School of Biomedical Sciences, The University of Queensland, Brisbane, Qld, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.
Scand J Med Sci Sports. 2018 Mar;28(3):1201-1208. doi: 10.1111/sms.12986. Epub 2017 Oct 26.
To compare tendon elastic and structural properties of healthy individuals with those with Achilles or patellar tendinopathy. Sixty-seven participants (22 Achilles tendinopathy, 17 patellar tendinopathy, and 28 healthy controls) were recruited between March 2015 and March 2016. Shear wave velocity (SWV), an index of tissue elastic modulus, and tendon thickness were measured bilaterally at mid-tendon and insertional regions of Achilles and patellar tendons by an examiner blinded to group. Analysis of covariance, adjusted for age, body mass index, and sex was used to compare differences in tendon thickness and SWV between the two tendinopathy groups (relative to controls) and regions. Tendon thickness was included as a covariate for analysis of SWV. Compared to controls, participants with Achilles tendinopathy had lower SWV at the distal insertion (Mean difference MD; 95% CI: -1.56; -2.49 to -0.62 m/s; P < .001) and greater thickness at the mid-tendon (MD 0.19; 0.05-0.33 cm; P = .007). Compared to controls, participants with patellar tendinopathy had higher SWV at both regions (MD 1.25; 0.40-2.10 m/s; P = .005) and greater thickness proximally (MD 0.17; 0.06-0.29 cm; P = .003). Compared to controls, participants with Achilles and patellar tendinopathy displayed lower Achilles tendon elastic modulus and higher patellar tendon elastic modulus, respectively. More research is needed to explore whether maturation, aging, or chronic load underlie these findings and whether current management programs for Achilles and patellar tendinopathy need to be tailored to the tendon.
比较健康人与跟腱或髌腱病患者的跟腱和髌腱弹性及结构特性。2015 年 3 月至 2016 年 3 月期间，招募了 67 名参与者（22 名跟腱病，17 名髌腱病和 28 名健康对照）。一位对分组不知情的检查者使用超声仪分别测量双侧跟腱和髌腱中部和止点区域的剪切波速度（SWV），即组织弹性模量的指标，以及肌腱厚度。采用协方差分析，调整年龄、体重指数和性别，比较两组（相对于对照组）和两个部位的肌腱厚度和 SWV 差异。SWV 的分析包括肌腱厚度作为协变量。与对照组相比，跟腱病患者在远端止点的 SWV 较低（平均差异 MD；95%CI：-1.56；-2.49 至-0.62 m/s；P < 0.001），而在中部的厚度较大（MD 0.19；0.05-0.33 cm；P = 0.007）。与对照组相比，髌腱病患者在两个部位的 SWV 均较高（MD 1.25；0.40-2.10 m/s；P = 0.005），且近端厚度较大（MD 0.17；0.06-0.29 cm；P = 0.003）。与对照组相比，跟腱病和髌腱病患者的跟腱弹性模量降低，髌腱弹性模量升高。需要进一步研究以探讨这些发现是否与成熟、老化或慢性负荷有关，以及目前针对跟腱和髌腱病的管理方案是否需要针对肌腱进行调整。
