Powerdopplersonografische Befunde der Achillessehnen von 953 Langstreckenläufern – eine Querschnittsstudie

Hirschmüller, Anja; Frey, V.; Deibert, Peter; Konstantinidis, Lukas; Mayer, Frank; Südkamp, N. P.; Helwig, Peter

doi:10.1055/s-0029-1245189

Cited by 30 publications

(16 citation statements)

References 13 publications

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“…The importance of tendon adaption to higher loads is underlined by the significant increase of tendon diameter at the thickest point in players with PTS (4.58 ± 0.98 mm vs. 4.0 ± 0.54 mm, p = 0.001). Tendon thickening has been proven to be an indicator of tendinopathy [ 15 ]. In healthy adults, tendon thickness of the patellar tendon varies between 3 and 5 mm [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy

Bode

Hammer

Karvouniaris

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe prevalence of patellar tendinopathy is elevated in elite soccer compared to less explosive sports. While the burden of training hours and load is comparably high in youth elite players (age < 23 years), little is known about the prevalence of patellar tendinopathy at this age. There is only little data available on the influence of age, the amount of training, the position on the field, as well as muscular strength, range of motion, or sonographical findings in this age group. The purpose of the present study was to examine the above-mentioned parameters in all age groups of a German youth elite soccer academy.MethodsOne hundred nineteen male youth soccer players (age 15,97 ± 2,24 years, height 174, 60 ± 10,16 cm, BMI 21, 24 ± 2,65) of the U-13 to U-23 teams were part of the study. Data acquisition included sport specific parameters such as footwear, amount of training hours, leg dominance, history of tendon pathologies, and clinical examination for palpatory pain, indurations, muscular circumference, and range of motion.Subjective complaints were measured with the Victorian Institute of Sport Assessment Patellar (VISA-P) Score. Furthermore, sonographical examinations (Aplio SSA-770A/80; Toshiba, Tokyo, Japan) with 12-MHz multifrequency linear transducers (8–14 MHz) of both patellar tendons were performed with special emphasis on hyper- and hypo echogenic areas, diameter and neovascularization.ResultsThe prevalence of patellar tendinopathies was 13.4%. Seventy-five percent of the players complained of pain of their dominant leg with onset of pain at training in 87.5%. The injured players showed a medium amount of 10.34 ± 3.85 training hours and a medium duration of symptoms of 11.94 ± 18.75 weeks. Two thirds of players with patellar tendinopathy were at the age of 15–17 (Odds ratio 1.89) while no differences between players of the national or regional league were observed.In case of patellar tendinopathy, VISA-P was significantly lower in comparison to healthy players (mean ± SD 76.80 ± 28.56 points vs. 95.85 ± 10.37). The clinical examination revealed local pain at the distal patella, pain at stretching, and thickening of the patellar tendon (p = 0.02).The mean tendon diameter measured 2 cm distally to the patella was 4.10 ± 0.68 mm with a significantly increased diameter of 0.15 mm in case of an underlying tendinopathy (p = 0.00). The incidence of hypo-echogenic areas and neovascularizations was significantly elevated in players with patellar tendon syndrome (PTS) (p = 0.05).ConclusionThe prevalence of patellar tendinopathy in youth elite soccer is relatively high in comparison to available data of adult players. Especially players at the age of 15 to 17 are at considerable risk. Tendon thickening, hypo-echogenic areas, and neovascularization are more common in tendons affected by PTS.

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Section: Discussionmentioning

confidence: 99%

“…Ultrasonography examination was performed after a resting period of at least a 2 h (mean 23.00 ± 23.59 h) in accordance to avoid intratendinous blood flow [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy

Bode

Hammer

Karvouniaris

et al. 2017

BMC Musculoskelet Disord

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“…2). The percentage of asymptomatic tendons with intratendinous neovascularizations is up to 35 % according to the literature [25]. The degree of neovascularization can be classified according to the Öhberg score (0 through 4 +) with 0 indicating the absence of neovascularization, 1 + the presence of neovascularization in the anterior tendon segment and 2 + through 4 + indicating varying degrees of irregular neovascularization [26].…”

Section: Intratendinous Changes Tendinosismentioning

confidence: 99%

Achillodynia - Radiological Imaging of Acute and Chronic Overuse Injuries of the Achilles Tendon

Syha

Springer

Ketelsen

et al. 2013

Fortschr Röntgenstr

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In the past decades the incidence of acute and chronic disorders of the Achilles tendon associated with sport-induced overuse has steadily increased. Besides acute complete or partial ruptures, achillodynia (Achilles tendon pain syndrome), which is often associated with tendon degeneration, represents the most challenging entity regarding clinical diagnostics and therapy. Therefore, the use of imaging techniques to differentiate tendon disorders and even characterize structure alterations is of growing interest. This review article discusses the potential of different imaging techniques with respect to the diagnosis of acute and chronic tendon disorders. In this context, the most commonly used imaging techniques are magnetic resonance imaging (MRI), B-mode ultrasound, and color-coded Doppler ultrasound (US). These modalities allow the detection of acute tendon ruptures and advanced chronic tendon disorders. However, the main disadvantages are still the low capabilities in the detection of early-stage degeneration and difficulties in the assessment of treatment responses during follow-up examinations. Furthermore, differentiation between chronic partial ruptures and degeneration remains challenging. The automatic contour detection and texture analysis may allow a more objective and quantitative interpretation, which might be helpful in the monitoring of tendon diseases during follow-up examinations. Other techniques to quantify tendon-specific MR properties, e.?g. based on ultrashort echo time (UTE) sequences, also seem to have great potential with respect to the precise detection of degenerative tendon disorders and their differentiation at a very early stage. Key Points: Citation Format:

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“…Achilles tendinopathy is a common disorder in sports and daily life. This injury is frequently encountered in middle-and long-distance runners with up to 36% incidence rate [1][2][3] and may cause up to 5% of professional athletes to a premature career end. 4 5 Achilles tendinopathy is considered as a multifactorial condition whose exact etiology remains to be determined and can be divided into insertional and noninsertional tendinopathy according to its anatomical location.…”

Section: Introductionmentioning

confidence: 99%

Does Additional Extracorporeal Shock Wave Therapy Improve the Effect of Isolated Percutaneous Radiofreqency Coblation in Patients with Insertional Achilles Tendinopathy? Study Protocol for A Randomized Controlled Clinical Trial

Song

Xuan

Hua

2020

Preprint

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Background: No conclusive evidence recommends a prior treatment for insertional Achilles tendinopathy (IAT). It is theorized that both percutaneous radiofreqency coblation and extracorporeal shockwave therapy (ESWT) relieve pain within the insertion. However, no clinical evidence shows that either treatment promote the regeneration of the tendon or if the combination of these 2 interventions offer better function and less pain than one therapy. Methods: The study is a randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups. Patients with insertional Achilles tendinopathy who are not satisfied with the effect of conservative treatment will be screened. A minimum of 38 patients will be enrolled after deciding to participate in the trial on an informed basis. Then the intervention group and the control group perform radial ESWT and sham-ESWT respectively at 6 months after percutaneous radiofreqency coblation. The primary outcome will be the Victorian Institute of Sports Assessment Achilles (VISA-A) Score. Secondary outcome measures will be Foot and Ankle Outcome Score (FAOS) scale, Visual Analogue Scale (VAS), Tegner Score, and MRI ultra-short echo time (UTE) T2* value. The assessments will occur in 6 months, 1 year, and 2 years post-operatively. The differences between 2 groups will be conducted as intention-to-treat basis. Discussion: We aim to investigate if radiofreqency coblation associated with ESWT can provide more encouraging imaging findings as well as functional and clinical outcomes regarding the treatment of the IAT comparing to the single radiofreqency coblation treatment.Trial registration: ChiCTR1800017898; Pre-results. Registered on 20 August 2018.

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Powerdopplersonografische Befunde der Achillessehnen von 953 Langstreckenläufern – eine Querschnittsstudie

Abstract: Contrary to frequent assumption, neovascularization is often found in tendons of asymptomatic runners, using modern power Doppler equipment. The pathological relevance of single microvessels in asymptomatic tendons must, therefore, be critically discussed.

Cited by 30 publications

References 13 publications

Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy

Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy

Achillodynia - Radiological Imaging of Acute and Chronic Overuse Injuries of the Achilles Tendon

Does Additional Extracorporeal Shock Wave Therapy Improve the Effect of Isolated Percutaneous Radiofreqency Coblation in Patients with Insertional Achilles Tendinopathy? Study Protocol for A Randomized Controlled Clinical Trial

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