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 k coefficient of 0.60. The concordance between the central radiologist's MRI and ultrasound readings at all time points was 85%, with a k coefficient of 0.40. The concordance between the investigator's MRI and ultrasound readings was 92%, with a k 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. Level of evidence: Level III, Diagnostic Study

Rotator Cuff Repair Augmentation in a Canine Model with Use of a Woven Poly-L-Lactide Device

Background: Despite advances in surgical treatment options, failure rates of rotator cuff repair have continued to range from 20% to 90%. Hence, there is a need for new repair strategies that provide effective mechanical reinforcement of rotator cuff repair as well as stimulate and enhance the intrinsic healing potential of the patient. The purpose of this study was to evaluate the extent to which augmentation of acute repair of rotator cuff tendons with a newly designed poly-L-lactide repair device would improve functional and biomechanical outcomes in a canine model