Ultrasound imaging of the patellar tendon attachment to the tibia during puberty: a 12-month follow-up in tennis players.
This longitudinal study investigated the ultrasound appearance of the patellar tendon attachment to the tibia throughout puberty in young tennis players with and without Osgood-Schlatter disease (OSD). Twenty-eight competitive players (17 boys), aged 10.6-15.3 years, had bilateral ultrasound imaging of the patellar tendon attachment to the tibia at baseline and 1 year later. On each occasion, anthropometric measurements, pubertal status and injury history were recorded. Ultrasound appearance of the patellar tendon attachment was categorized into three stages: cartilage attachment, insertional cartilage and mature attachment. Stage 1 appearance, a large anechoic region with or without ossicles and irregularity of the apophysis that are classically associated with OSD, was found in eight players, seven of them were pain free. A majority (62%) of the patellar tendons in stage 1 at baseline progressed toward stage 2 or stage 3 1 year later. Likewise the patellar tendon attachment in most athletes with cartilage insertion showed progression to a mature enthesis over 1 year. The imaging appearance that is classically interpreted as OSD was common in asymptomatic knees. This ultrasonographic description of the patellar tendon attachment to the tibia during growth provides a reference for the assessment of bone tendon attachments in adolescents.
Ducher
G
G
Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Victoria, Australia. gaele.ducher@deakin.edu.au
Cook
J
J
Spurrier
D
D
Coombs
P
P
Ptasznik
R
R
Black
J
J
Bass
S
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D055034:Osteochondrosis / Q000000981:diagnostic imaging*; D017847:Patellar Ligament / Q000000981:diagnostic imaging*; D011627:Puberty; D013715:Tennis; D013977:Tibia / Q000000981:diagnostic imaging*; D014463:Ultrasonography