Depth Dependent Variations in Human Achilles Tendon as a Result of Active Smoking: An Elastographic Study

Current study was set to determine the impact of active smoking on Achilles Tendon (AT) as soft tissue using an elastographic technique. This study comprises of 54 male individuals having sedentary lifestyle. Volunteers were categorized into two groups of smokers (n = 20) and non-smokers (n = 34). Body composition analysis was performed to evaluate the physiological changes in human body mass indexes. Ultrasound Strain Elastog-raphy (USE) technique was used to find the stiffness along with anatomical images to envisage the anomalous status of Achilles tendon. Statistical analysis of data obtained through body composition, tendon anatomy and Strain Elastography (SE) was used to scrutinize the physiological, anatomical and elasticity variations within the tendon. A reduction in Fat Free Mass Index (FFMI) was observed among smokers with a significant difference (P = 0.042). Further, an increased significant difference (P = 0.029) was found in AT Strain Ratios (SR) of smokers as compared to non-smokers. Lightening in tendon mass and dilution in tendon stiffness indicates that smoking mechanism may generate excessive apoptosis and decrease the density of tenocytes. Nicotine is the key element that inhibits the functional capacity of Tendon Stem Cells and is highly responsible for tendinopathy, eventually leading to tendon rupture and injury.