{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:07:52Z","timestamp":1788890872091,"version":"build-2803163510"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Scientific Research Fund Project for Teachers of the Department of Education of Yunnan Province","award":["Grant No. 2026J0026"],"award-info":[{"award-number":["Grant No. 2026J0026"]}]},{"name":"The Yunnan University Medical Research Foundation","award":["Grant No. YDYXJJ2024-0036"],"award-info":[{"award-number":["Grant No. YDYXJJ2024-0036"]}]},{"name":"The Yunnan Fundamental Research Projects","award":["Grant No. 202601AT070147"],"award-info":[{"award-number":["Grant No. 202601AT070147"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The development of rehabilitation protocols after rotator cuff repair has long lacked objective benchmarks. Traditional time\u2011based regimens are limited by considerable inter\u2011individual variability and an increased risk of re\u2011tear. Musculoskeletal ultrasound allows dynamic assessment of tendon healing and muscle morphology, yet evidence for directly linking its use to rehabilitation decisions remains scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically synthesize the evidence on the use of musculoskeletal ultrasound monitoring to inform rehabilitation decision\u2011making after rotator cuff repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following the Preferred Reporting Items for Systematic Reviews and Meta\u2011Analyses (PRISMA) guidelines, we searched PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data from January 2020 to April 2026. Original studies were included if they involved patients who had undergone rotator cuff repair, used musculoskeletal ultrasound (including gray\u2011scale ultrasound, elastography, etc.) to evaluate the rotator cuff tendons or shoulder muscles, and reported at least one parameter related to rehabilitation decision-making or functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven studies were included. Shear wave velocity (SWV), cross\u2011sectional area (CSA), and echo intensity (EI) were the most frequently reported ultrasound parameters. Available evidence indicated that SWV increased progressively after surgery, with an overall increase of approximately 22% to 25% from one week to 12 months postoperatively. This dynamic trajectory may serve as a reference baseline for judging rehabilitation progress. An abnormally elevated SWV in the early postoperative period was associated with an increased risk of re\u2011tear, suggesting that a more conservative rehabilitation strategy should be adopted. Tendon stiffness measured at 12 weeks after surgery independently predicted long\u2011term return to sport. Regarding muscle parameters, changes in CSA and EI were positively correlated with shoulder function scores, and the combination of these two parameters effectively identified patients with rehabilitation bottlenecks\n                      <jats:bold>.<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Musculoskeletal ultrasound parameters are associated with the initiation of active movement, adjustment of exercise load, prediction of return\u2011to\u2011sport prognosis, and identification of retear risk. Among these, SWV shows particular promise as an objective monitoring parameter for supporting rehabilitation assessment after rotator cuff repair. Future randomized controlled trials are needed to determine whether ultrasound-informed assessment can improve rehabilitation outcomes compared with traditional time-based regimens, and to establish standardized measurement protocols and clinically applicable reference values. Key findings of this review are summarized in S1 File.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357622","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:27:21Z","timestamp":1788888441000},"page":"e0357622","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of musculoskeletal ultrasound in postoperative rehabilitation assessment and monitoring after rotator cuff repair: A systematic review"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6234-567X","authenticated-orcid":true,"given":"Ying","family":"Shi","sequence":"first","affiliation":[{"name":"The Affiliated Hospital of Yunnan University","place":["Kunming, Yunnan Province, China"],"department":["Department of Rehabilitation Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Bao","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Yunnan University","place":["Kunming, Yunnan Province, China"],"department":["Department of Rehabilitation Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanxiong","family":"Li","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Yunnan University","place":["Kunming, Yunnan Province, China"],"department":["Department of Rehabilitation Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"3","key":"pone.0357622.ref001","doi-asserted-by":"crossref","first-page":"309","DOI":"10.32098\/mltj.03.2014.08","article-title":"Epidemiology of the rotator cuff tears: a new incidence related to thyroid disease","volume":"4","author":"F Oliva","year":"2014","journal-title":"Muscles Ligaments Tendons J"},{"issue":"4","key":"pone.0357622.ref002","doi-asserted-by":"crossref","first-page":"227","DOI":"10.32098\/mltj.04.2015.01","article-title":"I.S.Mu.L.T. rotator cuff tears guidelines","volume":"5","author":"F Oliva","year":"2016","journal-title":"Muscles Ligaments Tendons J"},{"issue":"1","key":"pone.0357622.ref003","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1186\/s12891-021-04634-6","article-title":"Retear rates after rotator cuff surgery: a systematic review and meta-analysis","volume":"22","author":"UG Longo","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"issue":"11","key":"pone.0357622.ref004","first-page":"1158","article-title":"Progress in rehabilitation after arthroscopic repair of massive rotator cuff tears","volume":"40","author":"CR Bai","year":"2025","journal-title":"Chinese J Bone Joint Injury"},{"issue":"7","key":"pone.0357622.ref005","doi-asserted-by":"crossref","DOI":"10.1016\/j.jse.2024.10.014","article-title":"Measurement properties of shear wave elastography for evaluating rotator cuff muscle stiffness: a systematic review","volume":"34","author":"D Borms","year":"2025","journal-title":"J Shoulder Elbow Surg"},{"key":"pone.0357622.ref006","unstructured":"Wang J, Chen DZ, Song HP. 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