Medial Subluxation or Dislocation of the Biceps on Magnetic Resonance Arthrography Is Reliably Correlated with Concurrent Subscapularis Full-Thickness Tears Confirmed Arthroscopically

الملخص EN

Background.

The purpose of this study was to investigate the relationship between biceps medial subluxation/dislocation on the magnetic resonance arthrography (MRA) imaging and subscapularis full-thickness tear confirmed arthroscopically.

We hypothesized that presence of a biceps medial subluxation or dislocation would strongly indicate a subscapularis full-thickness tear.

Methods.

A total of 432 consecutive patients who underwent arthroscopic repair for rotator cuff tears with/without subscapularis tears at our institute were retrospectively reviewed.

The inclusion criterion of this study was preoperative MRA images taken within 6 months of arthroscopic repair.

The presence of medial subluxation/dislocation was evaluated on the preoperative MRA images, and subscapularis tear was confirmed on arthroscopic examination.

Results.

Biceps subluxation/dislocation was identified in 46 of the 432 patients on MRA.

Forty-five of these 46 patients also had a subscapularis full-thickness tear identified in arthroscopic examination.

Among the 386 patients who did not have biceps subluxation or dislocation, 54 patients had a subscapularis full-thickness tear diagnosed arthroscopically.

The presence of a biceps subluxation/dislocation could predict a subscapularis full-thickness tear with sensitivity of 45% (45/99), specificity of 99% (332/333), positive predictive value of 98% (45/46), negative predictive value of 86% (332/386), and accuracy of 87% (377(45 +332)/432).

Conclusion.

Medial subluxation/dislocation of the biceps on MRA images was highly associated with a concurrent subscapularis full-thickness tear which was confirmed arthroscopically.

This association had 99% specificity and 98% positive predictive value.

Therefore, if a biceps subluxation/dislocation is identified on MRA images, there is a high chance that a concurrent subscapularis full-thickness tear exists.