Kraszewski Andrew, Harris Kindred, Argentieri Erin, Toresdahl Brett, Drakos Mark, Hillstrom Howard, Allen Answorth, Nwawka O Kenechi
Hospital for Special Surgery, New York, New York, USA.
University of Arizona College of Medicine, Tucson, Arizona, USA.
Orthop J Sports Med. 2024 Sep 6;12(9):23259671241261354. doi: 10.1177/23259671241261354. eCollection 2024 Sep.
The relationship between self-reported symptoms and the severity of patellar tendon abnormality (PTA) as seen on magnetic resonance imaging and ultrasound is unclear, but biomechanical testing may resolve this.
To (1) compare land-jump limb biomechanics between pre- and postseason timepoints, (2) assess whether seasonal changes in biomechanics are associated with seasonal changes in PTA and symptom severity, and (3) explore models that identify seasonal changes in PTA and symptoms with seasonal changes in biomechanics in collegiate basketball players.
Cohort study; Level of evidence, 2.
Victorian Institute of Sport Assessment Scale - Patellar Tendon (VISA-P) scores and bilateral measurements from 18 National Collegiate Athletic Association Division I and II male basketball players (n = 36 limbs) at the preseason (visit 1) and postseason (visit 2) timepoints were collected. PTA was graded with ultrasound and magnetic resonance imaging morphology measurements proximally and distally, and 3-dimensional lower extremity sagittal kinematics and kinetics were measured during a land-jump test. Multivariate and chi-square analyses assessed timepoint differences. The association of seasonal (Δ = visit 2 - visit 1) biomechanics with seasonal morphology (Δ: no change/worsened) and symptoms (Δ: improved/no change/worsened) was tested with multivariate models. Logistic regressions modeled the accuracy of seasonal biomechanics to classify seasonal PTA and symptoms.
Three athletes (6 limbs) at visit 1 and 2 athletes (4 limbs) at visit 2 were symptomatic. VISA-P scores were not significantly different between preseason and postseason. Regarding PTA, multivariate analyses found differences among grouped ground-reaction force variables ( < .05); univariate analyses found that worsened PTA was associated with seasonal decreases in peak vertical jumping force and with seasonal increases in knee flexion velocity at contact and maximum knee flexion velocity ( < .05 for all). Regarding VISA-P scores, multivariate analyses found differences among grouped hip ( < .01) and ankle ( < .05) kinematic variables; univariate analyses found that worsened VISA-P was associated with seasonal increases in hip ( < .01) and knee ( < .01) flexion velocity at contact and seasonal increases in ankle range of motion ( < .05).
The findings demonstrated an association between seasonal changes in dynamic lower extremity biomechanics and seasonal changes in patellar tendon imaging signals as well as self-reported symptoms.
自我报告的症状与磁共振成像和超声检查所见的髌腱异常（PTA）严重程度之间的关系尚不清楚，但生物力学测试可能会解决这一问题。
（1）比较赛季前和赛季后时间点的落地跳跃肢体生物力学；（2）评估生物力学的季节性变化是否与PTA和症状严重程度的季节性变化相关；（3）探索能够识别大学生篮球运动员中PTA和症状的季节性变化与生物力学季节性变化之间关系的模型。
队列研究；证据等级，2级。
收集了18名美国国家大学体育协会第一和第二分区的男性篮球运动员（n = 36条肢体）在赛季前（第1次就诊）和赛季后（第2次就诊）时间点的维多利亚体育评估量表-髌腱（VISA-P）评分及双侧测量数据。通过超声和磁共振成像对PTA进行近端和远端形态学测量，并在落地跳跃测试中测量三维下肢矢状面运动学和动力学。多变量分析和卡方分析评估时间点差异。用多变量模型测试季节性（Δ=第2次就诊-第1次就诊）生物力学与季节性形态（Δ：无变化/恶化）和症状（Δ：改善/无变化/恶化）之间的关联。逻辑回归模型模拟了季节性生物力学对季节性PTA和症状进行分类的准确性。
第1次就诊时有3名运动员（6条肢体）出现症状，第2次就诊时有2名运动员（4条肢体）出现症状。赛季前和赛季后的VISA-P评分无显著差异。关于PTA，多变量分析发现分组地面反作用力变量之间存在差异（P<0.05）；单变量分析发现，PTA恶化与垂直跳跃峰值力的季节性下降以及着地时膝关节屈曲速度和最大膝关节屈曲速度的季节性增加有关（所有P<0.05）。关于VISA-P评分，多变量分析发现分组髋部（P<0.01）和踝部（P<0.05）运动学变量之间存在差异；单变量分析发现VISA-P恶化与着地时髋部（P<0.01）和膝关节（P<0.01）屈曲速度的季节性增加以及踝关节活动范围的季节性增加有关（P<0.05）。
研究结果表明，下肢动态生物力学的季节性变化与髌腱成像信号的季节性变化以及自我报告的症状之间存在关联。
