A review of methods to measure tendon dimensions

Tendons are soft tissues of the musculoskeletal system that are designed to facilitate joint movement. Tendons exhibit a wide range of mechanical properties matched to their functions and, as a result, have been of interest to researchers for many decades. Dimensions are an important aspect of tendon properties.

Change in the dimensions of tissues is often seen as a sign of injury and degeneration, as it may suggest inflammation or general disorder of the tissue. Dimensions are also important for determining the mechanical properties and behaviours of materials, particularly the stress, strain, and elastic modulus. This makes the dimensions significant in the context of a mechanical study of degenerated tendons. Additionally, tendon dimensions are useful in planning harvesting for tendon transfer and joint reconstruction purposes.

Historically, many methods have been used in an attempt to accurately measure the dimensions of soft tissue, since improper measurement can lead to large errors in the calculated properties. These methods can be categorised as destructive (by approximation), contact, and non-contact and can be considered in terms of in vivo and ex vivo.

Structured white light scanning of rabbit Achilles tendon

BACKGROUND

The cross-sectional area (CSA) of a material is used to calculate stress under load. The mechanical behaviour of soft tissue is of clinical interest in the management of injury; however, measuring CSA of soft tissue is challenging as samples are geometrically irregular and may deform during measurement. This study presents a simple method, using structured light scanning (SLS), to acquire a 3D model of rabbit Achilles tendon in vitro for measuring CSA of a tendon.

METHOD

The Artec Spider™ 3D scanner uses structured light and stereophotogrammetry technologies to acquire shape data and reconstruct a 3D model of an object. In this study, the 3D scanner was integrated with a custom mechanical rig, permitting 360-degree acquisition of the morphology of six New Zealand White rabbit Achilles tendons. The reconstructed 3D model was then used to measure CSA of the tendon. SLS, together with callipers and micro-CT, was used to measure CSA of objects with a regular or complex shape, such as a drill flute and human cervical vertebra, for validating the accuracy and repeatability of the technique.

RESULTS

CSA of six tendons was measured with a coefficient of variation of less than 2%. The mean CSA was 9.9±1.0mm², comparable with those reported by other researchers. Scanning of phantoms demonstrated similar results to μCT.

CONCLUSION

The technique developed in this study offers a simple and accurate method for effectively measuring CSA of soft tissue such as tendons. This allows for localised calculation of stress along the length, assisting in the understanding of the function, injury mechanisms and rehabilitation of tissue.

A linear laser scanner to measure cross-sectional shape and area of biological specimens during mechanical testing

Measure of the cross-sectional area (CSA) of biological specimens is a primary concern for many biomechanical tests. Different procedures are presented in literature but besides the fact that noncontact techniques are required during mechanical testing, most of these procedures lack accuracy or speed. Moreover, they often require a precise positioning of the specimen, which is not always feasible, and do not enable the measure of the same section during tension. The objective of this study was to design a noncontact, fast, and accurate device capable of acquiring CSA of specimens mounted on a testing machine. A system based on the horizontal linear displacement of two charge-coupled device reflectance laser devices next to the specimen, one for each side, was chosen. The whole measuring block is mounted on a vertical linear guide to allow following the measured zone during sample tension (or compression). The device was validated by measuring the CSA of metallic rods machined with geometrical shapes (circular, hexagonal, semicircular, and triangular) as well as an equine superficial digital flexor tendon (SDFT) in static condition. We also performed measurements during mechanical testing of three SDFTs, obtaining the CSA variations until tendon rupture. The system was revealed to be very fast with acquisition times in the order of 0.1 s and interacquisition time of about 1.5 s. Measurements of the geometrical shapes yielded mean errors lower than 1.4% (n=20 for each shape) while the tendon CSA at rest was 90.29 ± 1.69 mm(2) (n=20). As for the tendons that underwent tension, a mean of 60 measures were performed for each test, which lasted about 2 min until rupture (at 20 mm/min), finding CSA variations linear with stress (R(2)>0.85). The proposed device was revealed to be accurate and repeatable. It is easy to assemble and operate and capable of moving to follow a defined zone on the specimen during testing. The system does not need precise centering of the sample and can perform noncontact measures during mechanical testing; therefore, it can be used to measure variations of the specimen CSA during a tension (or compression) test in order to determine, for instance, the true stress and transverse deformations.