Abstract
Imaging findings in patellar tendinopathy are questioned. The aim of this pilot study was to characterize ultrasound measures, by calculating ultrasound ratio and neovascularization of the patellar tendon in non-elite sport players with unilateral painful patellar tendinopathy. Cross-sectional area (CSA), width, and thickness of the patellar tendon were assessed bilaterally in 20 non-elite sport-players with unilateral painful patellar tendinopathy and 20 asymptomatic controls by a blinded assessor. Ultrasound ratios were calculated to discriminate between symptomatic and asymptomatic knees. The Ohberg score was used for characterizing neovascularization. We found that non-elite sport players with patellar tendinopathy exhibited bilateral increases in CSA, width, and thickness of the patellar tendon compared to asymptomatic controls (Cohen d > 2). The ability of ultrasound ratios to discriminate between painful and non-painful patellar tendons was excellent (receiver operating characteristic, ROC > 0.9). The best diagnostic value (sensitivity: 100% and specificity: 95%) was observed when a width ratio ≥ 1.29 between the symptomatic and asymptomatic patellar tendon was used as a cut-off. Further, neovascularization was also observed in 70% of non-elite sport players with unilateral patellar tendinopathy. A greater CSA ratio was associated with more related-disability and higher tendon neovascularization. This study reported that non-elite sport players with painful unilateral patellar tendinopathy showed structural ultrasound changes in the patellar tendon when compared with asymptomatic controls. Ultrasound ratios were able to discriminate between symptomatic and asymptomatic knees. Current results suggest that ultrasound ratios could be a useful imaging outcome for identifying changes in the patellar tendon in sport players with unilateral patellar tendinopathy.
Highlights
Tendinopathy can occur in tendons that receive excessive loads and can result in considerable pain and disability [1]
Ultrasound painful patellar tendinopathy; (3) the presence of neovascularization is associated with worse ratiosultrasound will discriminate between painful and knees4,in individuals painful gross imaging measures andnon-painful ratios; and ultrasound with ratios andpatellar tendon tendinopathy; (3)
TwentyTwenty (n = 20)(nnon-elite non-elite sport players with a diagnosis of unilateral painful patellar tendinopathy referred to a physical sport players with a diagnosis of unilateral painful patellar tendinopathy referred to a physical therapy clinicby bytheir theirsports sports physician physician were between
Summary
José L. Arias-Buría 1,2 , César Fernández-de-las-Peñas 1,2, * , Jorge Rodríguez-Jiménez 1,2 , Gustavo Plaza-Manzano 3,4 , Joshua A. Cleland 5 , Gracia M. Gallego-Sendarrubias 6 and Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, 28040 Madrid, Spain Received: 24 September 2020; Accepted: 27 October 2020; Published: 29 October 2020
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