青少年芭蕾舞舞者髌腱近端附着点的特征及其与骨骼成熟度的关系。
Characterising the proximal patellar tendon attachment and its relationship to skeletal maturity in adolescent ballet dancers.
作者信息
Rudavsky Aliza, Cook Jillianne, Magnusson Stig Peter, Kjaer Michael, Docking Sean
机构信息
Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
出版信息
Muscles Ligaments Tendons J. 2017 Sep 18;7(2):306-314. doi: 10.11138/mltj/2017.7.2.306. eCollection 2017 Apr-Jun.
BACKGROUND
It is unknown how and when the proximal attachment of the patellar tendon matures; puberty may be key in ensuring normal tendon formation. The aim of this study was to investigate the features of the proximal patellar tendon attachment at different stages of skeletal maturity, to help gain an understanding of how and when the tendon attachment matures.
METHODS
Sixty adolescent elite ballet students (ages 11-18) and eight mature adults participated. Peak height velocity (PHV) estimated skeletal maturity. Ultrasound tissue characterisation (UTC) scan was taken of the left knee and analysed for stability of echopattern. An image-based grading scale for greyscale ultrasound was developed to describe the tendon appearance. Anterior-posterior thickness was measured at the inferior pole of the patella, 1 and 2 centimetres distally. Outcomes were compared with skeletal maturity.
RESULTS
Mid-portion patellar tendon thickness increased with skeletal maturity (p=0.001 at 1 cm and p=0.007 at 2 cm). There was more variance in structural appearance (greyscale classification and UTC echopattern) in pre and peri-PHV participants. Tendon attachment one-year post PHV appeared similar to mature tendons.
CONCLUSIONS
Early adolescence was associated with highly variable tendon appearance, whereas the tendon appeared mature after PHV. Adolescence may be a critical time for the formation of normal tendon attachment.
LEVEL OF EVIDENCE
IIb individual cohort study.
背景
髌腱近端附着点如何以及何时成熟尚不清楚；青春期可能是确保正常肌腱形成的关键时期。本研究旨在调查骨骼成熟不同阶段髌腱近端附着点的特征，以帮助了解肌腱附着点如何以及何时成熟。
方法
60名青少年精英芭蕾舞学生（年龄11 - 18岁）和8名成年人参与研究。通过峰值身高速度（PHV）评估骨骼成熟度。对左膝进行超声组织特征（UTC）扫描，并分析回声模式的稳定性。开发了一种基于图像的灰度超声分级量表来描述肌腱外观。在髌骨下极、其远侧1厘米和2厘米处测量前后厚度。将结果与骨骼成熟度进行比较。
结果
髌腱中部厚度随骨骼成熟度增加（1厘米处p = 0.001，2厘米处p = 0.007）。在PHV前和PHV期间的参与者中，结构外观（灰度分类和UTC回声模式）的差异更大。PHV后一年的肌腱附着点与成熟肌腱相似。
结论
青春期早期肌腱外观变化很大，而在PHV后肌腱看起来成熟。青春期可能是正常肌腱附着点形成的关键时期。
证据水平
IIb级个体队列研究。
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