In Hamstring Muscles of Patients With Knee Osteoarthritis an Increased Ultrasound Shear Modulus Indicates a Permanently Elevated Muscle Tonus

Abstract

BackgroundSome patients with knee osteoarthritis (KOA) show pain, stiffness and limited flexion and extension at the back of the knee, leading to dysfunction and affecting life. This may be related to changes in the biomechanical properties of skeletal muscles. Shear wave elastography (SWE) can detect these changes by measuring muscle shear modulus.AimsTo investigate hamstring muscle shear modulus of healthy people and patients was studied using SWE method, and the correlation analysis between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score of patients’ subjective feeling and shear modulus of objective quantification was conducted.MethodsThe hamstring shear modulus was measured by SWE in 50 patients and 50 healthy individuals. Pearson correlation coefficient was used to evaluate the correlation between hamstring stiffness and shear modulus in patients.ResultsThe hamstring shear modulus were significantly higher in the KOA group [the semimembranosus (SM) 15.23 ± 7.23, the semitendinosus (ST) 15.94 ± 5.40, the biceps femoris long tendinitis (BFL) 14.21 ± 6.55] than in the control group (the SM 10.95 ± 2.41, the ST 11.25 ± 2.23, the BFL 9.98 ± 2.81) (p = 0.000, p = 0.000, p = 0.001). The hamstring shear modulus in the KOA group was moderately positively correlated with pain, shear modulus, and physical function score.ConclusionPreliminary results show that the shear modulus of the hamstring of KOA patients is higher than that of healthy people, the WOMAC score and the shear modulus of patients are moderately correlated. These preliminary results show that ultrasonic shear wave elastography measurement of shear modulus may be enough to sensitive, can detect these effects, more targeted in order to assist the doctor’s diagnosis and treatment.

Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography

“…The exclusion of muscle fascia from the measurement box was clearly stated in eight articles (26.6%) (Aljinović et al, 2020;Friede et al, 2020;Gökşen et al, 2021;Klauser et al, 2022;Koppenhaver et al, 2020;Murillo et al, 2019;Takashima et al, 2017;Zhang et al, 2022). The example images of eight more studies (26.6%) suggest the avoidance of fascia in the measurements (Botanlioglu et al, 2013;Botanlıoğlu et al, 2019;Ertekin et al, 2021;Leong et al, 2016;Li et al, 2021;Lin et al, 2022;Sedlackova et al, 2021;Taş et al, 2018) (Figure S1).…”

Latest advancements in imaging techniques in OA

“…81 These studies showed differences of SWE values in the aforementioned anatomical structures between OA and non-OA patients, [78][79][80][81] as well as correlation with knee pain and physical function. 81 Contrast-enhanced ultrasound provides the evaluation of dynamic blood perfusion via signals from a gas-filled microbubble contrast agent. 82 A prospective study included 31 patients with different degrees of radiographic knee OA.…”

“… 77 SWE has been applied to evaluate femoral cartilage in OA-affected knees, 78 abductor pollicis brevis and flexor pollicis brevis muscles in patients with thumb carpometacarpal OA, 79 vastus lateralis muscle in painful knee OA patients, 80 and in hamstring muscles of knee OA patients. 81 These studies showed differences of SWE values in the aforementioned anatomical structures between OA and non-OA patients, 78 – 81 as well as correlation with knee pain and physical function. 81 …”

“… 81 These studies showed differences of SWE values in the aforementioned anatomical structures between OA and non-OA patients, 78 – 81 as well as correlation with knee pain and physical function. 81 …”

Osteoarthritis and Neuromuscular Deficits: Can a Causative Role be Discounted- Key 2017-2022 Observations

“…At the knee, the most well studied joint, multiple authors have indeed observed muscle strength deficits, problems in voluntary muscle activation, muscle mass or volume declines/deficits, deficits in muscle flexibility, excessive muscle tone, generalized muscle weakness of the affected limb, muscle endurance losses, muscle power and force control ability [21][22][23][24][25][26][27][28]. Along with associated alterations in neuromuscular communication processes one or more of these attributes may be instrumental in inducing various molecular and cellular adaptations within both muscle as well as cartilage tissues that further provoke pathological joint changes [29], while altering dynamic joint stability that appears to impact osteoarthritis progression [28].…”