Effects of Cigarette Smoking on Elastographic Strain Ratio Measurements of Patellar and Achilles Tendons.
OBJECTIVE
The aim of this study was to explore the sonographic and elastographic properties of patellar and Achilles tendons in smoking and nonsmoking otherwise healthy adults.


METHODS
We conducted a level 3 case-control analytical study. Smoking and nonsmoking volunteers (>18 years) without musculoskeletal system disorders were included in the study. Demographic characteristics and smoking habits (pack-years) were recorded. Proximal, middle, and distal third thicknesses of the patellar and Achilles tendons were measured by B-mode sonography. Strain ratio measurements of the same regions were measured by real-time ultrasound elastography.


RESULTS
A total of 69 participants (57 male and 12 female; mean age ± SD, 35.5 ± 7.8 years) were evaluated in the study. Smoking (n = 35) and nonsmoking (n = 34) groups had no significant differences in terms of age, body mass index, sex, and activity level (all P > .05). Proximal, middle, and distal thirds of the patellar and Achilles tendons were significantly thinner in the smoking group (all P < .05). Furthermore, strain ratio measurements in the same regions were significantly lower in the smoking group (all P< .05). Patellar tendon thicknesses and strain ratios had negative correlations with the smoking amount (all P < .05).


CONCLUSIONS
Thickness and strain ratio measurements of patellar and Achilles tendons were reduced (thinner and harder tendons) in smokers. Clinical implications of these morphologic and elastographic changes should be investigated in future studies.
Department of Radiology, Pamukkale University Medical School, Denizli, Turkey.
Kadir
K
Ağladıoğlu
Department of Physical and Rehabilitation Medicine, Pamukkale University Medical School, Denizli, Turkey nrakkaya@gmail.com.
Nuray
N
Akkaya
Department of Orthopedics and Traumatology, Pamukkale University Medical School, Denizli, Turkey.
Harun R
HR
Güngör
Department of Orthopedics and Traumatology, Pamukkale University Medical School, Denizli, Turkey.
Semih
S
Akkaya
Department of Orthopedics and Traumatology, Pamukkale University Medical School, Denizli, Turkey.
Nusret
N
Ök
Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
Levent
L
Özçakar
D000125:Achilles Tendon / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000328:Adult; D016022:Case-Control Studies; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D017847:Patellar Ligament / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012907:Smoking / Q000503:physiopathology*
Achilles tendon; elastography; musculoskeletal ultrasound; patellar tendon; smoking; sonography