To explore the value of musculoskeletal ultrasound combined with shear wave elastography (SWE) in clinical monitoring of patients after arthroscopic rotator cuff repair.

Seventy-three patients with rotator cuff tears who underwent arthroscopic repair surgery at Changzhou No. 2 People’s Hospital between February 2024 and February 2025 were prospectively enrolled. Musculoskeletal ultrasound and SWE were performed preoperatively and at 1 week, 1 month, and 3 months postoperatively. Measurements included the thickness (TH), cross-section area (CSA), and shear wave velocity (SWV) at the tear site. Shoulder function was assessed using the Constant-Murley score. Based on the surgical results, patients were categorized into three groups: partial-thickness tear group (21 cases), partial-width full-thickness tear group (42 cases), and full-width full-thickness tear group (10 cases). The parameters at different time points and their trends pre- and post-surgery were observed across groups. The correlation between TH, CSA, SWV, and the Constant-Murley score was analyzed.

Statistically significant differences in TH and SWV were observed among the groups preoperatively and at 1 week, 1 month, and 3 months postoperatively (P<0.05). Significant differences in CSA across time points were found in the partial-thickness tear group and the partial-width full-thickness tear group (P<0.05), but not in the full-width full-thickness tear group (P =0.137). In all the three groups, TH and CSA demonstrated an initial increase followed by a decrease at every time points, whereas SWV and Constant-Murley scores exhibited a gradual upward trend. In the partial-thickness tear group, preoperative SWV showed a positive correlation with preoperative Constant-Murley score (r =0.484, P =0.026). In the partial-width full-thickness tear group, SWV at 1 month correlated positively with Constant-Murley score at 1 month postoperatively (r =0.571, P<0.001). Furthermore, SWV at 3 months correlated positively with Constant-Murley score at 3 months postoperatively in both the partial-width full-thickness tear group and the full-width full-thickness tear group (r =0.618, P<0.001 and r =0.643, P =0.045, respectively).

The combination of musculoskeletal ultrasound and SWE enables quantitative assessment of shoulder function following rotator cuff repair surgery. This approach allows for repeated and real-time monitoring of tendon morphology and biomechanical changes. SWV provides an objective imaging basis for the follow-up evaluation of patients with full-thickness tears, facilitating better guidance of rehabilitation exercise protocols. This combined method holds significant clinical reference value.