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Ultrasound shear wave elastography-derived tissue stiffness is positively correlated with rotator cuff tear size and muscular degeneration

  • SHOULDER
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to describe rotator cuff muscle stiffness in patients with different degrees of rotator cuff tear (RCT) severity and to assess its predictive ability for RCT reparability.

Methods

One hundred and thirty-three consecutive patients who were scheduled to undergo arthroscopic shoulder surgery were prospectively enrolled. Tendon retraction, fatty infiltration, and muscle atrophy were evaluated using magnetic resonance imaging. Shear modulus of supraspinatus (SSP) and infraspinatus (ISP) muscles were measured by ultrasound shear wave elastography (SWE). The tear size and reparability were determined intraoperatively.

Results

There were 97 patients in RCT group and 36 patients in control group. Bilateral shear modulus discrepancy (Δshear modulus) was used to represent rotator cuff stiffness. Severely fatty-infiltrated rotator cuff muscles possessed a significantly higher stiffness compared with their counterparts (SSP: CI 27.8–31.8 vs. 13.5–15.6 kPa, ISP: CI 33.2–38.1 vs. 8.8–11.2 kPa, p < 0.001). The same trend applied to muscles with distinct tendon retraction (SSP: CI 27.7–32.3 vs. 10.9–14.9 kPa, ISP: CI 33.2–38.6 vs. 6.5–11.0 kPa, p < 0.001) and obvious muscle atrophy (SSP: CI 27.9–32.1 vs. 13.6–15.8 kPa, ISP: CI 32.9–38.2 vs. 9.0–11.7 kPa, p < 0.001). Irreparable massive RCT (MRCT) patients had significantly stiffer SSP (CI 27.7–31.9 vs. 13.5–16.5 kPa, p < 0.001) and ISP (CI 33.5–37.8 vs. 10.3–14.8 kPa, p < 0.001) than reparable MRCT. The Δshear modulus of the ISP was a highly accurate predictor of RCT reparability. A cutoff value of 18.0 kPa had a sensitivity of 100% and specificity of 98.8% for irreparable MRCT.

Conclusion

Ultrasound SWE-derived rotator cuff muscle stiffness is closely correlated with RCT size and severity.

Level of evidence

I.

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Funding

Funding was provided by Chongqing medical scientific research project (Grant no. 2021MSXM032).

Author information

Author notes

  1. Jiaxing Huang, Lan Jiang contributed equally to this study.

  2. Ning Hu and Hong Chen contributed equally to this study.

Authors and Affiliations

  1. Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China

    Jiaxing Huang, Jiawei Wang, Wei Huang, Ning Hu & Hong Chen

  2. Orthopedic Laboratory of Chongqing Medical University, Chongqing, China

    Jiaxing Huang, Jiawei Wang, Wei Huang, Ning Hu & Hong Chen

  3. Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Lan Jiang

  4. Department of Rehabilitation, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Dandong Wu

Authors
  1. Jiaxing Huang
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  2. Lan Jiang
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  3. Jiawei Wang
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  5. Wei Huang
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  7. Hong Chen
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Corresponding author

Correspondence to Hong Chen.

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Conflict of interest

Jiaxing Huang, Lan Jiang, Jiawei Wang, Dandong Wu, Wei Huang, Ning Hu, and Hong Chen declare that they have no conflict of interest.

Ethical approval

All procedures performed in this prospective study were in accordance with the ethical standards of the First Affiliated Hospital of Chongqing Medical University. This study was approved by our institutional review board (IRB, No. 2020795) and registered in the Chinese Clinical Trial Register (ChiCTR2100042462).

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Huang, J., Jiang, L., Wang, J. et al. Ultrasound shear wave elastography-derived tissue stiffness is positively correlated with rotator cuff tear size and muscular degeneration. Knee Surg Sports Traumatol Arthrosc 30, 2492–2499 (2022). https://doi.org/10.1007/s00167-022-06892-w

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  • DOI: https://doi.org/10.1007/s00167-022-06892-w

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