Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA.
Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.
J Orthop Res. 2023 Oct;41(10):2232-2237. doi: 10.1002/jor.25563. Epub 2023 Apr 8.
Patellar tendons are assumed to be uniform in morphology and mechanical properties despite a higher prevalence of tendinopathies observed in the medial region. The purpose of this study was to compare the thickness, length, viscosity, and shear modulus of the medial, central, and lateral regions of healthy patellar tendons of young males and females in vivo. B-mode ultrasound and continuous shear wave elastography were performed on 35 patellar tendons (17 females, 18 males) over three regions of interest. A linear mixed-effects model (α = 0.05) was used to determine differences between the three regions and sexes followed by pairwise comparisons for significant findings. The lateral region (mean [95% confidence interval] = 0.34 [0.31-0.37] cm) was thinner compared with the medial (0.41 [0.39-0.44] cm, p < 0.001), and central (0.41 [0.39-0.44] cm, p < 0.001) regions regardless of sex. Viscosity was lower in the lateral (19.8 [16.9-22.7] Pa-s) versus medial region (27.4 [24.7-30.2] Pa-s, p = 0.001). Length had a region-by-sex interaction (p = 0.003) characterized by a longer lateral (4.83 [4.54-5.13] cm) versus medial (4.42 [4.12-4.72] cm) region in males (p < 0.001), but not females (p = 0.992). Shear modulus was uniform between regions and sexes. The thinner, and less viscous lateral patellar tendon may reflect the lower load the tendon experiences explaining the differences in regional prevalence of developing tendon pathology. Statement of Clinical Significance: Healthy patellar tendons are not uniform in morphology or mechanical properties. Considering regional tendon properties may help guide targeted interventions for patellar tendon pathologies.
尽管内侧区域观察到的腱病发病率较高，但髌腱在形态和力学性能上被认为是均匀的。本研究的目的是比较年轻男性和女性健康髌腱的内侧、中央和外侧区域的厚度、长度、粘度和剪切弹性模量。对 35 个髌腱（17 名女性，18 名男性）的三个感兴趣区域进行了 B 型超声和连续剪切波弹性成像。使用线性混合效应模型（α = 0.05）确定三个区域和性别之间的差异，然后对有显著意义的发现进行两两比较。与内侧（0.41 [0.39-0.44] cm，p < 0.001）和中央（0.41 [0.39-0.44] cm，p < 0.001）区域相比，外侧区域（平均值[95%置信区间] = 0.34 [0.31-0.37] cm）较薄，与性别无关。外侧（19.8 [16.9-22.7] Pa-s）的粘度低于内侧（27.4 [24.7-30.2] Pa-s，p = 0.001）。长度具有区域与性别相互作用（p = 0.003），其特征是男性的外侧（4.83 [4.54-5.13] cm）比内侧（4.42 [4.12-4.72] cm）更长（p < 0.001），而女性则没有（p = 0.992）。剪切弹性模量在区域和性别之间是均匀的。更薄、粘性更低的外侧髌腱可能反映了腱所承受的较低负荷，这解释了区域腱病发病率的差异。临床意义的陈述：健康的髌腱在形态或力学性能上并不均匀。考虑区域腱特性可能有助于指导髌腱病变的靶向干预。
