Reliability of Continuous Shear Wave Elastography in the Pathological Patellar Tendon

J Ultrasound Med. 2023 May;42(5):1047-1055. doi: 10.1002/jum.16115. Epub 2022 Oct 27.

Abstract

Objectives: Patellar tendon injuries occur via various mechanisms such as overuse, or due to surgical graft harvest for anterior cruciate ligament reconstruction (ACLR). Quantified patellar tendon stiffness after injury may help guide clinical care. Continuous shear wave elastography (cSWE) allows for the assessment of viscosity and shear modulus in tendons. The reliability of the measure, however, has not been established in the patellar tendon. The purpose of this study was to investigate the interrater reliability, intrarater reliability, and between-day stability of cSWE in both healthy and pathological patellar tendons.

Methods: Participants with patellar tendinopathy (n = 13), history of ACLR using bone-patellar tendon-bone autograft (n = 9), and with no history of patellar tendon injury (n = 13) were recruited. cSWE was performed 4 times by multiple raters over 2 days. Intraclass correlations (ICC) and minimum detectable change (MDC95% ) were calculated.

Results: Good to excellent between-day stability were found for viscosity (ICC = 0.905, MDC95% = 8.3 Pa seconds) and shear modulus (ICC = 0.805, MDC95% = 27.4 kPa). The interrater reliability measures, however, were not as reliable (ICC = 0.591 and 0.532).

Conclusions: cSWE is a reliable assessment tool for quantifying patellar tendon viscoelastic properties over time. It is recommended, however, that a single rater performs the measure as the interrater reliability was less than ideal.

Keywords: anterior cruciate ligament; bone-patellar tendon-bone graft; continuous shear wave elastography; patellar tendon; tendinopathy; viscoelastic properties.

MeSH terms

  • Anterior Cruciate Ligament Reconstruction*
  • Elasticity Imaging Techniques*
  • Humans
  • Patellar Ligament* / diagnostic imaging
  • Reproducibility of Results
  • Tendon Injuries* / surgery
  • Tendons