Patellar tendon morphology in volleyball athletes with and without patellar tendinopathy

Patellar tendon morphology in volleyball athletes with and without patellar tendinopathy

Appropriate management of patellar tendinopathy requires distinguishing between inflammatory and degenerative conditions, often difficult because tendon thickening can be a normal or pathological adaptation, and micromorphology is not observable on clinical imaging. The purpose of this study was to...

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Published in:Scandinavian journal of medicine & science in sports Vol. 23; no. 2; pp. e81 - e88
Main Authors: Kulig, K., Landel, R., Chang, Y.-J., Hannanvash, N., Reischl, S. F., Song, P., Bashford, G. R.
Format: Journal Article
Language:English
Published: Denmark Blackwell Publishing Ltd 01-03-2013
Subjects:
Analysis of Variance
anterior knee pain
Asymptomatic Diseases
Athletes
Case-Control Studies
Fourier Analysis
Humans
Image Processing, Computer-Assisted
Knee
Male
Morphology
Patellar Ligament - diagnostic imaging
patellar tendinopathy
Tendinopathy - diagnostic imaging
tendon morphology
Tendons
Ultrasonography
ultrasound
Volleyball
Volleyball - physiology
Young Adult
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Summary:Appropriate management of patellar tendinopathy requires distinguishing between inflammatory and degenerative conditions, often difficult because tendon thickening can be a normal or pathological adaptation, and micromorphology is not observable on clinical imaging. The purpose of this study was to quantitatively examine patellar tendon micro‐ and macromorphology in volleyball athletes and relate those findings to reported symptoms. Longitudinal ultrasound images of proximal and distal patellar tendons were acquired from 84 male elite volleyball athletes (44 symptomatic, 40 asymptomatic) and 10 asymptomatic nonathlete controls. Micromorphology was determined using two‐dimensional Fast Fourier Transform analysis providing a discriminating peak spatial frequency parameter (PSF). Macromorphology (patellar tendon thickness) was measured using Image J software. All athletes regardless of symptoms had thicker proximal tendons compared to nonathletes, suggesting a normal adaptation to training loads. However, symptomatic athletes demonstrated lower PSF than asymptomatic athletes and nonathletes at the proximal tendon, suggesting greater collagen disorganization, and tendon degeneration rather than inflammation. Only symptomatic athletes had thicker distal tendons than nonathletes, but there was no difference in PSF distally. Diagnostic ultrasound enhances the understanding of the micromorphology of patellar tendons, supporting the rationale for management that remodels the degenerated tendon instead of treating inflammation.
Bibliography:istex:6B3170B600897C99878D667DDB1E2D1FD0E9B1CF
ark:/67375/WNG-NC0F8ZZD-9
ArticleID:SMS12021
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Article-2
ObjectType-Feature-1
ISSN:0905-7188
1600-0838
DOI:10.1111/sms.12021