Validity of Elastic Imaging Evaluation of Hamstring Muscles With Knee Contracture Using Ultrasound Shear Wave Elastography.

Abstract

This study used ultrasound shear wave elastography (SWE) to evaluate the mechanical properties of hamstring muscles from cadaveric specimens with knee flexion contractures. Hamstring muscles for tensile testing were harvested from Thiel soft-embalmed cadavers with and without knee flexion contracture. Muscle specimens were mounted on a testing machine. The initial load detected when a tensile load was applied to the distal end was used as the slack length. The cross-sectional areas of the muscle at slack length were measured at the proximal and distal sites using B-mode ultrasonography. Subsequently, the muscle specimen was elongated from the slack length to 8% strain, with the shear modulus measured using SWE. Young's modulus (stress/strain) was calculated based on the displacement and tensile force obtained from the tensile test. Regression analysis showed a significant positive linear relationship between the Young's and shear moduli for all specimens at all the sites (P < 0.01 and coefficient of determination: 0.95-0.99). The Young's and average shear moduli at the proximal and distal sites were higher in all hamstring muscles with contractures than in those without contractures. SWE can be used to estimate Young's moduli of hamstring muscles with contractures. Muscle specimens with contractures exhibited higher resistance to elongation, thereby indicating that their mechanical properties differed from those of muscles without contractures.