Assessment of rotator cuff repair integrity using ultrasound and magnetic resonance imaging in a multicenter study

Background This study compared ultrasound and magnetic resonance imaging (MRI) evaluation of the repaired rotator cuff to determine concordance between these imaging studies. Methods We performed a concordance study using the data from a prospective nonrandomized multicenter study at 13 centers. A suture bridge technique was used to repair 113 rotator cuff tears that were between 1 and 4 cm wide. Repairs were evaluated with MRI and ultrasound at multiple time points after surgery. The MRI scans were read by a central radiologist and the surgeon, and the ultrasounds were read by a local radiologist or the surgeon who performed the ultrasound. Results The concordance between the central radiologist’s MRI reading and the investigator’s MRI readings at all time points was 89%, with a κ coefficient of 0.60. The concordance between the central radiologist’s MRI and ultrasound readings at all time points was 85%, with a κ coefficient of 0.40. The concordance between the investigator’s MRI and ultrasound readings was 92%, with a κ coefficient of 0.70. Conclusions In the community setting, ultrasound may be used to evaluate the integrity of a repaired rotator cuff tendon and constitutes a comparable alternative to MRI when evaluating the integrity of a rotator cuff repair. Clinical investigators should compare their postoperative ultrasound results with their postoperative MRI results for a certain time period to establish the accuracy of ultrasound before relying solely on ultrasound imaging to evaluate the integrity of their rotator cuff repairs.