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Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction
BACKGROUND: A classification system for the graft state after superior capsule reconstruction (SCR) using magnetic resonance imaging (MRI) has not been described previously. PURPOSE: To introduce a new, MRI-based classification system for graft integrity after SCR and to evaluate the system accordin...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536853/ https://www.ncbi.nlm.nih.gov/pubmed/37781637 http://dx.doi.org/10.1177/23259671231193315 |
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author | Lee, Jun-Bum Kholinne, Erica Yeom, Ji Woong So, Sang-Pil Ben, Hui Alsaqri, Hood Koh, Kyoung-Hwan Jeon, In-Ho |
author_facet | Lee, Jun-Bum Kholinne, Erica Yeom, Ji Woong So, Sang-Pil Ben, Hui Alsaqri, Hood Koh, Kyoung-Hwan Jeon, In-Ho |
author_sort | Lee, Jun-Bum |
collection | PubMed |
description | BACKGROUND: A classification system for the graft state after superior capsule reconstruction (SCR) using magnetic resonance imaging (MRI) has not been described previously. PURPOSE: To introduce a new, MRI-based classification system for graft integrity after SCR and to evaluate the system according to postoperative outcomes. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHOD: Included were 62 consecutive patients who underwent SCR using autologous fascia lata graft between January 2013 and April 2021. Postoperative outcomes were assessed (American Shoulder and Elbow Surgeons [ASES] score, Constant score, pain visual analog scale [pVAS], range of motion [ROM], acromiohumeral distance [AHD], Hamada grade). Graft status was classified by 2 orthopaedic surgeons on postoperative MRI in accordance with the signal intensity and the presence or extent of the tear, as follows: type 1 (hypointense signal without tear), type 2 (hyperintense signal without tear), type 3 (partial-thickness tear), type 4 (full-thickness tear with partial continuity), and type 5 (full-thickness tear with complete discontinuity). Intra- and interobserver agreement were assessed using Cohen kappa. The correlation between postoperative outcomes (ASES score, Constant score, pVAS, ROM, AHD, and Hamada grade) and the SCR graft classification system was assessed with the Pearson correlation coefficient, and the outcomes were compared according to classification type. RESULTS: Patients were classified according to the new system as follows: type 1 (n = 15), type 2 (n = 20), type 3 (n = 7), type 4 (n = 8), and type 5 (n = 12). There was excellent interobserver agreement (κ = 0.819) and intraobserver agreement (κ = 0.937 and 0.919). The classification system showed a moderate to high correlation with the ASES score (r = –0.451; P = .001), pVAS (r = 0.359; P = .005), AHD (r = –0.642; P < .001), and Hamada grade (r = 0.414; P < .001). Patients classified as having types 1 and 2 showed better outcomes in terms of ASES score, pVAS, ROM, and AHD compared with type 5 patients (P ≤ .021 for all). CONCLUSION: The new classification system was highly reproducible and showed clinical utility for both radiological and clinical evaluation after SCR. |
format | Online Article Text |
id | pubmed-10536853 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105368532023-09-29 Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction Lee, Jun-Bum Kholinne, Erica Yeom, Ji Woong So, Sang-Pil Ben, Hui Alsaqri, Hood Koh, Kyoung-Hwan Jeon, In-Ho Orthop J Sports Med Article BACKGROUND: A classification system for the graft state after superior capsule reconstruction (SCR) using magnetic resonance imaging (MRI) has not been described previously. PURPOSE: To introduce a new, MRI-based classification system for graft integrity after SCR and to evaluate the system according to postoperative outcomes. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHOD: Included were 62 consecutive patients who underwent SCR using autologous fascia lata graft between January 2013 and April 2021. Postoperative outcomes were assessed (American Shoulder and Elbow Surgeons [ASES] score, Constant score, pain visual analog scale [pVAS], range of motion [ROM], acromiohumeral distance [AHD], Hamada grade). Graft status was classified by 2 orthopaedic surgeons on postoperative MRI in accordance with the signal intensity and the presence or extent of the tear, as follows: type 1 (hypointense signal without tear), type 2 (hyperintense signal without tear), type 3 (partial-thickness tear), type 4 (full-thickness tear with partial continuity), and type 5 (full-thickness tear with complete discontinuity). Intra- and interobserver agreement were assessed using Cohen kappa. The correlation between postoperative outcomes (ASES score, Constant score, pVAS, ROM, AHD, and Hamada grade) and the SCR graft classification system was assessed with the Pearson correlation coefficient, and the outcomes were compared according to classification type. RESULTS: Patients were classified according to the new system as follows: type 1 (n = 15), type 2 (n = 20), type 3 (n = 7), type 4 (n = 8), and type 5 (n = 12). There was excellent interobserver agreement (κ = 0.819) and intraobserver agreement (κ = 0.937 and 0.919). The classification system showed a moderate to high correlation with the ASES score (r = –0.451; P = .001), pVAS (r = 0.359; P = .005), AHD (r = –0.642; P < .001), and Hamada grade (r = 0.414; P < .001). Patients classified as having types 1 and 2 showed better outcomes in terms of ASES score, pVAS, ROM, and AHD compared with type 5 patients (P ≤ .021 for all). CONCLUSION: The new classification system was highly reproducible and showed clinical utility for both radiological and clinical evaluation after SCR. SAGE Publications 2023-09-26 /pmc/articles/PMC10536853/ /pubmed/37781637 http://dx.doi.org/10.1177/23259671231193315 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Lee, Jun-Bum Kholinne, Erica Yeom, Ji Woong So, Sang-Pil Ben, Hui Alsaqri, Hood Koh, Kyoung-Hwan Jeon, In-Ho Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction |
title | Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction |
title_full | Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction |
title_fullStr | Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction |
title_full_unstemmed | Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction |
title_short | Evaluation of a New MRI-Based Classification of Graft Status After Superior Capsule Reconstruction |
title_sort | evaluation of a new mri-based classification of graft status after superior capsule reconstruction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10536853/ https://www.ncbi.nlm.nih.gov/pubmed/37781637 http://dx.doi.org/10.1177/23259671231193315 |
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