Interobserver reliability of the rotator cable and its relationship to rotator cuff congruity

Background: This study evaluated the presence of the rotator cable intraoperatively and compared its prevalence according to both patient age and rotator cuff integrity. The study hypothesis was that the cable would be more prevalent in older patients and patients with partial-thickness tears. Methods: Patients who were undergoing shoulder arthroscopy and were aged at least 16 years were included in this study, whereas those who had a cuff tear of more than 1 tendon or who had a video with poor visualization of the rotator cuff insertion were excluded. Intraoperative videos were collected, deidentified, and distributed to 7 orthopedic surgeons to define rotator cable and cuff tear characteristics. Results: A total of 58 arthroscopic videos (average patient age, 46 years; range, 16-75 years) were evaluated. The observers were in the most agreement on identifying the presence of a cable, with a k coefficient of 0.276. Patients with the rotator cable were significantly older than those without it (mean age, 52.1 years vs. 42.5 years; P=.008), and a positive and significant correlation was found between rotator cable presence and increasing patient age (r=0.27, P=.04). A significant association was noted between tear degree and cable presence (P=.002). There was no significant association with cable presence in patients with a full-thickness tear. Conclusions: In this study, an intraoperative analysis was performed to define the presence of the rotator cable and correlate this with both patient age and rotator cuff integrity. The hypothesis was confirmed in that patients older than 40 years had a significantly higher rotator cable prevalence. Level of evidence: Level III; Cross-Sectional Design; Epidemiology Study (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.