Fusion Sign of Tendon-to-Bone Healing on X-Ray after Rotator Cuff Repair

• 作者: Yukiyoshi Hisada Naoki Suenaga Naomi Oizumi Shuzo Morita Tadasuke Sawaza
• 来源期刊: 矫形学期刊(英文)
• 学科: 工学
• 关键词: Rotator Cuff Orthopedic Procedures X-RAY Magnetic Resonance Imaging
• 年，卷（期）: 2021,（1）
• 页码范围: 22-31
• 页数: 10页
• 分类号: TE3

摘要

<i><span>Purpose</span></i><span>: </span><span>In clinical practice, increased radiolucency at the insertion site of a repaired tendon on the humerus on postoperative radiographs of patients following rotator cuff repair is often observed. Separately, magnetic resonance imaging (MRI) revealed tendon-to-bone healing in conjunction with this finding. Thus, we suspected that such radiographic changes are associated with tendon-to-bone healing, a phenomenon we labeled as the “fusion sign.” This study sought to investigate the diagnosis rate of the fusion sign in relation to tendon-to-bone healing after rotator cuff repair.</span><span> </span><i><span>Methods</span></i><span>: </span><span>Patients who underwent open rotator cuff repair (ORCR) or arthroscopic rotator cuff repair (ARCR) at two centers from 2010 to 2018 and who underwent MRI </span><span>more than 6 months postoperatively were included in this study. The presence of radiolucency of the humeral footprint on a radiograph (the fusion sign) </span><span>was </span><span>investigated and checked for the concurrent presence of tendon-to-bone healing </span><span>on MRI.</span><span> </span><i><span>Results</span></i><span>: </span><span>In total, 187 shoulders after ARCR and 55 shoulders af</span><span>ter ORCR were included in this study. Among these, SH repair was performed </span><span>in 202 shoulders and suture-bridging repair was performed in 40 shoulders. </span><span>The fusion sign was positive in 67.8% of cases and negative in 32.3%. The posi</span><span>tive predictive value (PPV) of the total population was 0.963 and did not differ according to the suture method used, reported as 0.964 in ARCR, 0.962 in</span><span> ORCR, 0.966 in the surface-holding technique, and 0.938 in the suture-bridging </span><span>technique. The intraobserver reliability was <span style="white-space:nowrap;">&#312;</span> = 0.4478 (</span><i><span>p </span></i><span>< 0.001). The interobserver reliability for all observers was <span style="white-space:nowrap;">&#312