Kim Min-Woo, Lee Dong-Ha, Seo Young-Chae
Department of Orthopedic Surgery, Busan Medical Center, Busan 47527, Republic of Korea.
Department of Orthopaedic Surgery, 5th Air Mobility Wing, Republic of Korea Air Force Military Orthopaedic Surgeon, Busan 46718, Republic of Korea.
Bioengineering (Basel). 2024 Dec 13;11(12):1263. doi: 10.3390/bioengineering11121263.
This study hypothesized that changes in the elasticity of the quadriceps and patellar tendons before and after the diagnosis of patellar tendinopathy would correlate with the range of motion (ROM) following conservative treatment. We aimed to prospectively assess post-treatment ROM using multinomial logistic regression, incorporating elasticity measurements obtained via shear wave elastography (SWE).
From March 2023 to April 2024, 95 patients (86 men; aged 20-45 years, mean 25.62 ± 5.49 years) underwent SWE preoperatively and two days post-diagnosis of patellar tendinopathy. Elasticity measurements of the rectus femoris, vastus medialis, vastus lateralis, patellar tendon, and biceps tendon were obtained during full flexion and extension. Based on ROM 56 days post-treatment, patients were categorized into two groups: Group A (ROM > 120 degrees) and Group B (ROM < 120 degrees). A multinomial logistic regression algorithm was employed to classify the groups using patient information and tendon elasticity measurements both at diagnosis and 1-week post-diagnosis.
The predictive accuracy using only patient information was 62%, while using only elasticity measurements yielded 68% accuracy. When combining patient information with elasticity measurements taken at diagnosis and two days post-diagnosis, the algorithm achieved an accuracy of 79%, sensitivity of 92%, and specificity of 56%.
The combination of patient information and tendon elasticity measurements obtained via SWE at pre-conservative treatment and early post-conservative treatment periods effectively predicts post-treatment ROM. This algorithm can guide rehabilitation strategies for soldiers with patellar tendinopathy.
本研究假设,髌腱病诊断前后股四头肌和髌腱弹性的变化与保守治疗后的活动范围(ROM)相关。我们旨在使用多项逻辑回归前瞻性评估治疗后的ROM,并纳入通过剪切波弹性成像(SWE)获得的弹性测量值。
从2023年3月至2024年4月,95例患者(86名男性;年龄20 - 45岁,平均25.62±5.49岁)在髌腱病诊断前及诊断后两天接受了SWE检查。在完全屈伸过程中获取股直肌、股内侧肌、股外侧肌、髌腱和股二头肌的弹性测量值。根据治疗后56天的ROM,患者被分为两组:A组(ROM>120度)和B组(ROM<120度)。采用多项逻辑回归算法,利用诊断时和诊断后1周的患者信息及肌腱弹性测量值对两组进行分类。
仅使用患者信息的预测准确率为62%,仅使用弹性测量值的准确率为68%。当将患者信息与诊断时及诊断后两天的弹性测量值相结合时,该算法的准确率达到79%,灵敏度为92%,特异性为56%。
在保守治疗前和保守治疗早期,通过SWE获得的患者信息与肌腱弹性测量值相结合,可有效预测治疗后的ROM。该算法可为髌腱病士兵的康复策略提供指导。