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Techniques for In Vivo Measurement of Ligament and Tendon Strain: A Review
Annals of Biomedical Engineering ( IF 3.8 ) Pub Date : 2020-10-06 , DOI: 10.1007/s10439-020-02635-5
Qiang Zhang 1 , Naomi C Adam 1 , S H Hosseini Nasab 1 , William R Taylor 1 , Colin R Smith 1
Affiliation  

The critical clinical and scientific insights achieved through knowledge of in vivo musculoskeletal soft tissue strains has motivated the development of relevant measurement techniques. This review provides a comprehensive summary of the key findings, limitations, and clinical impacts of these techniques to quantify musculoskeletal soft tissue strains during dynamic movements. Current technologies generally leverage three techniques to quantify in vivo strain patterns, including implantable strain sensors, virtual fibre elongation, and ultrasound. (1) Implantable strain sensors enable direct measurements of tissue strains with high accuracy and minimal artefact, but are highly invasive and current designs are not clinically viable. (2) The virtual fibre elongation method tracks the relative displacement of tissue attachments to measure strains in both deep and superficial tissues. However, the associated imaging techniques often require exposure to radiation, limit the activities that can be performed, and only quantify bone-to-bone tissue strains. (3) Ultrasound methods enable safe and non-invasive imaging of soft tissue deformation. However, ultrasound can only image superficial tissues, and measurements are confounded by out-of-plane tissue motion. Finally, all in vivo strain measurement methods are limited in their ability to establish the slack length of musculoskeletal soft tissue structures. Despite the many challenges and limitations of these measurement techniques, knowledge of in vivo soft tissue strain has led to improved clinical treatments for many musculoskeletal pathologies including anterior cruciate ligament reconstruction, Achilles tendon repair, and total knee replacement. This review provides a comprehensive understanding of these measurement techniques and identifies the key features of in vivo strain measurement that can facilitate innovative personalized sports medicine treatment.



中文翻译:

韧带和肌腱应变的体内测量技术:综述

通过对体内肌肉骨骼软组织应变的了解获得的关键临床和科学见解推动了相关测量技术的发展。本综述全面总结了这些技术在动态运动过程中量化肌肉骨骼软组织应变的关键发现、局限性和临床影响。目前的技术通常利用三种技术来量化体内应变模式,包括可植入应变传感器、虚拟纤维伸长率和超声波。(1) 植入式应变传感器能够以高精度和最少的人工制品直接测量组织应变,但具有高度侵入性,目前的设计在临床上不可行。(2) 虚拟纤维伸长法跟踪组织附着物的相对位移,以测量深层和浅表组织的应变。然而,相关的成像技术通常需要暴露于辐射,限制可以执行的活动,并且只能量化骨对骨组织应变。(3) 超声方法能够对软组织变形进行安全且非侵入性的成像。然而,超声波只能对浅表组织进行成像,并且测量值会受到平面外组织运动的影响。最后,所有体内应变测量方法在确定肌肉骨骼软组织结构的松弛长度的能力方面受到限制。尽管这些测量技术存在许多挑战和局限性,但对体内软组织应变的了解已经改善了许多肌肉骨骼疾病的临床治疗方法,包括前交叉韧带重建、跟腱修复和全膝关节置换术。本综述提供了对这些测量技术的全面理解,并确定了体内应变测量的关键特征,可以促进创新的个性化运动医学治疗。

更新日期:2020-10-07
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