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Validation of a novel ultrasound measurement of achilles tendon length

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

A clinically applicable and accurate method for measuring Achilles tendon length is needed to investigate the influence of elongation of the Achilles tendon after acute rupture. The purpose of this study was to develop and validate an ultrasonographic (US) length measurement of the Achilles tendon-aponeurosis complex.

Methods

Both legs of 19 non-injured subjects were examined by magnetic resonance imaging (MRI) and US. The length from calcaneus to the medial head of m. Gastrocnemius was measured by three independent US examiners. Repeated US measurements were performed and compared to MRI measurements. Intra-rater and inter-rater reliability and the agreement between MRI and US were determined. Data were evaluated using the intraclass correlation coefficient (ICC), the standard error of the measurement (SEM) and the minimal detectable change (MDC).

Results

Intra-rater reliability of US assessment showed no significant differences between test days: ICC 0.96, SEM 4 mm and MDC 10 mm. Inter-rater reliability showed a systematic difference between US observers of 2–5 mm (p = 0.001–0.036); ICC 0.97, SEM 3 mm and MDC 9 mm. MRI measurements were on average 4 mm longer than US (p = 0.001).

Conclusion

The novel ultrasound measurement showed good reliability and accuracy. For comparison between groups of non-injured subjects differences of more than 4 mm can be detected. For repeated assessment of individual subjects differences of more than 10 mm can be detected. The measurement needs to be further assessed in the setting of acute Achilles tendon rupture.

Clinical relevance

This new ultrasound measurement might allow for length measurement of ruptured Achilles tendons in the acute and chronic state after rupture.

Level of evidence

II.

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Acknowledgments

The authors thank biostatistician Steen Ladelund, The Clinical Research Centre, Copenhagen University Hospital Hvidovre, for statistical guidance.

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Authors and Affiliations

  1. Department of Orthopedics, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark

    Kristoffer Weisskirchner Barfod & Anders Troelsen

  2. Department of Orthopedics, Copenhagen University Hospital Køge, Lykkebækvej 1, 4600, Køge, Denmark

    Anja Falk Riecke

  3. Institute of Sports Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark

    Anders Boesen

  4. Department of Radiology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark

    Philip Hansen

  5. Department of Radiology, Copenhagen University Hospital Køge, Lykkebækvej 1, 4600, Køge, Denmark

    Jens Friedrich Maier

  6. Department of Orthopedics, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark

    Simon Døssing

Authors
  1. Kristoffer Weisskirchner Barfod
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  2. Anja Falk Riecke
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  3. Anders Boesen
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  4. Philip Hansen
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  5. Jens Friedrich Maier
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  6. Simon Døssing
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  7. Anders Troelsen
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Correspondence to Kristoffer Weisskirchner Barfod.

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Barfod, K.W., Riecke, A.F., Boesen, A. et al. Validation of a novel ultrasound measurement of achilles tendon length. Knee Surg Sports Traumatol Arthrosc 23, 3398–3406 (2015). https://doi.org/10.1007/s00167-014-3175-2

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  • DOI: https://doi.org/10.1007/s00167-014-3175-2

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