1. A positive tangent sign predicts the repairability of rotator cuff tears
- Author
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Gabriel J. Rulewicz, Michael J. Kissenberth, Hannah E. Bruch, Richard J. Hawkins, and Stephen C. Hamilton
- Subjects
Male ,Operative note ,medicine.medical_specialty ,genetic structures ,Rotator Cuff Injuries ,Rotator Cuff ,Tendon Injuries ,medicine ,Humans ,Orthopedics and Sports Medicine ,Rotator cuff ,Retrospective Studies ,Rupture ,medicine.diagnostic_test ,business.industry ,Rotator cuff injury ,Reproducibility of Results ,Tangent ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Cuff ,Tears ,Female ,business ,Sign (mathematics) - Abstract
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.
- Published
- 2014
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