Onambélé Gladys N L, Burgess Katherine, Pearson Stephen J
Institute of Biophysical and Clinical Research into Human Movement, Department of Exercise & Sport Sciences, Manchester Metropolitan University, Hassall Road, Alsager ST7 2HL, United Kingdom.
J Orthop Res. 2007 Dec;25(12):1635-42. doi: 10.1002/jor.20404.
Human patellar tendon stress (sigma), strain (epsilon), stiffness (K), and tensile or Young's modulus (E), are determined in vivo through voluntary isometric contractions monitored with B-mode ultrasonography. The limitations in previous studies are: (1) they have generally not accounted for the fact that the distal attachment of the patellar tendon (the tibial tuberosity) also displaces; thus, they have underestimated epsilon (and, hence, injury risk) while overestimating K; (2) no gender effect has been studied despite the fact that females are seen to have higher incidences of tendon-related injuries. The current investigation therefore aimed to determine the gender specific values of sigma, epsilon, K, and E of the patellar tendon while also accounting for distal displacement of the patellar tendon. Healthy young males (aged 23.1 +/- 1.3 years, n = 10) and females (aged 21.3 +/-0.9 years, n = 10) were tested. The maximal epsilon of the young males was approximately 5-10% higher than that reported in earlier literature. Average female versus male values for epsilon, sigma, K, and E, taken at the same force level as the males for comparison purposes, were respectively 10.6 +/- 1.0 versus 9.0 +/- 1.0%, 36.9 +/- 1.4 versus 28.9 +/- 0.9 MPa, 1053 +/- 108 versus 1652 +/- 216 N x mm(-1), and 0.61 +/- 0.08 versus 0.68 +/- 0.10 GPa (p < 0.05). There are gender differences in tendon structural and mechanical properties. The current methodology may be useful in a clinical context where early prediction of injury risk and/or monitoring of reconstructed tendon needs to be an accurate, objective, and reliable method if optimal functionality is to be achieved.
通过B型超声监测的自愿等长收缩，在体内测定人体髌腱应力（σ）、应变（ε）、刚度（K）和拉伸模量或杨氏模量（E）。以往研究的局限性在于：（1）它们通常没有考虑到髌腱远端附着点（胫骨结节）也会移位这一事实；因此，它们低估了ε（进而低估了受伤风险），同时高估了K；（2）尽管女性肌腱相关损伤的发生率较高，但尚未研究性别效应。因此，本研究旨在确定髌腱的σ、ε、K和E的性别特异性值，同时考虑髌腱的远端移位。对健康的年轻男性（年龄23.1±1.3岁，n = 10）和女性（年龄21.3±0.9岁，n = 10）进行了测试。年轻男性的最大ε比早期文献报道的值高约5 - 10%。为了进行比较，在与男性相同的力水平下获取的女性与男性ε、σ、K和E的平均值分别为10.6±1.0% 对 9.0±1.0%、36.9±1.4 MPa对28.9±0.9 MPa、1053±108 N·mm⁻¹对1652±216 N·mm⁻¹、0.61±0.08 GPa对0.68±0.10 GPa（p < 0.05）。肌腱的结构和力学性能存在性别差异。如果要实现最佳功能，当前的方法在临床环境中可能有用，在这种环境中，损伤风险的早期预测和/或重建肌腱的监测需要一种准确、客观且可靠的方法。
