The Ability of Ultrasonography, Magnetic Resonance Imaging and Bone Mineral Densitometry to Predict the Strength of Human Achilles' Tendons

Devitt, Deanna; Koike, Yoichi; Doherty, Geoffrey P.; Ramachandran, Nanthan; Dinh, Laurent; Uhthoff, Hans K.; Lecompte, Martin; Trudel, Guy

doi:10.1016/j.apmr.2008.10.031

Cited by 11 publications

(9 citation statements)

References 28 publications

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“…This disparity between radiological and clinical severity in lateral epicondylitis is similar to that of other tendinopathies, such as the rotator cuff and Achilles tendon, in which imaging studies have shown high rates of tendon abnormality in asymptomatic patients. 16,17,18 This study has several limitations. We have been able to assess patients only following their referral to secondary care.…”

Section: Discussionmentioning

confidence: 93%

The Reliability and Validity of Magnetic Resonance Imaging in the Assessment of Chronic Lateral Epicondylitis

Walton

Mackie

Fallon

et al. 2011

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 93%

The Reliability and Validity of Magnetic Resonance Imaging in the Assessment of Chronic Lateral Epicondylitis

Walton

Mackie

Fallon

et al. 2011

The Journal of Hand Surgery

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“…Indeed, there is conflicting evidence from some pathological studies regarding mechanical properties. Some studies report no significant difference in mechanical properties in patients with tendon pathology from healthy subjects [18][19][20][21][22], but other studies reporting significant weakening of material and altered mechanical tendon properties, with both increased stiffness [23] and decreased stiffness [24][25][26] observed in patients. The inconsistent results regarding human in vivo mechanical properties between studies on tendon pathology may be a consequence of different tendon types under investigation, (total collagen levels vary between tendon types in normal tendons [27,28]) as well as varying subject age and sex.…”

Section: Tendon Propertiesmentioning

confidence: 99%

Genetic Variation, Protein Composition and Potential Influences on Tendon Properties in Humans

Foster¹

2012

TOSMJ

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Sequence variations in genes that code for proteins involved in homeostatic processes within tendons may influence tendon mechanical properties. Since variants of the four genes COL5A1, TNC, MMP3 and GDF5 have been implicated in the aetiopathogenesis of tendinopathies, which is ultimately characterised by abnormal structural and regulatory processes, sequence variations in these four genes may also influence how the tendon functions mechanically, even in the absence of tendinopathy. For example, two reports of association between variation in the COL5A1 gene and measures of flexibility complement reported associations between genotype and incidence of tendinopathy. Non-genetic factors such as age, body mass and physical activity status influence risk of tendon injury and physical performance potential independently from genomics, and also in gene-environment interactions. However, these non-genetic factors are often not considered in genetic association studies, probably due to their retrospective nature. Further research examining COL5A1, TNC, MMP3 and GDF5, as well as other genes that may influence the maintenance of tendon homeostasis such as COL1A1 which regulates the production of collagen type 1, the most abundant structural component of tendon is encouraged. Establishing the genetic basis of tendon properties in asymptomatic populations may advance understanding of some aspects relevant to physical performance and of the aetiology of tendinopathies. To improve understanding, accurate and reproducible assessments of tendon properties are required. However, no valid and reliable assessments of tendon properties, such as those involving in vivo ultrasound imaging techniques, have yet been applied to genetic association studies in humans.

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“…Clinical return-to-activity criteria include assessments of pain, function and appearance on ultrasound or MR images, which may differentiate symptomatic vs. asymptomatic tendons, but are not necessarily indicative of the strength of the tissue (Devitt et al 2009; van Schie et al 2014). Thus, there is a strong need for in vivo quantitative indicators of tendon strength, which would provide more objective assessment of the recovery of tissue mechanical integrity.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Measures of Shear Wave Speed as a Predictor of Tendon Elasticity and Strength

Martin

Biedrzycki

Lee

et al. 2015

Ultrasound in Medicine & Biology

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The purpose of this study was to assess the potential for ultrasound shear wave elastography (SWE) to assess tissue elasticity and ultimate stress in both intact and healing tendons. The lateral gastrocnemius (Achilles) tendons of 41 New Zealand white rabbits were surgically severed and repaired with growth factor coated sutures. SWE imaging was used to measure shear wave speed (SWS) in both the medial and lateral tendons pre-surgery, and at 2 and 4 weeks post-surgery. Rabbits were euthanized at 4 weeks, and both medial and lateral tendons underwent mechanical testing to failure. SWS significantly (p<0.001) decreased an average of 17% between the intact and post-surgical state across all tendons. SWS was significantly (p<0.001) correlated with both the tendon elastic modulus (r = 0.52) and ultimate stress (r = 0.58). Thus, ultrasound SWE is a potentially promising noninvasive technology for quantitatively assessing the mechanical integrity of pre-operative and post-operative tendons.

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The Ability of Ultrasonography, Magnetic Resonance Imaging and Bone Mineral Densitometry to Predict the Strength of Human Achilles' Tendons

Cited by 11 publications

References 28 publications

The Reliability and Validity of Magnetic Resonance Imaging in the Assessment of Chronic Lateral Epicondylitis

The Reliability and Validity of Magnetic Resonance Imaging in the Assessment of Chronic Lateral Epicondylitis

Genetic Variation, Protein Composition and Potential Influences on Tendon Properties in Humans

In Vivo Measures of Shear Wave Speed as a Predictor of Tendon Elasticity and Strength

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