Magnetic resonance arthrography results that indicate surgical treatment for partial articular-sided supraspinatus tendon avulsion: A retrospective study in a tertiary center

Background Specific findings on magnetic resonance arthrography (MRA) that indicate the need for surgery in patients with partial articular-sided supraspinatus tendon avulsion (PASTA) are not well understood. Purpose To determine which MRA findings are characteristic of patients who undergo surgery for PASTA. Material and Methods From July 2011 to February 2014, MRA findings for patients treated for PASTA were retrospectively reviewed. The patients were divided into two groups: conservative treatment and surgical repair. MRA findings were compared between the groups. The following MRA results were assessed: length grade, width grade, co-existing superior labrum anterior posterior (SLAP) lesions, degenerative changes in the glenohumeral joint, presence of subacromial-subdeltoid bursitis, acromion type, presence of adhesive capsulitis, and tears of the subscapularis or infraspinatus tendon within the rotator cuff. Logistic regression analyses were conducted to identify which MRA findings were significantly associated with surgical treatment. Results Forty-five surgically treated patients and 203 conservatively treated ones were evaluated. The MRA findings showed significant differences between the groups with respect to length grade, width grade, degenerative changes in glenohumeral joint, bursitis, and co-existing rotator cuff tears (P < 0.05). Multivariate logistic regression showed correlations between surgical repair and both grade 3 length tears (odds ratio, 30.8) and co-existing tears of the subscapularis or infraspinatus tendon (odds ratio, 2.9). Conclusion Surgical treatment is commonly performed in PASTA patients whose lesion lengths are grade 3 or who have co-existing tears in the subscapularis or infraspinatus tendon. Radiologists should pay attention to these MRA signs when evaluating PASTA patients.