Magnetic resonance imaging criteria for the assessment of the rotator cuff after repair: a systematic review

PURPOSE: The purpose of this systematic review was to detect the reliability of\r\nthe currently available magnetic resonance imaging measurements used in the\r\nevaluation of repaired rotator cuff.\r\nMETHODS: Search was performed using major electronic databases from their\r\ninception to February 2014. All studies reporting post-operative magnetic\r\nresonance assessment after rotator cuff repair were included. After the\r\nidentification of available magnetic resonance criteria, reliability studies were\r\nfurther analysed. Descriptive statistics were used to summarize findings.\r\nMethodological quality was assessed using the Quality Appraisal of Reliability\r\nStudies checklist.\r\nRESULTS: One hundred and twenty studies were included in the review. Twenty-six\r\ndifferent criteria were identified. Ten studies reported inter-observer\r\nreliability, and only two assessed intra-observer reliability of some of the\r\nidentified criteria. Structural integrity was the most investigated criterion.\r\nThe dichotomized Sugaya's classification showed the highest reliability (k =\r\n0.80-0.91). All other criteria showed moderate to low inter-observer reliability.\r\nTendon signal intensity and footprint coverage showed a complete discordance.\r\nIntra-observer reliability was high for the presence of structural integrity, and\r\nmoderate to low for all other criteria. Methodological quality was high only for \r\none study and moderate for three studies.\r\nCONCLUSIONS: Twenty-six different criteria described by multiple classification\r\nsystems have been identified for the magnetic resonance assessment of rotator\r\ncuff after repair. Reliability of most of them has not been analysed yet. With\r\nthe data available, only the presence of structural integrity showed good intra- \r\nand inter-observer agreement.\r\nLEVEL OF EVIDENCE: Systematic review of descriptive and qualitative studies,\r\nLevel IV.