scholarly journals Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

Effect of Electroacupuncture Stimulation on Long-Term Recovery following Achilles Tendon Rupture in a Rat Model

2018 ◽  
Vol 36 (5) ◽  
pp. 327-332
Author(s):  
Miwa Imaeda ◽  
Tatsuya Hojo ◽  
Hiroshi Kitakoji ◽  
Kazuto Tanaka ◽  
Megumi Itoi ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Breaking Strength ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional

Aims In this study we examined the effect of electroacupuncture (EA) stimulation on the mechanical strength of the rat Achilles tendon after long-term recovery. Methods Using 20 rats, an Achilles tendon rupture model was created in an invasive manner. The rats were assigned to one of three groups, that received EA treatment (EA group), minimal acupuncture (MA group) or remained untreated (Control group). In the EA group, EA stimulation (5 ms, 50 Hz, 20 µA, 20 min) was applied to the rupture region over a period of 90 days (five times/week). In the MA group, needles were inserted into the same positions as in the EA group but no electrical current was applied. After 90 days the tendon was measured to calculate the cross-sectional area of the rupture region. Then, the mechanical strength of the tendon was measured by tensile testing. Results No significant differences were observed between the three groups in cross-sectional area of the injured tendon. For maximum breaking strength, the EA group showed a significantly higher threshold compared with the Control group (P<0.05) but not the MA group (P=0.24). No significant difference was seen between the MA group and the Control group (P=0.96). Conclusion Given the EA group showed a significant increase in maximum breaking strength, it is likely that EA stimulation increases the mechanical strength of a repaired tendon after long-term recovery, and EA stimulation could be useful for preventing re-rupture.

scholarly journals Atrophy patterns in isolated subscapularis lesions

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Subscapularis Muscle ◽  
Mri Scans ◽  
The Mean ◽  
The Cross

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.

scholarly journals Erect Position as the Alternative Technique in Achilles Tendon US: Comparison with Prone Position

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Lailatul Muqmiroh ◽  
Safinah Fajarini Yusfadhiyah ◽  
Paulus Rahardjo
Keyword(s):  
Achilles Tendon ◽  
Prone Position ◽  
Longitudinal Axis ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Erect Position ◽  
Tendon Thickness ◽  
Alternative Position ◽  
The Mean

Background : Ultrasonography (US) is the cheaper and non invasive modality to determine Achilles tendon. Prone position is the standart position of Achilles tendon US. However, it is a discomfort for an uncooperative patient and a difficult technique too. The erect position is an alternative technique of Achilles tendon US. The goal of this study is to compare the erection as an alternative position with prone as a standart position.Material and Methode: The patient who had an injury or any inflamation process of Achilles tendon were excluded. The patient underwent two positions of Achilles tendon US, 900 and dorsoflexi. Longitudinal axis measured tendon thickness and a transversal axis which covered a cross-sectional area of the tendon.Result: From all the 21 patients coming, 13 patients were males (61,9%), and eight patients were females (38,1%). The mean of tendon thickness and cross-sectional area in 900 prone positions were 4,24±0,24 mm, 30,08±2,86 mm, respectively. The mean of tendon thickness and cross-sectional area in 900 erect positions were 4,27±0,23 mm, 31,36±2,19 mm, respectively. There was no anisotropy effect during longitudinal axis examination. Conclusion: We found that there were no significant differences between a prone and erect position (p<0.05). The erect postion could be an alternative position, uncooperative patient in particular, without reducing the diagnostic value. Keywords: Achilles tendon the US, erect position, prone position, tendon thickness, cross-sectional area

scholarly journals Cross Sectional Area of the Achilles Tendon in a Prospective Cohort of an Elite Military Population

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kevin Martin ◽  
Laura Dawson ◽  
Jeffrey Wake
Keyword(s):  
Achilles Tendon ◽  
Prospective Cohort ◽  
Military Training ◽  
Cross Sectional Area ◽  
Service Members ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean ◽  
Multiple Levels ◽  
The Cross

Category: Ankle, Hindfoot Introduction/Purpose: The prevalence of Achilles tendon pathology is common in many sports and daily activities. From ruptures to overuse injuries resulting in tendonopathies, AT dysfunction can result in disability and reduced productively. Continued research that increases our knowledge base of normal Achilles tendon properties can improve our ability to reduce and prevent future AT injuries. In this study, we examined the cross-sectional area (CSA) of the Achilles tendon (AT) at multiple levels in an asymptomatic population of elite American military service members that participate in greater than 20 hours of intense training per week. Methods: We conducted a prospective cohort study composed of 41 active duty United States Army Rangers. The Rangers are a specialized infantry organization that participates in extensive military training and rigorous combat missions. The service members were voluntarily recruited to participate while deployed in a combat theater. All subjects were members of the Ranger Regiment participating in greater than 20 hours of intense bipedal non-sport weekly training with no history of AT pathology. In a standing position, each subject had bilateral Achilles insertion marked along with additional skin markings made at 2 cm, 4 cm, and 6 cm above the AT insertion. At all four levels, the AT was measured in the coronal and sagittal plains using ultrasound. Results: In 41 subjects, a total of 82 Achilles tendons were examined. The mean age of the cohort was 26 years, 70 inches tall, with a mean weight of 187 pounds. The mean sagittal thickness of the AT at the insertion was 4.3 mm, 2 cm above the insertion is was 4.3 mm, 4 cm above the insertion is was 4.2 mm, and at 6 cm above the insertion it was 4 mm. In the coronal plain was 19.1 mm, 14.3 mm, 13.5 mm, and 14.4 mm respectively. The cross-sectional area was calculated at each respective level: 0.65 cm2, 0.48 cm2, 0.44 cm2 and 0.45 cm2. The non-dominant ankle was slightly larger at each level but was not found to be statistically significant. Conclusion: These results provide the mean sagittal and coronal diameters of the Achilles tendon as measured by ultrasound throughout the watershed area of a young active adult male population. Our data also suggest that increased non-sport activity may not increase the cross-sectional area of the Achilles tendon. Identifying the normal diameter at multiple levels throughout the most commonly injured area can potentially improve the provider’s ability to identify early disease processes and apply targeted interventions to help slow or prevent progression and possible rupture.

scholarly journals Ultrasonographic evaluation of the posterolateral radiohumeral plica in asymptomatic subjects and patients with osteoarthritis.

2015 ◽  
Vol 17 (2) ◽  
pp. 155 ◽  
Author(s):  
Fatih Celikyay ◽  
Ahmet Inanir ◽  
Erkal Bilgic ◽  
Zafer Ozmen
Keyword(s):  
Clinical Characteristics ◽  
Morphological Features ◽  
Cross Sectional Area ◽  
Control Group ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Elbow Osteoarthritis ◽  
Asymptomatic Subjects

Aims: The aim of this study was to describe the morphological features of posterolateral radiohumeral (RH) plica in asymptomatic subjects and in patients with elbow osteoarthritis using ultrasonography (US). Material and methods: The control group included a total of 100 healthy elbows (51 subjects) and the study group consisted of 22 elbows (22 patients) with osteoarthritis confirmed clinically and by imaging methods. The presence, length, height, thickness, cross sectional area, shape, and echogenicity of the posterolateral RH plica were evaluated in both groups. In addition, humeral and radial cartilage thicknesses were also measured. The clinical characteristics and radiographic findings of the study group were evaluated. Results: The posterolateral RH plica was present in all elbows of the control group (100%) and in 15 (68%) of elbows in the study group (p0.05). Conclusions: The posterolateral RH plica can be successfully evaluated using US. Based on these findings, it appears that osteoarthritis can result in a reduction of sizes of the RH plica and affect its morphological appearance.

Ultrasonographic Measurements of the Achilles Tendon in Elderly Athletes and Sedentary Men

1994 ◽  
Vol 35 (6) ◽  
pp. 560-563 ◽  
Author(s):  
M. Kallinen ◽  
H. Suominen
Keyword(s):  
Achilles Tendon ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Mean Width ◽  
Tendon Thickness ◽  
The Mean ◽  
Elderly Athletes ◽  
Time Linear

Ultrasonography was performed on the Achilles tendon of the dominant limb of 18 male elderly athletes and 11 sedentary men, aged 70 to 80 years. The tendons were examined with a real-time linear array scanner using a 7.5 MHz transducer. Both longitudinal and transverse images were taken. The mean width of the Achilles tendon was significantly larger in the athletes than in the control subjects. The tendon thickness and cross-sectional area did not differ significantly between the groups, but the figures may indicate a tendency for larger cross-sectional area in the athletes. The results suggest tendon hypertrophy following long-term training.

scholarly journals The influence of muscle pennation angle and cross-sectional area on contact forces in the ankle joint

2016 ◽  
Vol 52 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Ran S Sopher ◽  
Andrew A Amis ◽  
D Ceri Davies ◽  
Jonathan RT Jeffers
Keyword(s):  
Pennation Angle ◽  
Muscle Architecture ◽  
Cross Sectional Area ◽  
Contact Forces ◽  
Sectional Area ◽  
Muscle Forces ◽  
Cross Sectional ◽  
Contact Loads ◽  
The Mean ◽  
And Function

Data about a muscle’s fibre pennation angle and physiological cross-sectional area are used in musculoskeletal modelling to estimate muscle forces, which are used to calculate joint contact forces. For the leg, muscle architecture data are derived from studies that measured pennation angle at the muscle surface, but not deep within it. Musculoskeletal models developed to estimate joint contact loads have usually been based on the mean values of pennation angle and physiological cross-sectional area. Therefore, the first aim of this study was to investigate differences between superficial and deep pennation angles within each muscle acting over the ankle and predict how differences may influence muscle forces calculated in musculoskeletal modelling. The second aim was to investigate how inter-subject variability in physiological cross-sectional area and pennation angle affects calculated ankle contact forces. Eight cadaveric legs were dissected to excise the muscles acting over the ankle. The mean surface and deep pennation angles, fibre length and physiological cross-sectional area were measured. Cluster analysis was applied to group the muscles according to their architectural characteristics. A previously validated OpenSim model was used to estimate ankle muscle forces and contact loads using architecture data from all eight limbs. The mean surface pennation angle for soleus was significantly greater (54%) than the mean deep pennation angle. Cluster analysis revealed three groups of muscles with similar architecture and function: deep plantarflexors and peroneals, superficial plantarflexors and dorsiflexors. Peak ankle contact force was predicted to occur before toe-off, with magnitude greater than five times bodyweight. Inter-specimen variability in contact force was smallest at peak force. These findings will help improve the development of experimental and computational musculoskeletal models by providing data to estimate force based on both surface and deep pennation angles. Inter-subject variability in muscle architecture affected ankle muscle and contact loads only slightly. The link between muscle architecture and function contributes to the understanding of the relationship between muscle structure and function.

A computed method for noninvasive MRI assessment of pulmonary arterial hypertension

2004 ◽  
Vol 96 (2) ◽  
pp. 463-468 ◽  
Author(s):  
Eric Laffon ◽  
Christophe Vallet ◽  
Virginie Bernard ◽  
Michel Montaudon ◽  
Dominique Ducassou ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Cross Sectional Area ◽  
Physical Parameters ◽  
Sectional Area ◽  
Biophysical Parameters ◽  
Cross Sectional ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Arterial ◽  
The Mean

The present method enables the noninvasive assessment of mean pulmonary arterial pressure from magnetic resonance phase mapping by computing both physical and biophysical parameters. The physical parameters include the mean blood flow velocity over the cross-sectional area of the main pulmonary artery (MPA) at the systolic peak and the maximal systolic MPA cross-sectional area value, whereas the biophysical parameters are related to each patient, such as height, weight, and heart rate. These parameters have been measured in a series of 31 patients undergoing right-side heart catheterization, and the computed mean pulmonary arterial pressure value (PpaComp) has been compared with the mean pressure value obtained from catheterization (PpaCat) in each patient. A significant correlation was found that did not differ from the identity line PpaComp = PpaCat ( r = 0.92). The mean and maximal absolute differences between PpaComp and PpaCat were 5.4 and 11.9 mmHg, respectively. The method was also applied to compute the MPA systolic and diastolic pressures in the same patient series. We conclude that this computed method, which combines physical (whoever the patient) and biophysical parameters (related to each patient), improves the accuracy of MRI to noninvasively estimate pulmonary arterial pressures.

scholarly journals Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear

2017 ◽  
Vol 16 (3) ◽  
pp. 214-219 ◽  
Author(s):  
Marta Gimunová ◽  
Martin Zvonař ◽  
Kateřina Kolářová ◽  
Zdeněk Janík ◽  
Ondřej Mikeska ◽  
...  
Keyword(s):  
Blood Flow ◽  
Venous Blood ◽  
Cross Sectional Area ◽  
Popliteal Vein ◽  
Control Group ◽  
Venous Disease ◽  
Venous Blood Flow ◽  
Sectional Area ◽  
Cross Sectional ◽  
Experimental Group

Abstract Background During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen’s d test to calculate effect size. Results With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application.

scholarly journals Sex Differences in the Morphological and Mechanical Properties of the Achilles Tendon

2021 ◽  
Vol 18 (17) ◽  
pp. 8974
Author(s):  
Xini Zhang ◽  
Liqin Deng ◽  
Songlin Xiao ◽  
Lu Li ◽  
Weijie Fu
Keyword(s):  
Mechanical Properties ◽  
Achilles Tendon ◽  
Maximum Voluntary Contraction ◽  
Voluntary Contraction ◽  
Cross Sectional Area ◽  
Morphological Properties ◽  
Sectional Area ◽  
Cross Sectional ◽  
Force Peak ◽  
Strain Stress

Background: Patients with Achilles tendon (AT) injuries are often engaged in sedentary work because of decreasing tendon vascularisation. Furthermore, men are more likely to be exposed to AT tendinosis or ruptures. These conditions are related to the morphological and mechanical properties of AT, but the mechanism remains unclear. This study aimed to investigate the effects of sex on the morphological and mechanical properties of the AT in inactive individuals. Methods: In total, 30 inactive healthy participants (15 male participants and 15 female participants) were recruited. The AT morphological properties (cross-sectional area, thickness, and length) were captured by using an ultrasound device. The AT force–elongation characteristics were determined during isometric plantarflexion with the ultrasonic videos. The AT stiffness was determined at 50%–100% maximum voluntary contraction force. The AT strain, stress, and hysteresis were calculated. Results: Male participants had 15% longer AT length, 31% larger AT cross-sectional area and 21% thicker AT than female participants (p < 0.05). The plantarflexion torque, peak AT force, peak AT stress, and AT stiffness were significantly greater in male participants than in female participants (p < 0.05). However, no significant sex-specific differences were observed in peak AT strain and hysteresis (p > 0.05). Conclusions: In physically inactive adults, the morphological properties of AT were superior in men but were exposed to higher stress conditions. Moreover, no significant sex-specific differences were observed in peak AT strain and hysteresis, indicating that the AT of males did not store and return elastic energy more efficiently than that of females. Thus, the mechanical properties of the AT should be maintained and/or improved through physical exercise.

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