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Rougereau G, Marty-Diloy T, Vigan M, Donadieu K, Vialle R, Langlais T, Hardy A. Biomechanical evaluation of the spring ligament and the posterior tibial tendon by shear-waves elastography: validation of a reliable and reproducible measurement protocol. J Exp Orthop 2023; 10:121. [PMID: 38006458 PMCID: PMC10676337 DOI: 10.1186/s40634-023-00678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/19/2023] [Indexed: 11/27/2023] Open
Abstract
PURPOSE The anatomy of the spring ligament complex, as well as its pathology, is not well known in daily clinical practice. The purpose of this study was to evaluate the shear-wave elastography properties of the spring ligament and the posterior tibial tendon in healthy adults, and to assess the reliability and reproducibility of these measurements. METHODS Shear-wave elastography was used to evaluate both ankles in 20 healthy patients (10 females/10 males) resting on a hinge support with their ankles in neutral, valgus 20° and varus 30° positions. The stiffness of the spring ligament and posterior tibial tendon was assessed by measuring the speed of shear wave propagation through each structure. RESULTS Posterior tibial tendon and spring ligament reach a maximum estimated stiffness in valgus 20° position (7.43 m/s vs 5.73 m/s, respectively). Flat feet were associated with greater spring ligament stiffness in the 20° valgus position (p = 0.01), but not for the posterior tibial tendon (p = 0.71). The physiologic weightbearing hindfoot attitude had no impact on the stiffness of the posterior tibial tendon or the spring ligament, regardless of the analysis position. Intra- and inter-observer agreements were all excellent for spring ligament stiffness, regardless of ankle position, and were good or excellent for posterior tibial tendon. CONCLUSIONS This study describes a protocol to assess the stiffness of tibialis posterior and the spring ligament by shear-wave elastography, which is reliable, reproducible, and defines a corridor of normality. Further studies should be conducted to define the role of elastography for diagnosis/ evaluation of pathology, follow-up, or surgical strategies.
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Affiliation(s)
- Grégoire Rougereau
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France.
- Department of Adult Orthopedic Surgery, Sorbonne University, Pitié-Salpêtrière Hospital, APHP, 75571, Paris, France.
| | - Thibault Marty-Diloy
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
| | - Marie Vigan
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
- Unité de Recherche Clinique Hôpitaux Universitaires Paris Ile-de-France Ouest, APHP, 92100, Boulogne-Billancourt, France
| | - Kalinka Donadieu
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
| | - Raphaël Vialle
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
- Department for Innovative Therapies, Musculoskeletal Disease Sorbonne University, The MAMUTH Hospital University, Paris, France
| | - Tristan Langlais
- Department of Pediatric Orthopedic Surgery, Sorbonne University, Armand Trousseau Hospital, APHP, 75571, Paris, France
- Department of Pediatric Orthopedic Surgery, Toulouse University, Children's Hospital, Purpan, Toulouse, France
| | - Alexandre Hardy
- Department of Orthopedic Surgery, Clinique du Sport, 75005, Paris, France
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Sugino Y, Yoshimura I, Hagio T, Ishimatsu T, Nagatomo M, Yamamoto T. Effect of plantar fascia-specific stretching and Achilles tendon stretching on shear wave elasticity of the plantar fascia in healthy subjects. Foot Ankle Surg 2023; 29:208-212. [PMID: 36646592 DOI: 10.1016/j.fas.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/29/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND The effect of stretching on the mechanical properties of the plantar fascia (PF) remain unclear. This study was performed to determine the effect of PF-specific stretching (PFSS) and Achilles tendon stretching (ATS) on the viscoelastic properties of the PF with shear wave elastography (SWE). METHODS We recruited 14 participants (8 men, 6 women) with no history of PF disorders or painful episodes. The mean age of the participants was 30.9 ± 4.8 (range, 25-41) years. All participants performed sustained PFSS (sPFSS) on one foot and intermittent PFSS (iPFSS) on the other foot. Two weeks later, all participants performed sustained ATS (sATS) on one foot and intermittent ATS (iATS) on the other foot. SWE measurements were performed immediately after each stretching. RESULTS The PF elasticity immediately before stretching ranged from 133.8 kPa to 144.7 kPa. The PF elasticity after stretching ranged from 158.9 kPa to 215.8 kPa. There was a significant increase in PF elasticity after sPFSS, iPFSS, sATS, and iATS (P < .01). The elasticity after sATS was greater than that after iATS (P = .03). In contrast, there were no differences in PF elasticity after stretching between sPFSS and iPFSS (P = .13), sPFSS and sATS (P = .17), or iPFSS and iATS (P = .50). CONCLUSIONS PF elasticity increased after stretching regardless of the frequency and type of PFSS and ATS. LEVEL OF EVIDENCE Level II, prospective cohort study.
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Affiliation(s)
- Yuki Sugino
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Ichiro Yoshimura
- Fukuoka University Faculty of Sports and Health Science, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Tomonobu Hagio
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Tetsuro Ishimatsu
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
| | - Masaya Nagatomo
- Department of Orthopedic Surgery, Nagasaki Prefecture Tsushima Hospital, 1168-7 Kechiotsu, Mitsushima-machi, Tsushima-shi, Nagasaki 817-0322, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
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