Measuring stiffness of normal medial collateral ligament in healthy volunteers via shear wave elastography

Gürün, Enes; Aksakal, Mehmet; Akdulum, İsmail

doi:10.1007/s00276-021-02749-y

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…SWE is an evolving ultrasound technique which is progressively used in the musculoskeletal system to evaluate tissue elasticity [30][31][32]. It is reported to evaluate the stiffness of soft tissues such as quadriceps tendon or medial collateral ligament in healthy people [33,34], but it has never been used to assess quadriceps stiffness of patients undergoing TKA. Shear waves propagate faster through stiffer tissue so we decide to measure shear wave velocity along the long and short axes of quadriceps to represent quadriceps stiffness [35,36].…”

Section: Discussionmentioning

confidence: 99%

The effect of tourniquet application on the morphology and function of quadriceps in patients undergoing total knee arthroplasty: study protocol for a single-blind randomized controlled trial

Dong

Tao

et al. 2022

Trials

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Background Tourniquet is currently widely used in total knee arthroplasty to reduce intraoperative blood loss. The academic view of tourniquet application in TKA is now in dispute. Some scholars argue that tourniquet may cause quadriceps injury and bring extra side effects, so they oppose the application of tourniquet. Others find that tourniquet application has no significant adverse impact on TKA patients. Regarding its advantages in reducing intraoperative blood loss, they advocate the regular application of tourniquet in TKA. Quadriceps injury is considered the main cause of tourniquet side effects. There are now many high-quality trials about tourniquet application in TKA but few of them concentrate on quadriceps morphology and function. Methods A prospective, single-blind, randomized controlled trial will be adopted. The target sample is 130. Patients who meet the eligibility criteria will be randomly allocated to the tourniquet group and non-tourniquet group. The primary outcome is quadriceps thickness evaluated by ultrasound test. Secondary outcomes include quadriceps stiffness, rehabilitation outcomes, operation time, intraoperative and postoperative blood loss, blood transfusion rate, thigh circumference, VAS score, opioid consumption, d-dimer and C-reactive protein level in the serum, knee function score, postoperative satisfaction score, and complications. Discussion This proposed study will contribute to improve evidence of tourniquet application in total knee arthroplasty. This will be a high-quality single-blind randomized controlled trial with a sufficient sample size and strict study design. It will investigate the effects of tourniquet application especially on the morphology and function of quadriceps in patients undergoing total knee arthroplasty and offer advice for tourniquet application in clinical practice. Trial registration Chinese Clinical Trial Registry ChiCTR2000035097. Registered on 31 July 2020

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Section: Discussionmentioning

confidence: 99%

The effect of tourniquet application on the morphology and function of quadriceps in patients undergoing total knee arthroplasty: study protocol for a single-blind randomized controlled trial

Dong

Tao

et al. 2022

Trials

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show abstract

“…SWE is an evolving ultrasound technique which is progressively used in musculoskeletal system to evaluate tissue elasticity [35][36][37] . It is reported to evaluate the stiffness of soft tissues such as quadriceps tendon or medial collateral ligament in healthy people [38,39] , but it has never been used to assess quadriceps stiffness of patients undergoing TKA. Shear waves propagate faster through stiffer tissue so we decide to measure shear wave velocity along the long and short axis of quadriceps to represent quadriceps stiffness [40,41] .…”

Section: Discussionmentioning

confidence: 99%

The Effect of Tourniquet Application on the Morphology and Function of Quadriceps in Patients Undergoing Total Knee Arthroplasty: A Study Protocol for a Single Blind Randomized Controlled Trial

Dong

Tao

et al. 2021

Preprint

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Background:Tourniquet is currently widely used in total knee arthroplasty to reduce intraoperative blood loss. Academic view of tourniquet application in TKA is now in dispute. Some scholars argue that tourniquet may cause quadriceps injury and bring extra side effects so they oppose the application of tourniquet. Others find that tourniquet application has no significant adverse impact on TKA patients. Regarding its advantages in reducing intraoperative blood loss, they advocate regular application of tourniquet in TKA. Quadriceps injury is considered the main cause of tourniquet side effects. There are now many high-quality trials about tourniquet application in TKA but few of them concentrate on quadriceps morphology and function.Methods:A prospective, single blind, randomized controlled trail will be adopted. The target sample is 130. Patients who meet the eligibility criteria will be randomly allocated to tourniquet group and non-tourniquet group. Primary outcomes are thickness, stiffness and function of quadriceps, which will be evaluated by ultrasound and rehabilitation tests. Secondary outcomes consist of circumference of thigh, VAS score, opioid consumption, knee function score, postoperative satisfaction score, operation time, intraoperative blood loss, perioperative blood loss, blood transfusion rate, D-Dimer, C-reactive protein, and complications. Discussion:This proposed study will contribute to improve evidence of tourniquet application in total knee arthroplasty. This will be a high-quality single blind randomized controlled trial with sufficient sample size and strict study design. It will investigate the effects of tourniquet application especially on the morphology and function of quadriceps in patients undergoing total knee arthroplasty and offer advice for tourniquet application in clinical practice.Trial registration:Chinese clinical trial registry, ChiCTR2000035097. Registered 31 July 2020, http://www.chictr.org.cn/showproj.aspx?proj=57093

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“…Twenty consecutive subjects (10 females, 10 males), all residents or medical students of the department, with a mean age of 22.2 years (range [22][23][24][25][26][27][28][29][30][31] were enrolled in the study between November 2020 and January 2021. A questionnaire was administered to ensure the absence of any medical history of fracture, sprain, or ankle surgery.…”

Section: Patientsmentioning

confidence: 99%

“…15 Very recently, several studies have reported its use and proven its reproducibility for exploring ligament structures in the shoulder, knee, and lateral ankle ligaments. 20,24,53…”

Section: Introductionmentioning

confidence: 99%

“…15 Very recently, several studies have reported its use and proven its reproducibility for exploring ligament structures in the shoulder, knee, and lateral ankle ligaments. 20,24,53 The objective of this pilot study was to determine whether SWE quantifies SWS distributions and their changes with position in the deltoid ligament complex in a cohort of healthy adult volunteers.…”

Section: Introductionmentioning

confidence: 99%

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A Preliminary Study to Assess the Relevance of Shear-Wave Elastography in Characterizing Biomechanical Changes in the Deltoid Ligament Complex in Relation to Ankle Position

et al. 2022

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Background: The purpose of this study was (1) to evaluate the biomechanical properties of the different bundles of the deltoid ligament in various ankle positions in a cohort of healthy adult volunteers; (2) describe the impact of demographic and hindfoot morphology characteristics on their stiffness; (3) to assess the reliability and reproducibility of these measurements. Methods: Deltoid ligament complex of both ankles were assessed by shear-wave elastography (SWE) in 20 healthy patients resting on hinge support. The propagation shear-wave speed (SWS) in ligaments was measured, which is related to the tissue’s elastic modulus. The following ligaments were analyzed in a neutral position and then in varus, valgus, dorsal, and plantar flexions: tibionavicular ligament (TNL), tibiocalcaneal ligament (TCL), the superficial posterior tibiotalar ligament (SPTL), the anterior tibiotalar ligament (ATTL), and the deep posterior tibiotalar ligament (DPTTL). Results: The mean SWS increased between neutral and 20 degrees valgus position for TCL (4.08 ± 0.78 m/s vs 5.56 ± 0.62 m/s, respectively; P < .0001) and for DPTTL (2.58 ± 0.52 m/s vs 3.59 ± 0.87 m/s, respectively; P < .0001). The mean SWS increased between neutral and 30 degrees plantarflexion for ATTL (2.11 ± 0.44 m/s vs 3.1 ± 0.5 m/s, respectively; P < .0001) and TNL (2.96 ± 0.66 m/s vs 4.99 ± 0.69 m/s, respectively; P < .0001). The mean SWS increased between neutral and 20 degrees dorsal flexion for SPTL (4.2 ± 1 m/s vs 5.45 ± 0.65 m/s, respectively; P < .0001). Women had less DPTTL SWS than men in the neutral position (2.37 ± 0.35 m/s vs 2.71 ± 0.49 m/s, respectively; P = .007). Other demographics had no impact on the SWS value of other ligaments. All inter- and intraobserver agreements were good to excellent. Conclusion: This study presents a reliable and reproducible SWE measurement protocol to describe the physiological function of all bundles of the medial collateral ligament in healthy adults. Clinical relevance: This examination technique can be available to orthopaedic surgeons, allowing reliable and reproducible monitoring of the SWS of the various ligaments constituting the medial collateral plane. The biomechanical values described in this study may give insight into in what position medial ankle ligament reconstruction should be tensioned.

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Measuring stiffness of normal medial collateral ligament in healthy volunteers via shear wave elastography

Cited by 8 publications

References 17 publications

The effect of tourniquet application on the morphology and function of quadriceps in patients undergoing total knee arthroplasty: study protocol for a single-blind randomized controlled trial

The effect of tourniquet application on the morphology and function of quadriceps in patients undergoing total knee arthroplasty: study protocol for a single-blind randomized controlled trial

The Effect of Tourniquet Application on the Morphology and Function of Quadriceps in Patients Undergoing Total Knee Arthroplasty: A Study Protocol for a Single Blind Randomized Controlled Trial

A Preliminary Study to Assess the Relevance of Shear-Wave Elastography in Characterizing Biomechanical Changes in the Deltoid Ligament Complex in Relation to Ankle Position

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