Is elastography feasible in torn rotator cuffs before surgery?

Shear wave elastography (SWE) is a relatively recent ultrasound imaging technique that uses focused acoustic radiation forces to quantify the elasticity of biological tissues, commonly referred to as 'elastographic stiffness'. Preliminary data suggest that the elastographic stiffness of a torn supraspinatus tendon may serve as an independent predictor of retear risk following surgical repair. However, the feasibility of obtaining accurate preoperative SWE measurements remains uncertain, as tendon retraction beneath the acromion can limit visualization and reliable assessment.

This was a prospective cohort study that recruited 60 consecutive patients who had received a diagnosis of supraspinatus tear. SWE imaging was conducted to determine the elastographic stiffness of each patient's torn supraspinatus tendon.

SWE values of the edge of the torn supraspinatus were successfully measured in 59/60 (98%) of cases, resulting in a failure to measure rate of 2%. SWE measurements were not feasible in a single case where the anteroposterior or mediolateral tear lengths were greater than 28 mm. Tendon elastographic stiffness, measured as elasticity (kPa), was inversely correlated with anteroposterior tear length (R² -.51, P < .001), mediolateral tear length (R² -.54, P < .001), and patient age (R² -.27, P < .05).

This study shows that preoperative SWE of the torn supraspinatus tendon is a feasible imaging methodology if the supraspinatus tear is < 30 mm. Patients who had smaller tears and who were younger had greater SWE than older patients with larger tears.