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Updated: Jul 13, 2026
Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Elastographic Stiffness of the Rotator Cuff Pre and Post Surgical Repair in 115 Consecutive Patients
Antonette Mariama R Bilog1, Mina Shenouda1, Patrick H Lam1
1Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, NSW, Australia.
Background:
Higher retear rates after rotator cuff repair have been reported in older patients with large tears. Shear wave elastography (SWE) offers a noninvasive, objective way to assess tendon stiffness, yet the relationship between the preoperative and postoperative elastographic stiffness of the supraspinatus tendon has not been well studied.
Purpose:
To determine the association between preoperative and 6-week postoperative supraspinatus tendon elastographic stiffness and to assess the effect of age, symptom duration, tear thickness, and tear size on these measurements.
Study Design:
Case series; Level of evidence, 4.
Methods:
Included were 115 consecutive shoulders undergoing primary arthroscopic repair of isolated supraspinatus tears using the undersurface technique. SWE measurements were obtained of the torn supraspinatus tendon preoperatively and of the repaired tendon 6 weeks postoperatively using a standardized protocol.
Results:
The preoperative elastographic stiffness of the torn edge of the supraspinatus tendon was diminished in larger (R = -0.3; P < .0001), full-thickness (R = -0.4; P = .0001) tears and in older patients (R = -0.3; P = .002). The mean (± standard deviation) SWE velocity of the supraspinatus tendon decreased by 12% 6 weeks postoperatively (6 ± 1.8 m/s preoperatively vs 5 ± 0.85 m/s postoperatively). While a modest correlation existed between preoperative and 6-week postoperative SWE (R = 0.3; P = .01), a strong inverse relationship was found between preoperative SWE and the improvement in elastographic stiffness after repair (change in SWE [ΔSWE]) (R = -0.8; P < .0001). Multivariate analysis identified preoperative SWE as the strongest predictor of ΔSWE (F = 60; P < .0001).
Conclusion:
Preoperative elastographic stiffness of the supraspinatus tendon was only modestly associated with early postoperative elastographic stiffness, a finding largely explained by a regression-toward-the-mean effect. These data support the hypothesis that the elastographic stiffness of supraspinatus tendons decreases with advancing age and with larger full-thickness tears. While it was observed that these tendons were elastographically softer preoperatively, they demonstrated the capacity for significant improvement in elastographic stiffness after repair.
