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(2) To evaluate the reliability of shear-wave elastography (SWE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were consecutively enrolled between January 2017 and June 2019. PT was diagnosed clinically and confirmed by either grayscale US or power Doppler US, or both. Controls had no history of anterior knee pain and no clinical signs of PT. Patellar tendon stiffness (kilopascal, kPa) was assessed using SWE. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Reliability analyses included coefficients-of-variation (CV), coefficients-of-repeatability (CR), intraclass correlation coefficient (ICC) for intraobserver and interobserver reliability, and Bland-Altman analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 76 participants with PT (58 men, mean age 24.4\u2009\u00b1\u20093.8\u00a0years) and 35 asymptomatic controls (16 men, mean age 21.5\u2009\u00b1\u20093.8\u00a0years) were included. Univariate analyses (OR 1.094, 95% CI 1.061\u20131.128,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and adjusted multivariate analyses (OR 1.294, 95% CI 1.044\u20131.605,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.018) showed that athletes with PT had significantly increased patellar tendon stiffness. ICC for intraobserver reliability was 0.95 (95% CI 0.92\u20130.97), CR (CV) 12\u00a0kPa (10%) and 0.79 (95% CI 0.65\u20130.88), CR (CV) 18\u00a0kPa (21%) for interobserver reliability. Mean differences from Bland-Altman analysis were 5.6\u00a0kPa (95% CI 3.1\u20138.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) for intraobserver reliability and 4.6\u00a0kPa (95% CI 1.9\u20137.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) for interobserver reliability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PT is associated with significantly higher patellar tendon stiffness. SWE measurements demonstrate excellent intraobserver reliability and good interobserver reliability. Therefore, SWE is a promising tool to implement in longitudinal studies and future studies should evaluate its prognostic value and utility as a monitoring tool in athletes with PT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\u2022 Patellar tendon stiffness measured with shear-wave elastography (SWE) is higher in athletes with patellar tendinopathy than in healthy controls, also after adjusting for potential confounders.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 Excellent intraobserver reliability and good interobserver reliability were found for the quantitative assessment of patellar tendon stiffness using SWE.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-020-06952-0","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T15:02:17Z","timestamp":1591282937000},"page":"5942-5951","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The association between patellar tendon stiffness measured with shear-wave elastography and patellar tendinopathy\u2014a case-control study"],"prefix":"10.1007","volume":"30","author":[{"given":"Stephan J.","family":"Breda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arco","family":"van der Vlist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert-Jan","family":"de Vos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel P.","family":"Krestin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3727-3427","authenticated-orcid":false,"given":"Edwin H. 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Oei.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 case-control study\u2022 diagnostic study\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}