Centre for Sports and Exercise Medicine, Queen Mary, University of London, Mile End Hospital, London, UK.
Br J Sports Med. 2011 Oct;45(13):1048-51. doi: 10.1136/bjsm.2010.082180. Epub 2011 May 2.
A continuum of pathological ultrasound patellar tendon changes from normal tendons, followed by diffuse and then focal change in echogenicity has been proposed. The anteroposterior (AP) diameter of each pathological state and whether change in pathological state is accompanied by change in AP diameter are not known. The aims of this study were to (1) investigate the AP diameter of previously described patellar tendon ultrasound groups (normal, diffuse and focal change in echogenicity) and (2) investigate the change in AP diameter among active volleyball players during a season and whether this corresponds with change in ultrasound group.
The grey-scale ultrasound pathological groups (normal, diffuse, focal) and AP diameter were measured among 102 volleyball players at the beginning of a season and 58 volleyball players at 6 one-monthly intervals during a 5-month indoor season.
There was a significant ordinal relationship (analysis of variance, Student-Neuman-Keuls post hoc test, p < 0.05) between AP diameter and normal tendons, diffuse and focally abnormal tendons among men (3.4 ± 0.4, 4.9 ± 0.4, 6.5 ± 1.8 mm) and women (3.2 ± 0.4, 4.2 ± 0.4, 4.6 ± 0.7 mm). Tendons that stayed in the same group tended to have a smaller mean change than tendons that changed group.
These findings support the proposed continuum of tendon pathology. Mild patellar tendon thickening (>4.2 mm among men, >4 mm among women) may indicate pathology among active athletes.
从正常肌腱开始,病理超声髌腱变化呈现出一系列连续的改变,随后出现弥漫性和局灶性回声改变。每种病理状态的前后径(AP)以及病理状态的改变是否伴有 AP 直径的改变尚不清楚。本研究的目的是:(1)研究先前描述的髌腱超声组(正常、弥漫性和局灶性回声改变)的 AP 直径,(2)研究活跃排球运动员在一个赛季中的 AP 直径变化,以及这是否与超声组的变化相对应。
在一个赛季开始时,对 102 名排球运动员和 58 名排球运动员在 5 个月的室内赛季中进行了 6 次每月 1 次的随访,测量了灰阶超声病理组(正常、弥漫性、局灶性)和 AP 直径。
男性(3.4±0.4、4.9±0.4、6.5±1.8mm)和女性(3.2±0.4、4.2±0.4、4.6±0.7mm)的 AP 直径与正常肌腱、弥漫性和局灶性异常肌腱之间存在显著的有序关系(方差分析,Student-Neuman-Keuls 事后检验,p<0.05)。留在同一组的肌腱平均变化较小,而改变组的肌腱平均变化较大。
这些发现支持了肌腱病理的连续变化假说。轻度髌腱增厚(男性>4.2mm,女性>4mm)可能表明活跃运动员存在病理改变。