partial-thickness
retears in all evaluations at 6 months after ARCR.
Conclusions
Shoulder surgeons showed better intra- and inter-rater agreement in predicting full-thickness
tears compared with partial-thickness tears. The inter-rater agreement at 24 months
after ARCR was superior to that at 6 months in predicting not only full-thickness
retear but also partial-thickness retear. MRI evaluation of rotator cuff integrity
at 6 months after ARCR may be less reliable, regardless of which classification system
is used.
Level of Evidence
Level III, retrospective comparative study.
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Article Info
Publication History
Published online: June 16, 2016
Accepted:
April 21,
2016
Received:
December 10,
2015
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
The Institutional Review Board at Osaka Medical College approved the protocol of this study.
Identification
Copyright
© 2016 by the Arthroscopy Association of North America
