Developing and using fast shear wave elastography to quantify physiologically-relevant tendon forces.

Direct quantification of physiologically-relevant tendon forces can be used in a wide range of clinical applications. However, tendon forces have usually been estimated either indirectly by computational models or invasively using force transducers, and direct non-invasive measurement of forces remains a big challenge. The aim of this study was to investigate the feasibility of using Shear Wave Elastography (SWE) for quantifying human tendon forces at physiological levels. An experimental protocol was developed to measure Shear Wave Speed (SWS) and tensile force in a human patellar tendon using SWE and conventional tensile testing to quantify the correlation between SWS and load. The SWE system was customised to allow imaging of fast shear waves expected in human tendons under physiological loading which is outside the normal range of the existing SWE systems. SWS increased from 10.8 m/s to 36.1 m/s with the increasing tensile load from 8 N to 935 N and a strong linear correlation between SWS and load (r = 0.99, p < 0.01) was observed. The findings in this study suggest that SWE can be used as a potential non-invasive method for direct quantification of physiologically-relevant tendon forces, as well as for validating the estimated forces from other methods such as computational models.