An evaluation of shear wave elastographic characteristics of the supraspinatus tendon after rotator cuff repair

Abstract

Background: The main complication of rotator cuff repair is retear, which is most common in older patients and patients with greater tear sizes. However, it is unknown why these factors are associated with increased rates of retear. The aim of this study was to determine whether the factors associated with rotator cuff retear (age, tear size, sex, history of trauma, and duration of symptoms) are also associated with decreased mechanical stiffness of the supraspinatus tendon after repair, as assessed by shear wave elastography.

Methods: This was a prospective study of 50 patients undergoing primary rotator cuff repair. A sonographer conducted shear wave elastography ultrasound in all patients at 1, 6, 12, 26, and 52 weeks after repair. The shear wave velocity of the supraspinatus tendon was measured at the tendon-bone interface, 3 mm medial to the interface, and 6 mm medial to the interface. A multiple linear regression analysis was performed with calculation of Cohen F² values to determine the factors that independently affected supraspinatus tendon stiffness postoperatively.

Results: For every decade increase in age, the shear wave velocity of the supraspinatus tendon decreased by 0.5 m/s (P = .004). Greater tear size correlated with reduced supraspinatus shear wave velocity (P < .03 at 6 weeks). Male patients had greater supraspinatus tendon stiffness than female patients (8.2 m/s vs. 6.9 m/s, P = .04). Tendons in patients with a history of trauma were approximately 16% stiffer postoperatively than those in patients with no trauma history (P < .001). Duration of symptoms had no impact on the mechanical stiffness of the supraspinatus tendon.

Conclusion: Older age, larger tear size, female sex, and nontraumatic tear causation were independently associated with reduced shear wave velocity of the supraspinatus tendon postoperatively. The findings of our study correlate with the results of cohort studies assessing the influence of these variables on rotator cuff retear rates, suggesting that the mechanical stiffness of the supraspinatus tendon, as assessed by shear wave elastography, may have an important association with a successful repair.

Keywords: Shear wave elastography; mechanical stiffness; rotator cuff retear; supraspinatus tendon.