The application of shear wave elastography with ultrasound for rotator cuff tears: a systematic review

Background: Shear wave elastography (SWE) is an emerging ultrasound-based technology that provides a quantitative assessment of musculoskeletal tissue integrity. This systematic review investigates the use of SWE in the evaluation of rotator cuff tears. Methods: PubMed, Embase, Web of Science, Google Scholar, and the Cochrane Library databases were searched for relevant studies from 1901 up to June 2022. Articles utilizing SWE in rotator cuff tears were selected based on inclusion and exclusion criteria. The studies included involved the assessment of shear wave velocity, tendon thickness and stiffness after healing, and fatty infiltrates evaluation using SWE. The Newcastle-Ottawa Scale was used to evaluate the risk of bias in included observational studies. Double-sided P value < .05 was considered statistically significant. Results: Sixteen studies comprising 520 patients were included in the systematic review. SWE demonstrated that shear wave velocities in torn supraspinatus tendons were lower than in healthy supraspinatus tendons. A decrease in tendon SWE modulus elasticity was observed in tendinopathic tendons. Shear wave velocity decreased with increasing fat content and muscle atrophy. The velocity of SWE in muscle in re-tear groups was greater than in the healed group at 1 month after surgery (P < .05). Conclusion: SWE ultrasound of the supraspinatus tendon can be a useful diagnostic tool for orthopedic surgeons that provide quantitative information on tendinopathic stiffness, velocity, fatty infiltrate, and elasticity characteristics. Decreased tendon velocity of SWE may predict recurrent rotator cuff tears and be useful in postoperative evaluations for muscle healing to plan for future management