Effect of Knee Angle and Quadriceps Muscle Force on Shear-Wave Elastography Measurements at the Patellar Tendon

Ultrasound Med Biol. 2021 Aug;47(8):2167-2175. doi: 10.1016/j.ultrasmedbio.2021.03.031. Epub 2021 May 14.

Abstract

Shear-wave elastography (SWE) is a non-invasive imaging technique that provides estimates of tissue stiffness via shear-wave speed measurements. No standardized protocol currently exists for SWE of the patellar tendon, which may be influenced by knee angle and quadriceps muscle force. In this study, the reliability of SWE in cadaveric patellar tendons was examined at three knee angles (0°, 30° and 60°) and three quadriceps muscle forces (0, 50 and 100 N). Shear-wave speed was significantly higher at a knee angle of 60° than at 0° or 30° (increases of 7% and 9%, respectively), and when the quadriceps muscle force was greater than or equal to 50 N (increase of 15%). SWE of the patellar tendon displayed excellent repeatability regardless of knee angle as long as no quadriceps force was generated (intra-class correlation coefficient ≥0.91). This research illustrates the importance of controlling knee angle and quadriceps force for consistency and comparison of SWE results.

Keywords: Knee; Reliability; Tendinopathy; Tendon stiffness; Ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cadaver
  • Elasticity Imaging Techniques*
  • Female
  • Humans
  • Knee Joint / physiology*
  • Male
  • Middle Aged
  • Muscle Strength*
  • Patellar Ligament / diagnostic imaging*
  • Patellar Ligament / physiology*
  • Quadriceps Muscle / physiology*
  • Reproducibility of Results