Slane Laura C, Bogaerts Stijn, Thelen Darryl G, Scheys Lennart
1 KU Leuven.
2 University Hospitals Leuven.
J Appl Biomech. 2018 Feb 1;34(1):14-22. doi: 10.1123/jab.2017-0067. Epub 2018 Jan 26.
The purpose of this study was to evaluate localized patterns of patellar tendon deformation during passive knee flexion. Ultrasound radiofrequency data were collected from the patellar tendons of 20 healthy young adults during knee flexion over a range of motion of 50°-90° of flexion. A speckle tracking approach was used to compute proximal and distal tendon displacements and elongations. Nonuniform tissue displacements were visible in the proximal tendon (P < .001), with the deep tendon undergoing more distal displacement than the superficial tendon. In the distal tendon, more uniform tendon motion was observed. Spatial variations in percent elongation were also observed, but these varied along the length of the tendon (P < .002), with the proximal tendon remaining fairly isometric while the distal tendon underwent slight elongation. These results suggest that even during passive flexion the tendon undergoes complex patterns of deformation. Proximal tendon nonuniformity may arise from its complex anatomy where the deep tendon inserts onto the patella and the superficial tendon extends to the quadriceps tendon. Such heterogeneity is not captured in whole tendon average assessments, emphasizing the relevance of considering localized tendon mechanics, which may be key to understanding tendon behavior and precursors to injury and disease.
本研究的目的是评估被动膝关节屈曲过程中髌腱的局部变形模式。在20名健康年轻成年人的膝关节从50°至90°屈曲的运动范围内进行屈曲时，收集其髌腱的超声射频数据。采用散斑跟踪方法计算肌腱近端和远端的位移及伸长情况。在肌腱近端可见不均匀的组织位移（P < .001），深层肌腱比浅层肌腱有更多的远端位移。在肌腱远端，观察到更均匀的肌腱运动。还观察到伸长百分比的空间变化，但这些变化沿肌腱长度而异（P < .002），近端肌腱保持相当等长，而远端肌腱有轻微伸长。这些结果表明，即使在被动屈曲过程中，肌腱也会经历复杂的变形模式。近端肌腱的不均匀性可能源于其复杂的解剖结构，即深层肌腱附着于髌骨，而浅层肌腱延伸至股四头肌肌腱。这种异质性在整个肌腱平均评估中未被捕捉到，强调了考虑局部肌腱力学的相关性，这可能是理解肌腱行为以及损伤和疾病先兆的关键。
