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Hjortshoej MH, Agergaard A, Larsen FK, Thomsen LJP, Svensson RB, Couppé C, Magnusson SP. Determination of differences in ultrasound parameters for patellar tendons in males with unilateral patellar tendinopathy-An ancillary analysis of data from two randomized controlled trials. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:548-557. [PMID: 38488675 DOI: 10.1002/jcu.23655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/07/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE To investigate power Doppler (PD) activity and tendon structure (between the injured and contralateral limb) in patients with unilateral patellar tendinopathy (PT) using ultrasonography (US). Secondly, the aim was to determine the intra-rater reliability of the PD activity and tendon structure. METHODS This study analyzed US baseline data from 57 male participants with symptomatic unilateral PT who had been enrolled in one of two randomized clinical trials. Data were analyzed to examine if systematic differences existed between injured and contralateral limbs using Fiji ImageJ. RESULTS The PD activity of the symptomatic tendon was larger 25.6 (Q1 = 14.9; Q3 = 41.6) mm2 than the asymptomatic 0 (Q1 = 0.0; Q3 = 0.0) mm2 (p < 0.001). There was a significantly greater tendon thickness at the proximal (2.5 mm 95% CI [2.0; 3.0]), mid (0.8 mm 95% CI [0.5; 1.1]), and distal (0.2 mm 95% CI [0.1; 0.4]) part of the tendon for the symptomatic compared to the asymptomatic tendon. Intra-rater reliability for PD activity and tendon structure ranged from moderate-to-excellent (0.74; 0.99). CONCLUSION These results provide mean estimates for tendon thickness of symptomatic and asymptomatic tendons, that can be used for clinicians to reliably estimate pathological tendon thickness.
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Affiliation(s)
- M H Hjortshoej
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, NV, Denmark
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark
| | - A Agergaard
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, NV, Denmark
| | - F K Larsen
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, NV, Denmark
| | - L J P Thomsen
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - R B Svensson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - C Couppé
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, NV, Denmark
| | - S P Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, NV, Denmark
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Carrozzo A, Shatrov J, El Helou A, Pettinari F, Alayane A, Abed Ali A, Clechet J, Dutra Vieira T, Sonnery-Cottet B. Ultrasound-guided electrocoagulation of neovascularisation for persistent patellar tendinopathy in athletes: a cohort study of 25 patients with a mean follow-up of 5 years from the SANTI Study Group. BMJ Open Sport Exerc Med 2024; 10:e001900. [PMID: 38500579 PMCID: PMC10946354 DOI: 10.1136/bmjsem-2024-001900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/20/2024] Open
Abstract
Background Patellar tendinopathy (PT) is a common condition characterised by persistent patellar tendon pain and dysfunction, particularly in athletes. Neovascularisation is frequently observed in the PT and is associated with increased pain. Ultrasound-guided electrocoagulation of neovascularisation has emerged as a minimally invasive alternative treatment for recalcitrant PT. Hypothesis/purpose The purpose of this study was to evaluate the clinical outcomes of ultrasound-guided electrocoagulation of neovascularisation in athletes with persistent PT. Study design Case series; level of evidence, IV. Methods A retrospective analysis of prospectively collected data was performed on 25 athletes who underwent ultrasound-guided electrocoagulation of neovascularisation for recalcitrant PT. Clinical outcomes including complications, reinterventions and patient-reported outcome measures were recorded. Comparisons between variables were assessed using χ2 test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon test for quantitative variables. Results 25 patients were included in the final analysis. 96% returned to their preoperative activity level at a mean of 3.8 months. At a mean follow-up of 5 years 4% did not receive significant benefit from electrocoagulation therapy. Significant improvements were observed in outcome measures, including the Victorian Institute of Sport Assessment Questionnaire for Patients with Patellar Tendinopathy, Kujala score, modified Blazina score and Visual Analogue Scale for pain. Conclusion Ultrasound-guided electrocoagulation of neovascularisation for persistent PT in elite athletes resulted in a low complication rate, a high rate and rapid return to sport and a significant improvement in outcome measures.
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Affiliation(s)
- Alessandro Carrozzo
- Institute for Sports Medicine and Science, Italian Olympic Committee, Rome, Italy, Roma, Italy
| | - Jobe Shatrov
- Sydney Orthopaedic Research Institute, Landmark Orthopaedics, Sydney, New South Wales, Australia
| | - Abdo El Helou
- Mount Lebanon Hospital University Medical Center, Hazmiyeh, Lebanon
| | - Francesco Pettinari
- Centre Orthopédique Santy, 24av Paul Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Ali Alayane
- Centre Orthopédique Santy, 24av Paul Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Ahmad Abed Ali
- Centre Orthopédique Santy, 24av Paul Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Julien Clechet
- Centre Orthopédique Santy, 24av Paul Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Thais Dutra Vieira
- Centre Orthopédique Santy, 24av Paul Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
| | - Bertrand Sonnery-Cottet
- Centre Orthopédique Santy, 24av Paul Santy, FIFA Medical Center of Excellence, Hopital Mermoz, Groupe Ramsay, Lyon, France
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Watson J, Barker-Davies RM, Bennett AN, Fong DTP, Wheeler PC, Lewis M, Ranson C. Sport and exercise medicine consultants are reliable in assessing tendon neovascularity using ultrasound Doppler. BMJ Open Sport Exerc Med 2018; 4:e000298. [PMID: 29527321 PMCID: PMC5841524 DOI: 10.1136/bmjsem-2017-000298] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Several lower limb tendinopathy treatment modalities involve identification of pathological paratendinous or intratendinous neovascularisation to target proposed co-location of painful neoneuralisation. The ability to reliably locate and assess the degree of neovascularity is therefore clinically important. The Modified Ohberg Score (MOS) is frequently used to determine degree of neovascularity, but reliability has yet to be established among Sport and Exercise Medicine (SEM) consultants. This study aims to determine inter-rater and intra-rater reliability of an SEM consultant cohort when assessing neovascularity using the 5-point MOS. METHOD Eleven participants (7 male and 4 female) provided 16 symptomatic Achilles and patella tendons. These were sequentially examined using power Doppler (PD) enabled ultrasound (US) imaging by 6 SEM consultants who rated neovascular changes seen using the MOS. Representative digital scan images were saved for rescoring 3 weeks later. Inter-rater and intra-rater reliability of the MOS was examined using intraclass correlation coefficient (ICC) and Kappa Agreement scores. RESULTS Neovascular changes were reported in 65.6% of 96 scans undertaken. ICC for inter-rater reliability was 0.86 and Fleiss Kappa 0.52. ICC for intra-rater reliability was 0.95 and Weighted Kappa 0.91. CONCLUSIONS Neovascular changes were present in two-thirds of symptomatic tendons. Excellent SEM consultant inter-rater and intra-rater reliability was demonstrated. These findings support the use of PD-enabled US to assess neovascularity by appropriately experienced SEM consultants. Furthermore, future interventional research using a similarly experienced SEM consultant cohort can be undertaken with assurance that assessment of neovascularity will be reliable.
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Affiliation(s)
- James Watson
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, London, UK
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Robert M Barker-Davies
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, London, UK
- National Centre for Sport and Exercise Medicine, School of Sport Exercise and Health Sciences, Loughborough University, London, UK
| | - Alexander N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, London, UK
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport Exercise and Health Sciences, Loughborough University, London, UK
| | - Patrick C Wheeler
- National Centre for Sport and Exercise Medicine, School of Sport Exercise and Health Sciences, Loughborough University, London, UK
| | - Mark Lewis
- National Centre for Sport and Exercise Medicine, School of Sport Exercise and Health Sciences, Loughborough University, London, UK
| | - Craig Ranson
- Athlete Health Department, English Institute of Sport, Manchester, UK
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Chaudhry S, Fernando R, Screen H, Waugh C, Tucker A, Morrissey D. The use of medical infrared thermography in the detection of tendinopathy: a systematic review. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2016.1223575] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kanamoto T, Tanaka Y, Yonetani Y, Kita K, Amano H, Kusano M, Hirabayashi S, Horibe S. Anterior knee symptoms after double-bundle ACL reconstruction with hamstring tendon autografts: an ultrasonographic and power Doppler investigation. Knee Surg Sports Traumatol Arthrosc 2015; 23:3324-9. [PMID: 24981990 DOI: 10.1007/s00167-014-3142-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 06/12/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE Anterior knee pain related to the donor site is a frequent complication of anterior cruciate ligament reconstruction (ACLR) with bone-patellar tendon-bone autograft tissue. Even when hamstring tendon (HT) grafts are used instead, symptoms such as mild pain and discomfort can still occur. The purpose of this study was to elucidate the pathophysiology of anterior knee symptoms after ACLR with HT autografts. METHODS Fifty-seven patients (22 men and 35 women; mean age, 24.7 years) who underwent anatomic double-bundle ACLR with HT autografts were examined 6 months post-operatively. The presence of anterior knee symptoms, anterior knee laxity, range of motion, and muscle strength were assessed. Changes in patellar tendon and infrapatellar fat pad (IFP) morphology and blood flow were also evaluated using ultrasound. Potential variables affecting the presence of anterior knee symptoms were subjected to univariate analysis and multivariate logistic regression analysis to identify independent risk factors. RESULTS Six months post-operatively, the total incidence of anterior knee symptoms was 56.1 % (32/57). According to univariate analysis, age, quadriceps strength, and increased blood flow in the IFP were significantly associated with the presence of anterior knee symptoms. Multivariate logistic regression analysis revealed that increased blood flow in the IFP was an independent factor for the presence of anterior knee symptoms (odds ratio 5.0; 95 % confidence interval 1.3-19.9). There were no significant findings inside the patellar tendon. CONCLUSIONS Increased blood flow in the IFP was identified as an independent factor for the presence of anterior knee symptoms 6 months after ACLR with HT autografts. The ultrasound evaluation can help to define precisely the origin of anterior knee symptoms after ACLR with HT autografts. LEVEL OF EVIDENCE Case series with no comparison groups, Level IV.
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Affiliation(s)
- Takashi Kanamoto
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 597-8025, Japan.
| | - Yoshinari Tanaka
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Yasukazu Yonetani
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Keisuke Kita
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Hiroshi Amano
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Japan
| | - Masashi Kusano
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Sakai, Japan
| | - Shinji Hirabayashi
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai, Osaka, 597-8025, Japan
| | - Shuji Horibe
- Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Osaka, Japan
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Sunding K, Willberg L, Werner S, Alfredson H, Forssblad M, Fahlström M. Sclerosing injections and ultrasound-guided arthroscopic shaving for patellar tendinopathy: good clinical results and decreased tendon thickness after surgery-a medium-term follow-up study. Knee Surg Sports Traumatol Arthrosc 2015; 23:2259-2268. [PMID: 24797812 DOI: 10.1007/s00167-014-3028-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/19/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Treatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections or ultrasound-guided arthroscopic shaving has shown good clinical short-term results. Former studies indicate that the tendon thickness and structure stays unaffected after successful treatment. The aim of this study was to evaluate the sonographic findings and clinical outcome 3-5 years after treatment of patellar tendinopathy with ultrasound-guided sclerosing injections or arthroscopic shaving. METHODS Fifty-seven patellar tendons (43 patients) with chronic patellar tendinopathy were evaluated, with ultrasound, colour Doppler (CD) and visual analogue scale (VAS) for pain and satisfaction with treatment, 3-5 years after treatment. Functional status was evaluated with a single question-"Back in full loading activity?" yes or no. RESULTS At endpoint (mean 46 months), there was a significant decrease in anteroposterior thickness of the proximal patellar tendon in patients treated with ultrasound-guided arthroscopic shaving but not after sclerosing injections. Tendon structure had improved, and CD local blood flow had diminished significantly in both groups. There were good clinical results with a significant decrease in VAS for pain after sclerosing injections (VAS 64 ± 18 → 17 ± 23) with 74 % satisfied patients and also after arthroscopic shaving (VAS 77 ± 16 → 13 ± 23) with 80 % satisfied patients. There were no significant differences in VAS between groups. A significant correlation between low local blood flow and high patient satisfaction was found. CONCLUSIONS Tendon thickness decreased over time after ultrasound-guided arthroscopic shaving, and tendon structure and local blood flow decreased after both treatments. There were good, and similar, clinical results with both methods. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Kerstin Sunding
- Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden.
| | - Lotta Willberg
- Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden.,Sports Medicine Unit, Department of Surgical and Perioperative Science, Umeå University, 901 87, Umeå, Sweden
| | - Suzanne Werner
- Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden
| | - Håkan Alfredson
- Sports Medicine Unit, Department of Surgical and Perioperative Science, Umeå University, 901 87, Umeå, Sweden
| | - Magnus Forssblad
- Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden
| | - Martin Fahlström
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, 901 87, Umeå, Sweden
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Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 2015; 23:1046-52. [PMID: 24477495 DOI: 10.1007/s00167-014-2855-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 01/12/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the outcome of ultrasound (US)-guided intratissue percutaneous electrolysis (EPI(®)) and eccentric exercise in the treatment of patellar tendinopathy during a long-term follow-up. METHODS Forty patients with patellar tendinopathy were prospectively evaluated over a 10-year follow-up period. Pain and function were evaluated before treatment, at 3 months and at 2, 5 and 10 years using the Victorian Institute of Sport Assessment-Patella (VISA-P) score, the Tegner score and Blazina's classification. According to VISA-P score at baseline, patients were also dichotomized into Group 1 (<50 points) and Group 2 (≥50 points). There were 21 patients in Group 1 and 19 in Group 2. Patient satisfaction was measured according to the Roles and Maudsley score. RESULTS The VISA-P score improved globally by 41.2 points (p < 0.01) after a mean 4.1 procedures. In Group 1, VISA-P score improved from 33.1 ± 13 to 78.9 ± 14.4 at 3-month and to 88.8 ± 10.1 at 10-year follow-up (p < 0.001). In Group 2, VISA-P score improved from 69.3 ± 10.5 to 84.9 ± 9 at 3-month and to 96.0 ± 4.3 at 10-year follow-up (p < 0.001). After 10 years, 91.2 % of the patients had a VISA-P score >80 points. The same level (80 % of patients) or the Tegner score at no more than one level lower (20 % of patients) was restored, and 97.5 % of the patients were satisfied with the procedure. CONCLUSION Treatment with the US-guided EPI(®) technique and eccentric exercises in patellar tendinopathy resulted in a great improvement in knee function and a rapid return to the previous level of activity after few sessions. The procedure has proved to be safe with no recurrences on a long-term basis. LEVEL OF EVIDENCE Therapeutic study, Level IV.
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Affiliation(s)
- F Abat
- CEREDE-Sports Medicine, Dr. Roux 8-10, 08017, Barcelona, Spain,
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8
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Kanamoto T, Tanaka Y, Yonetani Y, Kita K, Amano H, Kusano M, Fukamatsu M, Hirabayashi S, Horibe S. Patellar mobility can be reproducibly measured using ultrasound. J Orthop Traumatol 2014; 16:55-8. [PMID: 24894965 PMCID: PMC4348527 DOI: 10.1007/s10195-014-0301-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 05/12/2014] [Indexed: 11/28/2022] Open
Abstract
UNLABELLED The present study was performed to examine the reliability of ultrasound in evaluating patellar mobility in the superior-inferior direction. Twelve healthy men volunteered for the study. Patellar mobility in the superior-inferior direction during isometric knee extension contraction with the knee immobilized in a semi-flexed knee brace was measured using ultrasound. Both intra-observer and inter-observer reliability were assessed by intra-class correlation coefficients (ICCs). Bland-Altman analysis was used for assessing agreement between measurements. ICC values were excellent for both intra-observer and inter-observer reliability at 0.97 and 0.93, respectively. In 95 % of measurements, the same observer measured within -0.55 to 0.61 mm, while different observers measured within -0.82 to 0.85 mm. In conclusion, patellar mobility in the superior-inferior direction during an isometric knee extension exercise can be reproducibly measured using ultrasound. THE LEVEL OF EVIDENCE VI (basic study of a novel evaluation method).
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Affiliation(s)
- Takashi Kanamoto
- Department of Rehabilitation, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 597-8025, Japan,
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Lesniak BP, Loveland D, Jose J, Selley R, Jacobson JA, Bedi A. Use of ultrasonography as a diagnostic and therapeutic tool in sports medicine. Arthroscopy 2014; 30:260-70. [PMID: 24485118 DOI: 10.1016/j.arthro.2013.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/23/2013] [Accepted: 10/29/2013] [Indexed: 02/02/2023]
Abstract
Ultrasonography has many important advantages over other imaging modalities and many important applications in sports medicine. This article presents an evidence-based discussion of the use of ultrasound technology to diagnose and treat common musculoskeletal disorders, with emphasis on the shoulder, elbow, hip, knee, and foot and ankle. Topics include basic principles, scan artifacts, the appearance of musculoskeletal structure characteristics and pathologies, and various diagnostic and therapeutic applications in sports medicine.
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Affiliation(s)
- Bryson P Lesniak
- UHealth Sports Medicine, the Department of Orthopaedics, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Dustin Loveland
- UHealth Sports Medicine, the Department of Orthopaedics, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Jean Jose
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Ryan Selley
- Section of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Jon A Jacobson
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Asheesh Bedi
- Section of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
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Neovascularity in patellar tendinopathy and the response to eccentric training: A case report using Power Doppler ultrasound. ACTA ACUST UNITED AC 2013; 18:602-5. [PMID: 23022320 DOI: 10.1016/j.math.2012.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 09/06/2012] [Accepted: 09/08/2012] [Indexed: 11/23/2022]
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Simpson M, Smith TO. Quadriceps tendinopathy — a forgotten pathology for physiotherapists? A systematic review of the current evidence-base. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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12
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Wilde B, Havill A, Priestley L, Lewis J, Kitchen S. The efficacy of sclerosing injections in the treatment of painful tendinopathy. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Helland C, Bojsen-Møller J, Raastad T, Seynnes OR, Moltubakk MM, Jakobsen V, Visnes H, Bahr R. Mechanical properties of the patellar tendon in elite volleyball players with and without patellar tendinopathy. Br J Sports Med 2013; 47:862-8. [DOI: 10.1136/bjsports-2013-092275] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Rees JD, Houghton J, Srikanthan A, West A. THE LOCATION OF PATHOLOGY IN PATELLAR TENDINOPATHY: Table 1. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092459.28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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15
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De Jonge S, Warnaars JLF, De Vos RJ, Weir A, van Schie HTM, Bierma-Zeinstra SMA, Verhaar JAN, Tol JL. Relationship between neovascularization and clinical severity in Achilles tendinopathy in 556 paired measurements. Scand J Med Sci Sports 2013; 24:773-8. [DOI: 10.1111/sms.12072] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2013] [Indexed: 01/14/2023]
Affiliation(s)
- S. De Jonge
- Sports Medicine Department; The Hague Medical Center; Leidschendam The Netherlands
- Department of Orthopedics; Erasmus Medical Center; Rotterdam The Netherlands
| | - J. L. F. Warnaars
- Sports Medicine Department; The Hague Medical Center; Leidschendam The Netherlands
| | - R. J. De Vos
- Sports Medicine Department; The Hague Medical Center; Leidschendam The Netherlands
| | - A. Weir
- Sports Medicine Department; The Hague Medical Center; Leidschendam The Netherlands
| | - H. T. M. van Schie
- Department of Orthopedics; Erasmus Medical Center; Rotterdam The Netherlands
- Department of Equine Sciences; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - S. M. A. Bierma-Zeinstra
- Sports Medicine Department; The Hague Medical Center; Leidschendam The Netherlands
- Department of General Practice; Erasmus University Medical Center; Rotterdam The Netherlands
| | - J. A. N. Verhaar
- Department of Orthopedics; Erasmus Medical Center; Rotterdam The Netherlands
| | - J. L. Tol
- Sports Medicine Department; The Hague Medical Center; Leidschendam The Netherlands
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16
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Musculoskeletal ultrasonography of the lower extremities in infants and children. Pediatr Radiol 2013; 43 Suppl 1:S8-22. [PMID: 23478916 DOI: 10.1007/s00247-012-2589-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 11/08/2012] [Accepted: 11/15/2012] [Indexed: 12/26/2022]
Abstract
Ultrasonography is a powerful diagnostic imaging tool for evaluating lower extremity anatomy and pathology in children. Indications for pediatric musculoskeletal lower extremity sonography include developmental dysplasia of the hip, hip joint sonography for the child with a painful hip, evaluation and characterization of superficial soft-tissue masses, evaluation for deep venous thrombosis, and foreign body localization, characterization and removal. This review highlights these established indications, but primarily focuses on additional US applications for evaluation of the lower extremities, including diagnosis and characterization of arthritis and monitoring of therapy, evaluation of tendon tears and muscle strain injuries, characterization of soft-tissue masses and evaluation of certain congenital abnormalities of the lower extremities. Techniques for optimal utilization of musculoskeletal US in children are also discussed.
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van der Worp H, van den Akker-Scheek I, van Schie H, Zwerver J. ESWT for tendinopathy: technology and clinical implications. Knee Surg Sports Traumatol Arthrosc 2013; 21:1451-8. [PMID: 22547246 PMCID: PMC3657080 DOI: 10.1007/s00167-012-2009-3] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 04/12/2012] [Indexed: 12/19/2022]
Abstract
PURPOSE The general consensus that tendinopathy, at least in the chronic stage, is mainly a degenerative condition and inflammation plays a minor role has led to a shift from treatments that target inflammation towards treatment options that promote regeneration. One of these treatments is extracorporeal shockwave therapy (ESWT), a physical therapy modality that uses pressure waves to treat tendinopathy. This review was undertaken to give an overview of the literature concerning this treatment, and special attention is given to the differences between focused and radial ESWT. METHODS A narrative description of wave characteristics, generation methods and in vitro effects of ESWT is given. The literature on ESWT as a treatment for one common tendinopathy, patellar tendinopathy, was systematically reviewed. RESULTS Waves that are generated for focused and radial ESWT have very different physical characteristics. It is unclear how these characteristics are related to clinical effectiveness. Studies into the biological effects of ESWT have mainly used focused shockwave therapy, showing a number of effects of shockwaves on biological tissue. The systematic review of studies into the clinical effects of ESWT for patellar tendinopathy showed conflicting evidence for its effectiveness. CONCLUSION Physical characteristics of focused and radial waves differ substantially, but effect on clinical effectiveness is unclear. Whereas in vitro studies often show the effects of ESWT on tendon tissue, results of clinical studies are inconsistent. Based on the review of the literature, suggestions are given for the use of ESWT in clinical practice regarding timing and treatment parameters.
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Affiliation(s)
- Henk van der Worp
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Inge van den Akker-Scheek
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
| | - Hans van Schie
- Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands ,Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Johannes Zwerver
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
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Couppé C, Kongsgaard M, Aagaard P, Vinther A, Boesen M, Kjaer M, Magnusson SP. Differences in tendon properties in elite badminton players with or without patellar tendinopathy. Scand J Med Sci Sports 2012; 23:e89-95. [DOI: 10.1111/sms.12023] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2012] [Indexed: 12/16/2022]
Affiliation(s)
| | - M. Kongsgaard
- Institute of Sports Medicine Copenhagen; Department of Orthopedic Surgery M; Bispebjerg Hospital and Centre for Healthy Aging; Faculty of Health Sciences; University of Copenhagen; Copenhagen; Denmark
| | - P. Aagaard
- Department of Clinical Biomechanics and Exercises Science; University of Southern Denmark; Odense; Denmark
| | - A. Vinther
- Department of Physical Therapy; Herlev Hospital; Herlev; Denmark
| | - M. Boesen
- Department of Radiology and the Parker Institute Bispebjerg; Frederiksberg Hospital; Copenhagen NV; Denmark
| | - M. Kjaer
- Institute of Sports Medicine Copenhagen; Department of Orthopedic Surgery M; Bispebjerg Hospital and Centre for Healthy Aging; Faculty of Health Sciences; University of Copenhagen; Copenhagen; Denmark
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Malliaras P, Voss C, Garau G, Richards P, Maffulli N. Achilles tendon shape and echogenicity on ultrasound among active badminton players. Scand J Med Sci Sports 2010; 22:149-55. [DOI: 10.1111/j.1600-0838.2010.01156.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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