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Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):393-8. doi: 10.1007/s00167-013-2551-7. Epub 2013 Jun 16.

Tendon quality in small unilateral supraspinatus tendon tears. Real-time sonoelastography correlates with clinical findings.

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Department of Orthopaedic Surgery, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy,



To investigate the feasibility of real-time sonoelastography in the assessment of the mechanical tendon properties in small unilateral supraspinatus tears, to describe the sonoelastographic properties of the torn supraspinatus tendons and to correlate real-time sonoelastography findings with clinical results and demographic data.


All the patients presenting for a unilateral rotator cuff tear were prospectively scrutinized. Clinical evaluation included complete physical examination, VAS, Quick DASH, Constant-Murley score, Simple Shoulder Test, ASES score and UCLA score. Radiological evaluation was performed with conventional ultrasounds and real-time sonoelastography; this is a noninvasive method that uses ultrasounds to evaluate the mechanical properties of tissues, reflecting their quality, that can be semi-quantitatively estimated using the strain index. During the enrolment period, 92 patients were scrutinized, and 50 were included in the study.


A negative correlation between strain index and VAS for pain, a strong positive correlation between strain index and Constant-Murley score and ASES score were found. Comparable results were observed in male and female patients, but in males, we found a strong positive correlation also for Simple Shoulder Test and UCLA score.


Real-time sonoelastography was a feasible method applicable in the assessment of tendon quality in small supraspinatus tears, and its findings correlated with the clinical results of the patients. In day-by-day clinical practice, this information is very important because quality of tendons is one of the most important prognostic factors for surgeons performing rotator cuff repair.



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