Application Value Of Musculoskeletal Ultrasound After Rotator Cuff Repair

Arthroscopic repair of rotator cuff tears usually has good results,but there is still a high rate of rotator cuff re-tear after rotator cuff repair due to many risk factors,it is difficult to diagnose the retear of rotator cuff by clinical symptoms and physical examination,so it is necessary to help the clinician to evaluate the patients after rotator cuff surgery,to provide the basis for the next treatment of patients.MRI is often used as a means of evaluation,but its high cost puts a great burden on patients.Therefore,the exploration of a cheap,convenient and efficient auxiliary examination method is bound to bring good news to all patients with rotator cuff.Objective:Spread out the musculoskeletal ultrasound of the shoulder.The results of MRI were used as the gold standard to evaluate the healing of rotator cuff after rotator cuff repair.The imaging features of the rotator cuff repair were compared and analyzed.Methods:This study collected 76 patients with rotator cuff tear diagnosed by detailed medical history,physical examination and related imaging(MRI,ultrasound)from April 2018 to September 2020 in emergency department and out-patient department,all patients received arthroscopic rotator cuff repair and rehabilitation treatment after admission,and both muscle ultrasound and MRI were performed 6 months after operation.Using Mc Nemar test,when p < 0.05,the difference between the two methods was statistically significant.The sensitivity,specificity,accuracy,positive predictive value(PPV),negative predictive value(NPV)and Joden’s index(Yi)of musculoskeletal ultrasound in the diagnosis of rotator cuff re-tear and postoperative classification were calculated based on MRI findings.The consistency between ultrasound and MRI of muscle bone was examined by Kappa consistency test.Results:The type I and V patients were not diagnosed by musculoskeletal ultrasound and MRI,51 cases were diagnosed by musculoskeletal ultrasound as type II,15 cases as type III,10 cases as type IV,and 48 cases as type II by MRI,there were 17 cases of type III and 11 cases of type IV.Type IV and type V of MRI and musculoskeletal ultrasound based on suggested by Sugaya and Barth were the types of rotator cuff retear after repair.So 10 cases and 11 cases of rotator Cuff retear were diagnosed by musculoskeletal ultrasound and MRI respectively,and 66 cases and 65 cases were healed.There was no significant difference in the detection rate(p > 0.05)between musculoskeletal ultrasound and MRI in the diagnosis of retear of rotator cuff,nor in the diagnosis of Type II and type III(p > 0.05).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Joden’s index(Yi)of musculoskeletal ultrasound were evaluated by the gold standard of MRI findings: Diagnosis of retear(type IV): 81.82%,98.46%,96.05%,90.00%,96.97%,0.80;Type II: 95.83%,82.14%,90.79%,90.20%,92.00%,0.78;type III:70.59%,94.92%,89.47%,80.00%,91.80%,0.66.The consistency between musculoskeletal ultrasound and MRI in diagnosis of diseases was analyzed by Kappa Consistency test: there was a high consistency in diagnosis of type IV and type II rotator cuff retear,and a high consistency in diagnosis of type III rotator cuff retear,the Kappa values were(0.834,0.798,0.684)Conclusion:Musculoskeletal ultrasound performs well in the evaluation of rotator cuff repair,and it is much cheaper than MRI.It can be used multiple times in the evaluation of the rotator cuff repair,so that doctors can guide the next step of rehabilitation or treatment,prevention of retear or extension of the rotator cuff can be used as one of the auxiliary methods to evaluate the rotator cuff recovery after rotator cuff repair,It should be widely used in postoperative evaluation of rotator cuff.