<scp>Ultrasound‐MRI</scp> Correlation for Healing of Rotator Cuff Repairs Using Power Doppler, Sonographic Shear Wave Elastography and <scp>MR</scp> Signal Characteristics

Nocera, Nicole; Burke, Christopher J.; Gyftopoulos, Soterios; Adler, Ronald S.

doi:10.1002/jum.15583

Cited by 13 publications

(12 citation statements)

References 32 publications

(66 reference statements)

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“…Itoigawa et al 27 examined the tendon at the anteromedial anchor insertion in patients who underwent double‐row rotator cuff repairs, whereas all repairs in this study, and 10/12 repairs in the Nocera et al 26 study used a single‐row inverted mattress configuration. A single‐row inverted mattress repair likely subject the tendon areas measured under load, whereas areas in‐between medial and lateral anchors in the double‐row configuration may not be under load.…”

Section: Discussionmentioning

confidence: 88%

“…Best et al 25 Several studies have evaluated tendon stiffness post-rotator cuff repair using shear wave elastography. Nocera et al 26 reported that SWE stiffness of the repaired supraspinatus tendon at its insertion on the greater tuberosity increased in 12 human patients, 6 months post-rotator cuff repair using the Siemens ACUSON S3000 HELIX Evolution ultrasound system (Siemens Medical Solutions, Mountain View, CA). Itoigawa et al 27 measured SWE stiffness of repaired tendons at the site of the anteromedial anchor insertion at 1 week, and monthly from 1 to 6 months postoperatively in 60 human patients who underwent double-row rotator cuff repair using the Aixplorer system: Version 9.2 (SuperSonic Imagine, Aix-en Prevence, Cadex, France), and found that the SWE stiffness of the repaired tendon was greatest at 1 week postoperatively, reduced by 15% at 1 month, then stabilized out to 6 months.…”

Section: Found Thatmentioning

confidence: 99%

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A Systematic Temporal Assessment of Changes in Tendon Stiffness Following Rotator Cuff Repair

Hackett

Ting

Lam

et al. 2023

J of Ultrasound Medicine

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Objectives-How the material properties of the human supraspinatus tendon change following arthroscopic rotator cuff repair is undetermined. Shear wave elastography ultrasound is a relatively new, noninvasive measure of tissue stiffness. We aimed to evaluate any temporal changes in stiffness and/or thickness of supraspinatus tendons in humans following primary arthroscopic rotator cuff repair.Methods-Shear wave elastography was performed at three predetermined regions by a single sonographer at 1-, 6-, 12-, 24-, and 52 weeks postoperatively in 50 consecutive single-row inverted mattress primary arthroscopic rotator cuff repairs. One-way ANOVA with Tukey's correction and Spearman's correlation tests was performed.Results-Of 50 patients, two retore by 1-week and were excluded. Two patients retore at 6 weeks, two at 12 weeks, and one at 24 weeks. The mean tendon stiffness in 48 patients at the tendon footprint increased by 21% (1.32 m/s) at 6 months (P < .001), with the lateral tendon stiffening before the medial tendon. Tendon thickness decreased by 11% (0.6 mm) at 6 weeks (P = .008), then stabilized to 24 weeks. Tendons that were less elastographically stiff at 1 week were more likely to be thinner at 6-weeks (r = .38, P = .010).Conclusions-The data supports the hypothesis that rotator cuff tendons repaired using the single-row inverted-mattress technique take 6 weeks to heal to bone. Unlike in other tendons, there was no hypertrophic healing response. Prior to 6 weeks, the tendon may stretch/thin-out, particularly if its material properties, as assessed by shear wave elastography, are inferior. The material properties of the tendon improved at the tendon insertion site first, then medially out to 12 months post-repair.

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Section: Discussionmentioning

confidence: 88%

Section: Found Thatmentioning

confidence: 99%

A Systematic Temporal Assessment of Changes in Tendon Stiffness Following Rotator Cuff Repair

Hackett

Ting

Lam

et al. 2023

J of Ultrasound Medicine

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“…Nocera et al determined the healing response after RC repairs using a multimodality imaging approach with MRI, power Doppler and SWE ( 12 ). They evaluated 12 patients with unilateral, full-thickness, supraspinatus tendon tear in a cohort study with preoperative and postoperative (at 3 and 6 months post-operation) US and MRI.…”

Section: Resultsmentioning

confidence: 99%

“…Concerning recently published shoulder SE articles, shoulder capsulitis showed increased stiffness in supraspinatus and infraspinatus tendons and CHL on SWE evaluation ( 14 ). For fatty infiltration assessment and correlation with MRI grading, two recent studies with different conclusions and further studies seem necessary ( 5 , 12 ). One study showed a softer supraspinatus tendon after 60 years of age.…”

Section: Discussionmentioning

confidence: 99%

Sonoelastography of the Shoulder: A Narrative Review

Babaei-Ghazani

Majdalani

Luong

et al. 2021

Front. Rehabilit. Sci.

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Sonoelastography is a relatively new non-invasive imaging tool to assess the in vivo qualitative and quantitative biomechanical properties of various tissues. Two types of sonoelastography (SE) are commonly explored: strain and shear wave. Sonoelastography can be used in multiple medical subspecialties to assess pathological tissular changes by obtaining mechanical properties, shear wave speed, and strain ratio data. Although there are various radiological imaging methods, such as MRI or CT scan, to assess musculoskeletal structures (muscles, tendons, joint capsules), SE is more accessible since this approach is of low cost and does not involve radiation. As of 2018, SE has garnered promising data in multiple studies. Preliminary clinico-radiological correlations have been established to bridge tissue biomechanical findings with their respective clinical pathologies. Specifically, concerning the shoulder complex, recent findings have described mechanical tissue changes in shoulder capsulitis. The long head of the biceps and supraspinatus SE were among the recently studied structures with conditions regarding impingement, tendinosis, and tears. Since ultrasonography has established itself as an important tool in shoulder evaluation, it completes the history and physical examination skills of the clinicians. This study will provide an update on the most recent findings on SE of shoulder structures.

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“…30,31 Nocera et al 31 identified that the SWE stiffness of the repaired supraspinatus tendon increased over time post rotator cuff repair. However, the results reported by Nocera et al 31 did not achieve statistical significance, which may be due to the study's small sample size (n = 12) and short postoperative follow-up of 6 months. Itoigawa et al 30 conducted a temporal SWE study assessing the stiffness of the healing supraspinatus tendon at 1 week and monthly from 1 to 6 months post rotator cuff repair.…”

Section: Discussionmentioning

confidence: 99%

The Fate of the Shoulder Post Rotator Cuff Repair: Biomechanical Properties of the Supraspinatus Tendon and Surrounding Structures

Solari,

Hackett,

Lam

et al. 2024

Sports Medicine and Arthroscopy Review

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The study aimed to describe the changes in biomechanical properties of the supraspinatus tendon, deltoid muscle, and humeral head post arthroscopic rotator cuff repair using shear wave elastography. Shear wave velocity of the tendon, deltoid, and humeral head of 48 patients was measured at predetermined sites at 1 week, 6 weeks, 12 weeks, 6 months, and 12 months post repair. One-way ANOVA with Tukey’s correction and Spearman’s correlation were performed. Mean±SEM healing tendon stiffness, adjacent to tendon footprint, increased from 1 week (6.2±0.2 m/s) to 6 months (7.5±0.3 m/s) and 12 months (7.8±0.3 m/s) (P<0.001). Mean±SEM deltoid muscle stiffness was higher at 12 months (4.1±0.2 m/s) compared to 1 week (3.4±0.1 m/s) and 12 weeks (3.5±0.1 m/s) (P<0.05). Humeral head stiffness did not change. Following arthroscopic rotator cuff repair, supraspinatus tendon stiffness increased in a curvilinear fashion over 6 months. From 6 months, deltoid muscle stiffness increased, corresponding to when patients were instructed to return to normal activities.

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Ultrasound‐MRI Correlation for Healing of Rotator Cuff Repairs Using Power Doppler, Sonographic Shear Wave Elastography and MR Signal Characteristics

Cited by 13 publications

References 32 publications

A Systematic Temporal Assessment of Changes in Tendon Stiffness Following Rotator Cuff Repair

A Systematic Temporal Assessment of Changes in Tendon Stiffness Following Rotator Cuff Repair

Sonoelastography of the Shoulder: A Narrative Review

The Fate of the Shoulder Post Rotator Cuff Repair: Biomechanical Properties of the Supraspinatus Tendon and Surrounding Structures

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