Reliability of Distal Hamstring Tendon Length and Cross-sectional Area Using 3-D Freehand Ultrasound

Sahinis, Chrysostomos; Kellis, Eleftherios; Dafkou, Konstantinos; Ellinoudis, Athanasios

doi:10.1016/j.ultrasmedbio.2021.05.025

Cited by 8 publications

(20 citation statements)

References 29 publications

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“…Then, the distal tendon length (mm) was quantified as the distance between the distal end of the most distal fascicle (without any muscle fiber attachment) and the insertion of its tendon according to a procedure similar to our previous studies. 11,12 In summary, for each tendon length landmarks were then positioned roughly at the center of each transverse slice. Throughout this process, the placement of each landmark was visualized using a combination of frontal, sagittal, and transverse image reslices to ensure optimal positioning near the center of the examined structure across all reconstructed slices.…”

Section: Image Analysismentioning

confidence: 99%

“…Subsequently, the distances between successive landmarks were measured and cumulatively added to determine the overall tendon length. 11,12 Then, the anatomical CSA (mm 2 ) as well as the widths (anteroposterior diameter [APD] and mediolateral diameter [MLD]) were calculated from three measurement sites along the distal tendon: at 20% (Proximal), 50% (Middle), and at 80% (Distal). For the measurement of anatomical CSA, a region of interest (ROI) was defined manually as the tendon region without bone or fascia with the best reflection.…”

Section: Image Analysismentioning

confidence: 99%

“…Previous investigations have established that that hamstrings are a very complex muscle group 9 with various architectural characteristics 10 . However, up to date, very few studies have explored the morphological and mechanical characteristics of hamstrings tendon and, hence, the information for the tendon architecture is scarce 11–13 . Recently, Sahinis et al 11 .…”

Section: Introductionmentioning

confidence: 99%

“…In theory, a greater tendon length coupled with a lower CSA may lead to a less stiff ST distal tendon compared to the other hamstring tendons 9 . Beyond the variations in morphological characteristics among distal hamstring tendons, noteworthy differences have been identified along the length of each tendon 11,12 . Specifically, research has indicated that the CSA of the hamstring tendon tends to be higher at the midpoint, whereas it diminishes in the distal measurement sites closer to the insertion point 11,12 .…”

Section: Introductionmentioning

confidence: 99%

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Distal hamstrings tendons mechanical properties at rest and contraction using free‐hand 3‐D ultrasonography

Sahinis,

Kellis

2024

Scandinavian Med Sci Sports

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Tendon properties impact human locomotion, influencing sports performance, and injury prevention. Hamstrings play a crucial role in sprinting, particularly the biceps femoris long head (BFlh), which is prone to frequent injuries. It remains uncertain if BFlh exhibits distinct mechanical properties compared to other hamstring muscles. This study utilized free‐hand three‐dimensional ultrasound to assess morphological and mechanical properties of distal hamstrings tendons in 15 men. Scans were taken in prone position, with hip and knee extended, at rest and during 20%, 40%, 60%, and 80% of maximal voluntary isometric contraction of the knee flexors. Tendon length, volume, cross‐sectional area (CSA), and anteroposterior (AP) and mediolateral (ML) widths were quantified at three locations. Longitudinal and transverse deformations, stiffness, strain, and stress were estimated. The ST had the greatest tendon strain and the lowest stiffness as well as the highest CSA and AP and ML width strain compared to other tendons. Biceps femoris short head (BFsh) exhibited the least strain, AP and ML deformation. Further, BFlh displayed the highest stiffness and stress, and BFsh had the lowest stress. Additionally, deformation varied by region, with the proximal site showing generally the lowest CSA strain. Distal tendon mechanical properties differed among the hamstring muscles during isometric knee flexions. In contrast to other bi‐articular hamstrings, the BFlh high stiffness and stress may result in greater energy absorption by its muscle fascicles, rather than the distal tendon, during late swing in sprinting. This could partly account for the increased incidence of hamstring injuries in this muscle.

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Section: Image Analysismentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Distal hamstrings tendons mechanical properties at rest and contraction using free‐hand 3‐D ultrasonography

Sahinis,

Kellis

2024

Scandinavian Med Sci Sports

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“…In the past, identification of variations in anatomy was usually limited to unexpected findings at surgery or during the process of anatomical dissection [ 1 ]. Advancements in ultrasound (US) and magnetic resonance imaging (MRI) enabled us to recognize accessory anatomical structures [ 2 , 7 , 17 , 18 , 19 ]. Τhe appearance of the TVI has been evaluated using such diagnostic imaging techniques with high reliability [ 17 , 18 , 20 , 21 ] and this provides the opportunity to examine the shape and role of this function, if any, in vivo [ 18 , 20 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Anatomy, Morphology and Function of the Tensor of Vastus Intermedius: A Systematic Review

Sahinis

Kellis

2021

JFMK

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The tensor of vastus intermedius is a newly discovered muscle that is located at the anterior compartment of the thigh. The aim of the present study is to report, assess and synthetize the existing evidence on the anatomy, variation and morphological characteristics of the TVI as well as to examine its clinical importance. A systematic review was performed evaluating both anatomical and medical imaging studies which provided information about TVI anatomy, prevalence, variations and morphological characteristics. The search strategy was conducted in major electronic databases. Two reviewers worked independently to screen all possible references via a title/abstract examination. Methodological quality was examined with the Anatomical Quality Assurance checklist. A total of 295 cadaveric knees were included in the nine studies where in 244 (82.7%) cases the TVI was identified. Based on this evidence, it appears that the TVI is located between the vastus lateralis and vastus intermedius. The muscle belly is located proximally, and it is combined with a broad and flat aponeurosis before forming a tendinous structure that is attached at the medial aspect of the patella. The TVI presented some morphological variations and complex muscle architecture that varied along its length. There is insufficient good quality evidence as more than half of the included studies were ranked as having a “High” risk of bias with various methodological issues. Higher quality studies are recommended to evaluate the TVI morphology to better understand its functional and clinical importance.

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Reliability of Semitendinosus and Biceps Femoris Aponeurosis Thickness Using B‐Mode Ultrasound

Sahinis,

Kellis

2024

J of Ultrasound Medicine

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ObjectivesThe aim of the present study was to assess the reliability of aponeurosis and muscle thickness of the hamstrings using ultrasound (US).MethodsUS images were captured from the semitendinosus (ST) and biceps femoris long head (BFlh) of 30 individuals (15 females), undergoing two testing sessions with a 24‐hour interval. Measurements were taken at six sites along the thigh at two knee angles (0° = full extension and 90°) in prone position. Aponeurosis and muscle thickness across the entire length of ST and BFlh were evaluated using computational image segmentation which generated ~360 data points per participant.ResultsThe intraclass correlation coefficients ranged from 0.937 to 0.998 while the standard error of measurement varied from 0.88 to 2.72% for superficial aponeurosis, from 1.41 to 2.29% for deep aponeurosis, and from 1.50 to 4.22% for muscle thickness. The minimal detectable change ranged from 2.44 to 7.56% for the superficial aponeurosis, from 3.57 to 6.27% for deep aponeurosis, and from 4.17 to 11.70% for BF and ST muscle thickness.ConclusionsEvaluation of hamstring aponeurosis and muscle thickness measurements at rest displayed very high reliability and, hence, such measurements can be used to diagnose changes in thickness due to injury or exercise interventions.

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Reliability of Distal Hamstring Tendon Length and Cross-sectional Area Using 3-D Freehand Ultrasound

Cited by 8 publications

References 29 publications

Distal hamstrings tendons mechanical properties at rest and contraction using free‐hand 3‐D ultrasonography

Distal hamstrings tendons mechanical properties at rest and contraction using free‐hand 3‐D ultrasonography

Anatomy, Morphology and Function of the Tensor of Vastus Intermedius: A Systematic Review

Reliability of Semitendinosus and Biceps Femoris Aponeurosis Thickness Using B‐Mode Ultrasound

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