Espen Femmo Brouwer1,2, Ståle Bergman Myhrvold1,2, Jūratė Šaltytė Benth2,3, Sigurd Erik Hoelsbrekken4. 1. Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway. 2. Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway. 3. Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway. 4. Department of Orthopaedic and Rheumatic Surgery, Kongsvinger Hospital, Kongsvinger, Norway. s.e.hoelsbrekken@medisin.uio.no.
Abstract
PURPOSE: Elongation of the Achilles tendon has been associated with poorer function in patients treated for ruptures. This has led to the development of various ultrasound-based measurements, and the purpose of the present study was to compare the reliability of three ultrasound-based measuring procedures. METHODS: Twenty healthy individuals (40 tendons) were assessed by two testers at two occasions, 12 weeks apart. The tendon length was measured from the calcaneal insertion to the mid-sagittal muscle tendon junction (MTJ) using skin markings or extended-field-of-view (EFOV) imaging, or from the calcaneal insertion to the distal medial MTJ using skin markings. Test-retest and inter-tester reliability as well as side-to-side length differences were assessed for all three procedures. RESULTS: Test-retest intraclass correlation coefficients (ICCs) for measurements from the mid-sagittal MTJ using EFOV imaging and skin markings, and from the distal medial MTJ using skin markings were 0.83, 0.90 and 0.96 for tester 1 and 0.87, 0.91 and 0.96 for tester 2, respectively. The corresponding inter-tester ICCs were 0.85, 0.91 and 0.96. Side-to-side lengths were significantly different for measurements from the mid-sagittal MTJ and the distal medial MTJ using skin markings, with mean differences of 0.3 and 0.4 cm, respectively. CONCLUSIONS: Test-retest and inter-tester ICCs were excellent for all three measuring procedures, however, the use of skin markings provided consistently better agreement and reliability compared to EFOV images. The best agreement and highest ICCs were achieved for measurements from the distal medial MTJ, but side-to-side length differences warrant caution when contralateral measurements are used to evaluate tendon elongation. LEVEL OF EVIDENCE: III.
PURPOSE: Elongation of the Achilles tendon has been associated with poorer function in patients treated for ruptures. This has led to the development of various ultrasound-based measurements, and the purpose of the present study was to compare the reliability of three ultrasound-based measuring procedures. METHODS: Twenty healthy individuals (40 tendons) were assessed by two testers at two occasions, 12 weeks apart. The tendon length was measured from the calcaneal insertion to the mid-sagittal muscle tendon junction (MTJ) using skin markings or extended-field-of-view (EFOV) imaging, or from the calcaneal insertion to the distal medial MTJ using skin markings. Test-retest and inter-tester reliability as well as side-to-side length differences were assessed for all three procedures. RESULTS: Test-retest intraclass correlation coefficients (ICCs) for measurements from the mid-sagittal MTJ using EFOV imaging and skin markings, and from the distal medial MTJ using skin markings were 0.83, 0.90 and 0.96 for tester 1 and 0.87, 0.91 and 0.96 for tester 2, respectively. The corresponding inter-tester ICCs were 0.85, 0.91 and 0.96. Side-to-side lengths were significantly different for measurements from the mid-sagittal MTJ and the distal medial MTJ using skin markings, with mean differences of 0.3 and 0.4 cm, respectively. CONCLUSIONS: Test-retest and inter-tester ICCs were excellent for all three measuring procedures, however, the use of skin markings provided consistently better agreement and reliability compared to EFOV images. The best agreement and highest ICCs were achieved for measurements from the distal medial MTJ, but side-to-side length differences warrant caution when contralateral measurements are used to evaluate tendon elongation. LEVEL OF EVIDENCE: III.
Authors: Eric D Ryan; Joseph G Rosenberg; Michael J Scharville; Eric J Sobolewski; Brennan J Thompson; Gilbert E King Journal: Ultrasound Med Biol Date: 2013-09-21 Impact factor: 2.998
Authors: Nicklas Olsson; Katarina Nilsson-Helander; Jón Karlsson; Bengt I Eriksson; Roland Thomée; Eva Faxén; Karin Grävare Silbernagel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-04-30 Impact factor: 4.342
Authors: Katarina Nilsson-Helander; Karin Grävare Silbernagel; Roland Thomeé; Eva Faxén; Nicklas Olsson; Bengt I Eriksson; Jon Karlsson Journal: Am J Sports Med Date: 2010-08-27 Impact factor: 6.202