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Peer-reviewedCC BYJSES international

The usefulness of a newly developed ultrasonographic measurement method for predicting post-operative stiffness after arthroscopic rotator cuff repair.

8 affiliations
  1. 1Department of Rehabilitation, Funabashi Orthopaedic Clinic, Funabashi, Chiba, Japan.
  2. 2Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan.
  3. 3Medical Corporation Tanaka Clinic, Sendai-shi, Miyagi, Japan.
  4. 4Takeda Orthopaedic Clinic, Koriyama, Fukushima, Japan.
  5. 5Tamura Orthopedics Clinic, Shizuoka-si, Shizuoka, Japan.
  6. 6Tokyo Sports & Orthopaedic Clinic, Toshima-ku, Tokyo, Japan.
  7. 7Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
  8. 8Department of Orthopaedic Surgery, Yachiyo Hospital, Anjo, Aichi, Japan.

Abstract

Background

Post-operative shoulder stiffness (POSS) is one of the most common complications following arthroscopic rotator cuff repair (ARCR) and is thought to be caused by pathologic changes in the anterosuperior soft-tissue structures of the glenohumeral joint. The aim of this study was to determine whether objective ultrasonographic evaluation can predict the occurrence of POSS at 1 year after surgery and to investigate the reliability of a newly developed ultrasonographic measurement method.Methods

This retrospective cohort study included patients who underwent ARCR at a single institution between April 2017 and June 2018. Ultrasonographic external rotation (UER) and the subscapularis (SSC) sliding rate, representing anterosuperior soft-tissue sliding mobility assessed by ultrasonography, were evaluated at 1 and 3 months post-operatively. POSS was defined as passive external rotation <30° and forward elevation <120° at 12 months. Patients were assigned to 1 of the 2 groups: Group N (without POSS) or Group S (with POSS). Propensity score matching was performed to minimize baseline differences between groups. UER and SSC sliding rate were compared between the groups. Receiver operating characteristic curve analysis was also used to determine predictive thresholds values for POSS at 12 months after surgery, and intrarater and inter-rater reliability were assessed using intraclass correlation coefficients.Results

After propensity score matching, 40 shoulders (20 per group) were analyzed. The SSC sliding rate at 1 and 3 months and UER at 3 months were significantly greater in Group N than in Group S. The greatest between-group difference was observed for the SSC sliding rate at 1 month post-operatively. Regarding receiver operating characteristic curve analysis, the thresholds for POSS at 1 year post-operatively were 48% for the SSC sliding rate at 1 month after surgery, 38% for the SSC sliding rate at 3 months post-operatively, and 7° for UER at 3 months post-operatively. Reliability analysis showed substantial to almost perfect intrarater and inter-rater reliability for both SSC sliding rate and UER.Conclusion

Early post-operative ultrasonographic evaluation is useful for predicting the development of POSS at 1 year after ARCR. Reduced SSC sliding rate and limited UER in the early post-operative period were significantly associated with subsequent POSS.

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BibTeX
@article{miyasaka2026usefulness,
  title = {{The usefulness of a newly developed ultrasonographic measurement method for predicting post-operative stiffness after arthroscopic rotator cuff repair.}},
  author = {Yuki Miyasaka and Takahiro Sekiguchi and Norimasa Takahashi and Toshiki Nagaoka and Keisuke Kimura and Kohei Matsuda and Keisuke Matsuki and Shota Hoshika and Hiroyuki Sugaya and Itaru Kawashima},
  journal = {JSES international},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jseint.2026.101789},
  url = {https://europepmc.org/article/MED/42910300},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The usefulness of a newly developed ultrasonographic measurement method for predicting post-operative stiffness after arthroscopic rotator cuff repair.
AU  - Yuki Miyasaka
AU  - Takahiro Sekiguchi
AU  - Norimasa Takahashi
AU  - Toshiki Nagaoka
AU  - Keisuke Kimura
AU  - Kohei Matsuda
AU  - Keisuke Matsuki
AU  - Shota Hoshika
AU  - Hiroyuki Sugaya
AU  - Itaru Kawashima
PY  - 2026
DA  - 2026/09/04
JO  - JSES international
DO  - 10.1016/j.jseint.2026.101789
UR  - https://europepmc.org/article/MED/42910300
AB  - Background  Post-operative shoulder stiffness (POSS) is one of the most common complications following arthroscopic rotator cuff repair (ARCR) and is thought to be caused by pathologic changes in the anterosuperior soft-tissue structures of the glenohumeral joint. The aim of this study was to determine whether objective ultrasonographic evaluation can predict the occurrence of POSS at 1 year after surgery and to investigate the reliability of a newly developed ultrasonographic measurement method.Methods  This retrospective cohort study included patients who underwent ARCR at a single institution between April 2017 and June 2018. Ultrasonographic external rotation (UER) and the subscapularis (SSC) sliding rate, representing anterosuperior soft-tissue sliding mobility assessed by ultrasonography, were evaluated at 1 and 3 months post-operatively. POSS was defined as passive external rotation <30° and forward elevation <120° at 12 months. Patients were assigned to 1 of the 2 groups: Group N (without POSS) or Group S (with POSS). Propensity score matching was performed to minimize baseline differences between groups. UER and SSC sliding rate were compared between the groups. Receiver operating characteristic curve analysis was also used to determine predictive thresholds values for POSS at 12 months after surgery, and intrarater and inter-rater reliability were assessed using intraclass correlation coefficients.Results  After propensity score matching, 40 shoulders (20 per group) were analyzed. The SSC sliding rate at 1 and 3 months and UER at 3 months were significantly greater in Group N than in Group S. The greatest between-group difference was observed for the SSC sliding rate at 1 month post-operatively. Regarding receiver operating characteristic curve analysis, the thresholds for POSS at 1 year post-operatively were 48% for the SSC sliding rate at 1 month after surgery, 38% for the SSC sliding rate at 3 months post-operatively, and 7° for UER at 3 months post-operatively. Reliability analysis showed substantial to almost perfect intrarater and inter-rater reliability for both SSC sliding rate and UER.Conclusion  Early post-operative ultrasonographic evaluation is useful for predicting the development of POSS at 1 year after ARCR. Reduced SSC sliding rate and limited UER in the early post-operative period were significantly associated with subsequent POSS.
SN  - 2666-6383
ER  -