Reliability of a special device for measuring the cross-sectional area of the patellar tendon by ultrasonography

The objective of this study was to evaluate the intra- and inter-rater reliability and agreement between conditions with and without a special device (SD) in the evaluation of the patellar tendon (PT) cross-sectional area (CSA). Forty trained adult volunteers participated in the study. With the knee positioned at 90°, the ultrasound probe was placed in the transverse plane at 25, 50, and 75% of the PT length. Two raters and one analyzer obtained the images. We use a two-way ANOVA with a significance level of α = 0.05. No significant differences were found between raters or conditions. Intra-rater reliability ranged from moderate to good. Inter-rater reliability without the SD ranged from low to good, improving from moderate to good when the SD was used. Evaluation of the PT ends showed a lower coefficient of variation with the SD. We observed a moderate correlation at the ends and a strong correlation in the middle between conditions. The mean difference in the three positions is small (~ 0.013 cm 2 / ~ 1.7%) with an upper limit of 43.2% and a lower limit of 32.5%. Therefore, we conclude that the use of the SD can be employed for evaluating the PT ends, while for the central region, it becomes optional.