Abstract
Background
Tears of the rotator cuff are a common pathology and poorly understood. Achieving a good functional outcome for patients may be difficult, and the degree of fat infiltration into the muscle is known to be a major determining factor to surgical repair and post operative function. It is the hypothesis of this study that the degree of retraction of the common central tendon as seen on MRI corresponds to the amount of fat infiltration classified according to the Goutallier grading System.
Methods
MRI scans of the supraspinatus were reviewed and two groups identified: no tear (NT) and full thickness tear (FTT). The following measures were taken: central tendon retraction (CTR) and the Goutallier Grade according to MRI. The difference between Goutallier grade between NT and FTT were measured using the Mann-Whitney test. The relationship between Goutallier grade and increasing amount of CTR was described using Spearman's rank correlation and differences assessed using Mann-Whitney tests.
Results
143 scans had NT and 148 scans had FTT after exclusion and inclusion criteria were satisfied. All FTT involved the central tendon, with varying retraction. 143 in the NT group were Goutallier Grade 0–1. FTT revealed 2 Grade 0, 21 Grade 1, 35 Grade 2, 14 Grade 3, 76 Grade 4. The difference in Goutallier grade between the NT and FTT was highly significant (p<0.001).
The increase in Goutallier grade associated with increasing retraction of the central tendon was also highly significant p<0.001.
Conclusion
CTR can be directly linked to Goutallier grading and as such may help to determine surgical intervention between groups.
Level of Evidence
Level 1 Diagnostic Study
