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IS BASELINE STRAIN INDEX A PROGNOSTIC FACTOR FOR SMALL UNILATERAL SUPRASPINATUS TENDON TEARS? A PROSPECTIVE STUDY

Andrea Cappiello, Verdiana Stano, Michele Bisaccia, Luigi Meccariello, Gabriele Falzarano, Antonio Medici, Marco Pellegrino, Olga Bisaccia, Giuseppe Rinonapoli, Auro Caraffa.

Abstract
Purpose: From prospectively report the 2-year follow-up clinical and real-time sonoelastography (RTSE) outcomes of a group of patients affected by small unilateral supraspinatus tendon tears. Our hypothesis was that patients with lower baseline strain indexes would have worst outcomes at follow-up.
Methods: We recruited patients suffering by a unilateral rotator cuff tear. All patients have prospectively scrutinized. Patients were initially managed non-operatively, after at least 3 months of failed conservative treatment patients went under surgery. Our clinical evaluation and follow up was done by: complete physical examination; VAS for pain; Quick DASH; Constant–Murley score; Simple Shoulder Test; ASES score and UCLA score. The mechanical properties of tissues were evalutated by Conventional ultrasounds and RTSE and they were estimated uging the Strain index.
Results: Forty-three patients were available for evaluation at 2 years. Fifteen had undergone surgery (operative group), while 28 recovered from pain and dysfunction with conservative management andhad not required surgery (non-operative group). Patients in both groups significantly improved at follow-up, and no differences were found in all considered clinical outcomes. The biomechanical properties of repaired tendons were maintained, while non-operatively treated tendons softened over time. Baseline and follow-up strain indexes were linearly correlated with clinical outcomes at 2 years.
Conclusions: Baselinestrain index could be associated with post-operative functional outcomes at 2-year follow-up. The biomechanical properties of surgically repaired tendons were maintained, while non-operatively treated tendons softened over time. At least in this cohort of patients, baseline strain index did not suggest who could be managed conservatively and who will need surgery.

Key words: ELASTOGRAPHY; ROTATOR CUFF; STRAIN INDEX; SOVRASPINATUS TEAR; SHOULDER.


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