Ultrasonographic tissue characterisation of human Achilles tendons: quantification of tendon structure through a novel non-invasive approach

Schie, Hans T. M. van; Vos, Robert‐Jan de; Jonge, Suzan de; Bakker, Erwin M.; Heijboer, M.P.; Verhaar, Jan A N; Tol, Johannes L.; Weinans, Harrie

doi:10.1136/bjsm.2009.061010

Cited by 173 publications

(341 citation statements)

References 32 publications

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“…This is supported by the finding that most ultrasonographic mid-portion disorders (91%) are found in the posteromedial segment of the tendon [131,135] . The Plantaris Longus…”

Section: The Plantaris Longus Tendon and Its Relationship With The Acsupporting

confidence: 74%

The Achilles Tendinopathy: Pathogenesis Review

Bondi¹,

Rossi²,

Magnan³

et al. 2015

International Journal of Orthopaedics

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Achilles tendinopathy is a degenerative disease with high prevalence in runners. For the comprehension of achilles tendinopathy we have to consider intrinsic conditions such as age, sex, BMI, tendon temperature, systemic diseases, flexibility, previous injuries and anatomical variations, genetic predisposition and blood supply and extrinsic factors such as drugs and overuse. Both categories can be responsible for development of achilles' degenerative tendinopathy. Different hypothesis were studied, those concerning the pathogenesis of tendinopathy and those concerning the etiology of complaints in patients. This review of the literature demonstrates the heterogeneity of Achilles tendinopathy pathogenesis.

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“…This is supported by the finding that most ultrasonographic mid-portion disorders (91%) are found in the posteromedial segment of the tendon [131,135] . The Plantaris Longus…”

Section: The Plantaris Longus Tendon and Its Relationship With The Acsupporting

confidence: 74%

The Achilles Tendinopathy: Pathogenesis Review

Bondi¹,

Rossi²,

Magnan³

et al. 2015

International Journal of Orthopaedics

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“…[2] Our findings for Achilles tendon thickness are around 4 mm. Van Schie et al [14] measured Achilles tendon thickness as 6.8±1.2 mm, Fahlstrom and Alfredson [15] measuring 6±1 mm, Mabuchi et al [16] 6.03±0.2 mm, Pang and Ying [17] 5.1±0.6 mm, and Kallinen and Suomin [18] 5.7±1.4 mm. There are differences in Achilles tendon sizes between males and females, possibly due to differences in muscle strength and mechanical properties.…”

Section: Anatomy • Volume 9 / Issue 3 / December 2015mentioning

confidence: 99%

Effects of physical characteristics, exercise and smoking on morphometry of human Achilles tendon: an ultrasound study

Canbolat¹,

Özbağ²,

Özdemir³

et al. 2015

Anatomy

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Objectives: The aim of this study was to reveal the normal morphometric values of Achilles tendon using ultrasound (US) imaging in subjects of different gender, age groups, smoking status, and physical exercise habits. Methods:A total of 342 Achilles tendons were examined in the 171 volunteers (69 females, 102 males) with different age, gender, weight, height, smoking and physical exercise habits. Achilles tendon width, length, thickness, cross-sectional area and length were measured using a commercial ultrasound machine with a 9-15 mHz linear-array transducer. Results:The average width, thickness, cross-sectional area and length of the Achilles tendon in male subjects were significantly higher than females. Tendon width, thickness, cross-sectional area and length showed no significant difference between the right and left side. With the exception of the left Achilles tendon thickness, measurements taken for non-smoking subjects were larger than smokers. Achilles tendon measurements of subjects engaged in sportive activities were significantly larger than those with sedentary lifestyle Weight and body mass index were the only anthropometric measurements in correlation with Achilles tendon size. Conclusion:Achilles tendon size varies with age, gender, physical activity and smoking habits. The measurements presented in this study give normal variations of the tendon's morphologic characteristics, which will be of use in clinical diagnosis.

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“…1,2 Ultrasound tissue characterization (UTC) is a novel approach that overcomes these limitations by using an automatic ultrasound-probe-tracking device and dedicated image analyzing algorithms. 3 The tracking device standardizes the transducer tilt, angle, focus, gain, and depth. 3,4 A software reconstructs and analyses a 3-dimensional image of the tendon and quantifies the internal tendon structure based on fibrillar alignment.…”

mentioning

confidence: 99%

Effects of Training Load and Leg Dominance on Achilles and Patellar Tendon Structure

Esmaeili¹,

Stewart²,

Hopkins³

et al. 2017

International Journal of Sports Physiology and Performance

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Purpose: Detrimental changes in tendon structure increase the risk of tendinopathies. The aim of this study was to investigate the influence of individual internal and external training loads and leg dominance on changes in the Achilles and patellar tendon structure. Methods: The internal structure of the Achilles and patellar tendons of both limbs of 26 elite Australian footballers was assessed using ultrasound tissue characterization at the beginning and the end of an 18-wk preseason. Linear-regression analysis was used to estimate the effects of training load on changes in the proportion of aligned and intact tendon bundles for each side. Standardization and magnitude-based inferences were used to interpret the findings. Results: Possibly to very likely small increases in the proportion of aligned and intact tendon bundles occurred in the dominant Achilles (initial value 81.1%; change, ±90% confidence limits 1.6%, ±1.0%), nondominant Achilles (80.8%; 0.9%, ±1.0%), dominant patellar (75.8%; 1.5%, ±1.5%), and nondominant patellar (76.8%; 2.7%, ±1.4%) tendons. Measures of training load had inconsistent effects on changes in tendon structure; eg, there were possibly to likely small positive effects on the structure of the nondominant Achilles tendon, likely small negative effects on the dominant Achilles tendon, and predominantly no clear effects on the patellar tendons. Conclusion: The small and inconsistent effects of training load are indicative of the role of recovery between tendon-overloading (training) sessions and the multivariate nature of the tendon response to load, with leg dominance a possible influencing factor. Keywords: tendinopathy, UTC, ultrasound, football, recoveryTendons transfer forces from muscles to bones to facilitate movement. Tendon properties change in response to forces applied to the tendon through training 1 and detrimental changes in tendon structure are associated with increased risk of tendinopathies. 2 Tendon stiffness, elastic modulus, and cross-sectional area are measures of tendon mechanical, material, and (macro)morphological properties, respectively, which generally increase after controlled episodes of increased loading. 1 Little is known about changes in the internal tendon structure in the form of fibrillar alignment (micromorphology) in response to training.Traditional assessment of the internal tendon structure using ultrasound imaging requires manual tracking of the ultrasound probe. This approach along with the subjective and qualitative interpretation of the ultrasound images does not allow for quantification of subtle changes in the tendon structure. 1,2 Ultrasound tissue characterization (UTC) is a novel approach that overcomes these limitations by using an automatic ultrasound-probe-tracking device and dedicated image analyzing algorithms. 3 The tracking device standardizes the transducer tilt, angle, focus, gain, and depth. 3,4 A software reconstructs and analyses a 3-dimensional image of the tendon and quantifies the internal tendon structure based on fibrillar...

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Ultrasonographic tissue characterisation of human Achilles tendons: quantification of tendon structure through a novel non-invasive approach

Abstract: UTC can quantitatively evaluate tendon structure and thereby discriminate symptomatic and asymptomatic tendons. As such, UTC might be useful to monitor treatment protocols.

Cited by 173 publications

References 32 publications

The Achilles Tendinopathy: Pathogenesis Review

The Achilles Tendinopathy: Pathogenesis Review

Effects of physical characteristics, exercise and smoking on morphometry of human Achilles tendon: an ultrasound study

Effects of Training Load and Leg Dominance on Achilles and Patellar Tendon Structure

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