Siev-Ner Itzhak, Stern Myriam D, Tenenbaum Shay, Blankstein Alexander, Zeev Aviva, Steinberg Nili
a Orthopedic Rehabilitation Department , Sheba Medical Center , Tel-Hashomer , Israel.
b Department of Radiology , Sheba Medical Center, Sackler School of Medicine , Tel Aviv University , Israel.
Phys Sportsmed. 2018 Feb;46(1):48-55. doi: 10.1080/00913847.2018.1391048. Epub 2017 Oct 20.
To identify whether a physical examination for patello-femoral pain (PFP) is related to ultrasonography findings at the knee, and to identify possible factors related to PFP in young dancers.
Sixty-seven young female dancers (7th grade, aged 12.8 ± 0.5) from three schools with identical special dance programs were included in the study. All the dancers were interviewed for demographic details, dance background, and training intensity; were evaluated for anthropometric measurements; underwent physical examination of both knees for PFP and for knee range of motion (ROM); and, had ultrasonography assessment for pathologies and of anatomical parts of their knees.
PFP was found in 54.5% of the 134 knees physically examined. In ultrasonography assessment, infra-articular effusion was found in 46.2% of the knees examined. H/week of dance practice was significantly higher among dancers with PFP (in both knees) compared with dancers with no PFP (p < .05). Knees with PFP had a significantly higher prevalence of intra articular effusion (p = .018) and higher prevalence of genu-recurvatum (p = .042). Knees with PFP had significantly greater growth plate width-anterior tibial tuberosity (p = .022) and a greater bony trochlear groove angle (p = .048).
This study describes the relationship between physical examination for PFP and the sonographic findings, and the factors related to knee injuries. The results showed a high prevalence of PFP and intra articular knee effusion among young dancers at the age of 12-13 years; and, that the number of hours of practice and anatomical structure are related to PFP. Our results should alert physicians, physiotherapists, athletic trainers and dance teachers to the need for devising modifications of training and injury prevention strategies from a young age (<12 years old).
确定髌股疼痛(PFP)的体格检查是否与膝关节超声检查结果相关,并确定年轻舞者中与PFP相关的可能因素。
来自三所具有相同特殊舞蹈项目学校的67名年轻女性舞者(七年级,年龄12.8±0.5岁)纳入本研究。所有舞者均接受了关于人口统计学细节、舞蹈背景和训练强度的访谈;进行了人体测量评估;对双膝进行了PFP体格检查和膝关节活动范围(ROM)评估;并对其膝关节的病理情况和解剖部位进行了超声检查评估。
在接受体格检查的134个膝关节中,54.5%发现有PFP。在超声检查评估中,46.2%的受检膝关节发现有关节内积液。与无PFP的舞者相比,有PFP的舞者(双膝)每周舞蹈练习时间显著更高(p<0.05)。有PFP的膝关节关节内积液患病率显著更高(p=0.018),膝反屈患病率更高(p=0.042)。有PFP的膝关节生长板宽度-胫骨结节前方显著更大(p=0.022),骨滑车沟角度更大(p=0.048)。
本研究描述了PFP体格检查与超声检查结果之间的关系,以及与膝关节损伤相关的因素。结果显示,12 - 13岁的年轻舞者中PFP和膝关节内积液的患病率很高;并且,练习时长和解剖结构与PFP相关。我们的结果应提醒医生、物理治疗师、运动训练师和舞蹈教师,需要从年轻时(<12岁)就制定训练调整和损伤预防策略。