Visualizing tendon elasticity in an ex vivo partial tear model.

Supersonic shear imaging (SSI) is evaluated as a means of visualizing changes in regional tendon elasticity caused by partial tears in a porcine model. Thirty digital flexor tendons were cut to 25% (n = 10), 50% (n = 10) and 75% (n = 10) of the tendon thickness along the deep surface. Tendon elasticity was mapped left of, centered on and right of the tear site before and after tearing from 0% to 2% strain. Shear wave speed increased at 1% (p < 0.05) and 2% (p < 0.001) strain for all regions. Deep surface shear wave speed decreased in the 25%, 50% and 75% tears (p < 0.05 and p < 0.001). Computational tendon tear models were also created to investigate regional changes in strain resulting from a tear. In the computational models, strain on the deep surface decreased progressively with increasing tear size. Visualization of tendon shear wave speed was achieved in normal and partially torn tendons, indicating the potential of SSI to add tendon shear wave speed to traditional morphologic assessment of partial tears, which may improve assessment of tendon health.

[1]  B. Kastler,et al.  Biomechanical properties of the calcaneal tendon in vivo assessed by transient shear wave elastography , 2013, Skeletal Radiology.

[2]  G. Ferns,et al.  Achilles Tendinopathy , 2004, Journal of the Royal Society of Medicine.

[3]  J. Weiss,et al.  Recruitment of tendon crimp with applied tensile strain. , 2002, Journal of biomechanical engineering.

[4]  M. Tanter,et al.  On the effects of reflected waves in transient shear wave elastography , 2011, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[5]  Mathieu Couade,et al.  Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. , 2011, Ultrasound in medicine & biology.

[6]  R. Arciero,et al.  Intra-Articular Partial-Thickness Rotator Cuff Tears , 2008, The American journal of sports medicine.

[7]  N. Reeves,et al.  Adaptation of the tendon to mechanical usage. , 2006, Journal of musculoskeletal & neuronal interactions.

[8]  M. Fink,et al.  Supersonic shear imaging: a new technique for soft tissue elasticity mapping , 2004, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[9]  L. Soslowsky,et al.  Exercise following a short immobilization period is detrimental to tendon properties and joint mechanics in a rat rotator cuff injury model , 2010, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[10]  Miguel Ángel Martínez,et al.  A three-dimensional finite element analysis of the combined behavior of ligaments and menisci in the healthy human knee joint. , 2006, Journal of biomechanics.

[11]  Ray Vanderby,et al.  Viscoelastic Relaxation and Recovery of Tendon , 2009, Annals of Biomedical Engineering.

[12]  Hervé Delingette,et al.  Subject-Specific Ligament Models: Toward Real-Time Simulation of the Knee Joint , 2010 .

[13]  M. Fink,et al.  Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results. , 2010, Radiology.

[14]  Shawn P. Reese,et al.  Micromechanical models of helical superstructures in ligament and tendon fibers predict large Poisson's ratios. , 2010, Journal of biomechanics.

[15]  J. Ophir,et al.  Elastography: A Quantitative Method for Imaging the Elasticity of Biological Tissues , 1991, Ultrasonic imaging.

[16]  R. Memo,et al.  Shear Wave Ultrasound Elastography of the Prostate: Initial Results , 2012, Ultrasound quarterly.

[17]  Werner Jaschke,et al.  Real-time sonoelastography of lateral epicondylitis: comparison of findings between patients and healthy volunteers. , 2009, AJR. American journal of roentgenology.

[18]  T. Derrick,et al.  Effects of stride length and running mileage on a probabilistic stress fracture model. , 2009, Medicine and science in sports and exercise.

[19]  C. Maganaris.  Tensile properties of in vivo human tendinous tissue. , 2002, Journal of biomechanics.

[20]  M. Bey,et al.  ShearWave elastography: repeatability for measurement of tendon stiffness , 2013, Skeletal Radiology.

[21]  A N Natali,et al.  Anisotropic elasto-damage constitutive model for the biomechanical analysis of tendons. , 2005, Medical engineering & physics.

[22]  Sophia Mã ¶ ller,et al.  Biomechanics — Mechanical properties of living tissue , 1982 .

[23]  C. Maganaris,et al.  Influence of 90-day simulated microgravity on human tendon mechanical properties and the effect of resistive countermeasures. , 2005, Journal of applied physiology.

[24]  G. Feuchtner,et al.  Real-Time Sonoelastography: Findings in Patients with Symptomatic Achilles Tendons and Comparison to Healthy Volunteers , 2009, Ultraschall in der Medizin.

[25]  P. Kannus,et al.  Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. , 1991, The Journal of bone and joint surgery. American volume.

[26]  R. Tashjian.  Epidemiology, natural history, and indications for treatment of rotator cuff tears. , 2012, Clinics in sports medicine.

[27]  J. P. Paul,et al.  In vivo human tendon mechanical properties , 1999, The Journal of physiology.

[28]  Ping He,et al.  Shear Wave Elastographic Characterization of Normal and Torn Achilles Tendons , 2013, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[29]  Benjamin J. Ellis,et al.  FEBio: finite elements for biomechanics. , 2012, Journal of biomechanical engineering.

[30]  Kemal Arda,et al.  Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. , 2011, AJR. American journal of roentgenology.

[31]  M. Järvinen,et al.  Current concepts review: Achilles tendinopathy , 2002 .

[32]  C. Court-Brown,et al.  The epidemiology of musculoskeletal tendinous and ligamentous injuries. , 2008, Injury.