Park Kyungmi, Keyak Joyce H, Kulig Kornelia, Powers Christopher M
Jacquelin Perry Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA.
Department of Radiological Sciences, Department of Biomedical Engineering, and Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA.
Med Sci Sports Exerc. 2023 Apr 1;55(4):642-649. doi: 10.1249/MSS.0000000000003084. Epub 2022 Nov 17.
This study aimed to compare peak maximum principal stress in the patellar tendon between persons with and without patellar tendinopathy during a simulated single-leg landing task. A secondary purpose was to determine the biomechanical predictor(s) of peak maximum principal stress in the patellar tendon.
Using finite element (FE) modeling, patellar tendon stress profiles of 28 individuals (14 with patellar tendinopathy and 14 pain-free controls) were created at the time of the peak knee extensor moment during single-leg landing. Input parameters to the FE model included subject-specific knee joint geometry and kinematics, and quadriceps muscle forces. Independent t -tests were used to compare the peak maximum principal stress in the patellar tendon and biomechanical variables used as input variables to the FE model (knee flexion, knee rotation in the frontal and transverse planes and the peak knee extensor moment) between groups. A stepwise regression model was used to determine the biomechanical predictor(s) of peak maximum principal stress in the patellar tendon for both groups combined.
Compared with the control group, persons with patellar tendinopathy exhibited greater peak maximum principal stress in the patellar tendon (77.4 ± 25.0 vs 60.6 ± 13.6 MPa, P = 0.04) and greater tibiofemoral joint internal rotation (4.6° ± 4.6° vs 1.1° ± 4.2°, P = 0.04). Transverse plane rotation of the tibiofemoral joint was the best predictor of peak maximum principal stress in the patellar tendon ( r = 0.51, P = 0.01).
Persons with patellar tendinopathy exhibit greater peak patellar tendon stress compared with pain-free individuals during single-leg landing. The magnitude of peak patellar tendon stress seems to be influenced by the amount of tibiofemoral rotation in the transverse plane.
本研究旨在比较髌腱病患者与无髌腱病患者在模拟单腿落地任务期间髌腱的峰值最大主应力。次要目的是确定髌腱峰值最大主应力的生物力学预测指标。
采用有限元（FE）建模，在单腿落地时膝关节伸肌力矩峰值时刻创建了28名个体（14名髌腱病患者和14名无疼痛对照组）的髌腱应力分布。有限元模型的输入参数包括个体特异性膝关节几何形状和运动学，以及股四头肌力量。采用独立t检验比较两组之间髌腱的峰值最大主应力以及作为有限元模型输入变量的生物力学变量（膝关节屈曲、额面和横断面膝关节旋转以及膝关节伸肌力矩峰值）。采用逐步回归模型确定两组合并后髌腱峰值最大主应力的生物力学预测指标。
与对照组相比，髌腱病患者髌腱的峰值最大主应力更大（77.4±25.0 vs 60.6±13.6 MPa，P = 0.04），胫股关节内旋更大（4.6°±4.6° vs 1.1°±4.2°，P = 0.04）。胫股关节横断面旋转是髌腱峰值最大主应力的最佳预测指标（r = 0.51，P = 0.01）。
与无疼痛个体相比，髌腱病患者在单腿落地时髌腱的峰值应力更大。髌腱峰值应力的大小似乎受胫股关节在横断面旋转量的影响。
