Abstract
PurposeAnterior insertion of the supraspinatus muscle plays an essential role in rotator cuff tissue. We aimed to determine whether the distance between the midpoints of the supraspinatus central tendon and long head of the biceps tendon on a sagittal shoulder magnetic resonance imaging scan can help to preoperatively diagnose an injury of the anterior insertion of the supraspinatus.MethodThis retrospective study reviewed 103 patients with a full-thickness supraspinatus tendon tear: 50 patients with (injured group) and 53 patients without (intact group) anterior supraspinatus insertion tear. The inter-tendon distance was measured based on an oblique sagittal magnetic resonance imaging scan. SPSS was used for statistical analyses. Two independent samples t-test and receiver operating curve analysis were also performed.ResultsThe measurements of inter-tendon distance revealed good intra- and inter-observer reliabilities with intra-class correlation coefficients of 0.92 and 0.97, respectively. The inter-tendon distance of the injured group was significantly greater than that of the intact group (10.1 ± 2.7 vs 8.0 ± 2.3 mm, P < 0.001). The diagnostic ability of the inter-tendon distance was fair (area under the curve = 0.745), and a threshold of 9 mm had a specificity of 73% and sensitivity of 74%.ConclusionThe distance between the supraspinatus central tendon and long head of the biceps tendon on magnetic resonance imaging was greater in patients with anterior supraspinatus insertion injury than those without the injury. A distance of 9 mm may be the cut-off value and a good diagnosis marker for anterior supraspinatus insertion injury.Level of evidenceLevel III, diagnostic case–control study.
Highlights
Rotator cuff tear, usually associated with shoulder pain and dysfunction, is a common shoulder condition [16]
The distance between the supraspinatus central tendon and long head of the biceps tendon on magnetic resonance imaging was greater in patients with anterior supraspinatus insertion injury than those without the injury
On the oblique sagittal shoulder magnetic resonance imaging (MRI) scan, the area where the coracoid process just disappears, the central distance between the supraspinatus central tendon and long head of the biceps tendon (LHBT) was greater when the tears involved the anterior area than when it involved other areas, and it depicted a good ability to diagnose anterior injury when a 9-mm distance was set as the cut-off value
Summary
Usually associated with shoulder pain and dysfunction, is a common shoulder condition [16]. Injuries of the supraspinatus tendon can be assessed by magnetic resonance imaging (MRI) clearly [4, 9]. Recent studies have reported that the anterior insertion of the supraspinatus muscle plays an essential role in supraspinatus function [2, 3, 6, 8, 10, 12, 14]. Biomechanical studies have demonstrated that injury to the anterior supraspinatus muscle significantly affects stress distribution [6, 10, 11]. Clinical studies observed that anterior supraspinatus tears are often accompanied by more severe tears, muscle atrophy, and re-tearing after repair [2, 3]. Complete preoperative understanding of the anterior supraspinatus tear is critical for preoperative diagnosis and intraoperative repair strategies
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