A positive tangent sign predicts the repairability of rotator cuff tears

Hypothesis We hypothesize that patients with a positive tangent sign will have rotator cuff tears that are not able to be repaired primarily. Methods We performed a retrospective review of the charts of patients who had undergone surgery for repair of a rotator cuff tear. The operative note was revi...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2014-07, Vol.23 (7), p.1023-1027
Main Authors: Kissenberth, Michael J., MD, Rulewicz, Gabriel J., MD, Hamilton, Stephen C., MD, Bruch, Hannah E., BS, Hawkins, Richard J., MD
Format: Article
Language:English
Subjects:
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
MRI
Orthopedics
Prognosis
Reproducibility of Results
Retrospective Studies
Rotator Cuff - pathology
Rotator Cuff - surgery
Rotator Cuff Injuries
rotator cuff tear
Rupture
Tangent sign
Tendon Injuries - diagnosis
Tendon Injuries - surgery
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Summary:Hypothesis We hypothesize that patients with a positive tangent sign will have rotator cuff tears that are not able to be repaired primarily. Methods We performed a retrospective review of the charts of patients who had undergone surgery for repair of a rotator cuff tear. The operative note was reviewed to determine whether the cuff tear was primarily repaired. The magnetic resonance imaging study of each patient was reviewed to assess for a positive or negative tangent sign. The reviewer was blinded to the result of each measurement. Results Eighty-one patients met the inclusion criteria. Of the 79 included in our analyses, 17 had a positive tangent sign and 62 had a negative tangent sign. There was only 1 patient with a negative tangent sign who had an irreparable rotator cuff tear. There were 3 patients with a positive tangent sign who had a repairable rotator cuff. With a pretest prevalence of irreparable tears of 18.9%, a positive finding suggested a post-test probability of 82.3% with a positive tangent sign and a post-test probability of only 1.6% when the tangent sign was negative. Conclusion Our results showed decision-making value in both a negative tangent sign and a positive tangent sign. The tangent sign is an easily performed and reproducible tool with good intraobserver and interobserver reliability that is a powerful predictor of whether a rotator cuff tear will be repairable.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2014.02.014