Preoperative shear-wave elastography can predict success of rotator cuff repair
Incorporating shear-wave elastography into preoperative imaging protocols for patients with rotator cuff tears could serve as a valuable prognostic tool for predicting successful surgical repair, new research suggests.
When used in conjunction with MRI, shear-wave elastography (SWE) offers surgeons additional diagnostic insights into the integrity of a patient’s shoulder muscle. Noting that postoperative re-tears can occur in 34%-70% of cases, researchers of the study stressed the importance of a thorough preoperative evaluation.
“Studies have shown a greater frequency of repair failure and re-tear as the severity of muscle degeneration increases. Therefore, accurate evaluation of muscle quality during preoperative planning of rotator cuff repair is important for guiding prognostic assessments,” Eun Kyung Khil, MD, with the Department of Radiology at Hallym University Dongtan Sacred Heart Hospital and co-authors explained.
Typically, elasticity is higher in patients with insufficient repairs. And given that SWE can quantify tissue elasticity, the researchers hypothesized such additional imaging could be beneficial in analyzing the supraspinatus tendon of the rotator cuff before surgery.
The doctors prospectively examined 74 patients after they had undergone rotator cuff repair surgery. Each patient had a preoperative MRI in addition to a shoulder ultrasound using SWE. After measuring the elasticity of the supraspinatus and trapezius muscles, the researchers were able to come up with an elasticity ratio for both.
Using SWE, the doctors determined that patients deemed to have had insufficient repairs all had higher mean supraspinatus elasticity and elasticity ratios. In fact, when factoring in tear size and various muscle characteristics, the increased elasticity proved to be an independent predictor of insufficient repair.
“In this study of patients who underwent preoperative SWE before rotator cuff repair, those with insufficient repair exhibited stiffer supraspinatus muscles compared with those with sufficient repairs,” the doctors wrote.
The doctors noted that though there are limitations to their study, they do believe SWE could be a valuable and cost-effective diagnostic tool.
“The findings indicate a complementary role for SWE as a prognostic marker during preoperative evaluation in patients with rotator cuff tear,” the experts concluded.
You can view the detailed research in the American Journal of Roentgenology.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.