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Observational Study
. 2019 Dec;54(12):1280-1286.
doi: 10.4085/1062-6050-285-17. Epub 2019 Sep 4.

Lower Limb Dominance, Morphology, and Sonographic Abnormalities of the Patellar Tendon in Elite Basketball Players: A Cross-Sectional Study

Josep C Benítez-Martínez  1 , Fermín Valera-Garrido  2 , Pablo Martínez-Ramírez  3 , José Ríos-Díaz  4 , María Elena Del Baño-Aledo  5 , Francesc Medina-Mirapeix  5
Affiliations
Observational Study

Lower Limb Dominance, Morphology, and Sonographic Abnormalities of the Patellar Tendon in Elite Basketball Players: A Cross-Sectional Study

Josep C Benítez-Martínez et al. J Athl Train. 2019 Dec.

Abstract

Context: Patellar tendinopathy is common in basketball players, and structural ultrasound abnormalities can be found in symptomatic and asymptomatic tendons. Lower limb dominance may also be a critical load factor, potentially leading to overloading of the patellar tendon.

Objective: To describe and compare the prevalence by lower limb dominance of patellar tendons with structural and vascular abnormalities and to describe the morphologic measures of tendons without abnormalities among adult male elite basketball players.

Design: Cross-sectional study.

Setting: Medical center of a professional basketball team in the Spanish league.

Patients or other participants: A total of 73 adult male elite basketball players (146 patellar tendons; age = 26.8 ± 4.9 years, height = 198.0 ± 0.1 cm, mass = 95.4 ± 11.4 kg).

Main outcome measure(s): We used ultrasound to screen the patellar tendons for the presence of structural and vascular abnormalities. Tendons were categorized as abnormal if they demonstrated a focal area of hypoechogenicity, thickening, or neovascularization. We also examined the cross-sectional area and thickness of tendons without abnormalities. Prevalence and morphologic measures were compared by limb dominance.

Results: A total of 35 players (48%) had bilateral abnormalities, whereas 21 (28.7%) had unilateral abnormalities. Among the 91 abnormal tendons, 90 (61.6% of 146 tendons) exhibited a focal area of hypoechogenicity, 59 (40.4% of 146 tendons) exhibited thickening, and 14 (9.6% of 146 tendons) exhibited neovascularization. No group differences were detected between the dominant and nondominant limbs. Among the 55 normal patellar tendons, 34 were bilateral (from 17 players) and 21 were unilateral. Approximately 25% (n = 14) of all 55 normal tendons had a cross-sectional area that was greater than 182.8 mm2 and a thickness greater than 7.2 mm. Among the 34 bilateral normal tendons, no group differences were observed between the dominant and nondominant limbs for either cross-sectional area or thickness.

Conclusions: The prevalence of abnormal tendons was high among adult male elite basketball players, and bilateral presentations were more frequent. Structural abnormalities were most common.

Keywords: lower extremity; pain; tendon injury; ultrasonography.

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Figures

Figure 1
Figure 1
Morphologic measures in an ultrasonographic image of a tendon without abnormalities. A, Longitudinal view to measure thickness. B, Cross-sectional view and cross-sectional area delimited by semiautomatic adaptive contours.
Figure 2
Figure 2
Sonographic images of tendon assessments. A, Transverse scan shows tendon with focal area of hypoechogenicity (FAH). B, Longitudinal scan shows tendon with FAH and thickening. C, Transverse scan shows tendon with FAH and thickening. D, Longitudinal view shows tendon with FAH, thickening, and neovascularization.
See this image and copyright information in PMC

References

    1. Lian OB, Engebretsen L, Bahr R. Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med. 2005;33(4):561–567. - PubMed
    1. Kregel J, van Wilgen P, Zwerver J. Pain assessment in patellar tendinopathy using pain pressure threshold algometry: an observational study. Pain Med. 2013;14(11):1769–1775. - PubMed
    1. Malliaras P, Kamal B, Nowell A, et al. Patellar tendon adaptation in relation to load-intensity and contraction type. J Biomech. 2013;46(11):1893–1899. - PubMed
    1. Malliaras P, Voss C, Garau G, Richards P, Maffuli N. Achilles tendon shape and echogenicity on ultrasound among active badminton players. Scand J Med Sci Sports. 2012;22(2):149–155. - PubMed
    1. Cook JL, Malliaras P, De Luca J, Ptasznik R, Morris ME, Neovascularization Goldie P. and pain in abnormal patellar tendons of active jumping athletes. Clin J Sport Med. 2004;14(5):296–299. - PubMed

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