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Goutallier, Patte and Warner scoring with MRI found unreliable in treatment of rotator cuff tears
Lippe J. Arthroscopy. 2012. doi: 10.1016/j.arthro.2011.07.016
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A study published recently in Arthroscopy examined the interobserver reliability of three commonly used classification systems in describing preoperative MRI studies of patients undergoing surgery for full-thickness rotator cuff tears.
The researchers selected 31 patients who had recently underwent arthroscopic rotator cuff repair and had preoperative MRI studies available, according to the study abstract. Three board-certified shoulder surgeons were instructed in the published method for determining the Patte score on the T2 coronal images, supraspinatus and infraspinatus atrophy on the T1 sagittal images as described by Warner et al. and the Goutallier score of fatty infiltration of the supraspinatus on the T1 coronal/sagittal images. The surgeons then independently reviewed the MRI scans, and statistical analysis was reportedly performed to determine the interobserver agreement using the k statistic.
None of the classification systems studied yielded excellent or high interobserver reliability. The strongest agreement was found with the Patte classification assessing tendon retraction in the frontal plane. The Goutallier classification showed moderate interobserver agreement, and muscle atrophy of both the supraspinatus and infraspinatus yielded the worst interobserver reliability, with only 28% agreement.
“The Goutallier, Patte and Warner MRI classification systems for describing rotator cuff tears did not have high interobserver reliability among 3 experienced surgeons,” the authors wrote in the abstract. “These findings have potential implications in the evaluation of the literature regarding the preoperative classification of rotator cuff tears and subsequent treatment algorithms.”