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Application of shear wave elastography and B-mode ultrasound in patellar tendinopathy after extracorporeal shockwave therapy

  • Original Article–Orthopedics
  • Published:
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A Correction to this article was published on 11 June 2020

This article has been updated

Abstract

Purpose

The purpose of this study was to investigate changes in morphological and elastic properties, as estimated by B-mode ultrasound (B-US) and shear wave elastography (SWE), in volleyball athletes with patellar tendinopathy (PT) and changes after extracorporeal shockwave therapy (ESWT) as well as their relationships with US measurements and Victorian Institute of Sport Assessment-Patella (VISA-P) scores in PT.

Methods

Twelve healthy athletes (24 patellar tendons) and 31 volleyball athletes with PT (48 tendons) were included. All were examined by US and received VISA-P scores before the start of the study. The athletes received 3 months of ESWT and underwent US and VISA-P at 1 month and 3 months. VISA-P scores were used to evaluate therapeutic efficacy. Tendon thickness and cross-sectional area (CSA) were detected by B-US, and the elastic modulus was measured by SWE. Correlations between VISA-P and US measurements were calculated.

Results

Thickness, CSA, and elastic modulus of the patellar tendon in PT were higher than those in healthy athletes (P < 0.000). In PT with ESWT, VISA-P scores decreased by 22.1% (P < 0.000) and thickness decreased by 11.2% relative to baseline (P < 0.000). CSA decreased by 1.4% (P < 0.000). The elastic modulus decreased by 15.2% (P < 0.000). Elastic modulus, thickness, and CSA had significant negative correlations with VISA-P scores (P ≤ 0.005), with a stronger correlation between elastic modulus and VISA-P.

Conclusion

Athletes with PT had stiffer and larger tendons than healthy athletes. SWE combined with B-US could clearly show the changes in tendon thickness, CSA, stiffness in PT, and changes after treatment. SWE combined with B-US provided visualization with quantitative, reproducible, and noninvasive imaging in the follow-up evaluation of PT and is worth promoting clinically.

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Change history

  • 11 June 2020

    In the original publication of the article the Fig. 1 has been removed, as the authors did not obtain the appropriate permission from the rights holder to use the image in this article.

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Acknowledgements

The authors appreciate the cooperation of the volleyball team.

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Authors and Affiliations

  1. Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, China

    Cici Zhang, Lixia Duan & Qiong Liu

  2. Exercise Rehabilitation Department, Ersha Sports Training Center Hospital of Guangdong Province, No. 28, Da-tong Road, Ersha, Yue-xiu District, Guangzhou, 510105, Guangdong, China

    Wen Zhang

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  1. Cici Zhang
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Correspondence to Wen Zhang.

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All procedures performed in this study were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants included in the study.

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The original version of this article was revised: In the original publication of the article the Fig. 1 has been removed, as the authors did not obtain the appropriate permission from the rights holder to use the image in this article.

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Zhang, C., Duan, L., Liu, Q. et al. Application of shear wave elastography and B-mode ultrasound in patellar tendinopathy after extracorporeal shockwave therapy. J Med Ultrasonics 47, 469–476 (2020). https://doi.org/10.1007/s10396-019-00979-7

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