title: Relationship between the skeletal maturation of the distal attachment of the patellar tendon and physical features in preadolescent male football players.
abstract: OBJECTIVE
  The aim of this study was to compare ultrasonography stages of the tibial tuberosity development and physical features.
  
  
  METHODS
  This study examined 200 knees in 100 male football players aged 10-15 years. Tibial tuberosity development on ultrasonography was divided into 3 stages: Sonolucent stage (stage S), Individual stage (stage I), and Connective stage (stage C). Age, height, quadriceps and hamstring muscle tightness, and muscle strength in knee extension and flexion were determined. These findings were compared with the respective stages of development.
  
  
  RESULTS
  The tibial tuberosity was stage S in 27 knees, stage I in 69 knees, and stage C in 104 knees, with right and left sides at the same stage in 95 %. Average age and height significantly increased with advancing tibial tuberosity development. Quadriceps tightness increased with tibial tuberosity development. Hamstring tightness decreased with development. The strength of both knee extension and flexion increased with advancing development, with a greater change seen in knee extension, hamstring/quadriceps ratio: stage C, 0.74; stage A, 0.64; stage E, 0.53.
  
  
  CONCLUSIONS
  Osgood-Schlatter pathogenesis reportedly involves increased quadriceps tightness with rapidly increasing femoral length during tibial tuberosity development. In this study, it was confirmed that quadriceps tightness increased, yet hamstring tightness decreased, suggesting that quadriceps tightness is not due to femoral length alone. Other factors, including muscle strength, may be involved. The study shows that thigh muscle tightness and thigh muscle performance change with the skeletal maturation of the distal attachment of the patellar tendon. These results add new information to the pathogenesis of Osgood-Schlatter disease.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan, nakase1007@yahoo.co.jp.
authors.forename: Junsuke
authors.initials: J
authors.lastname: Nakase
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Aiba
authors.forename: Kenichi
authors.initials: K
authors.lastname: Goshima
authors.forename: Ryohei
authors.initials: R
authors.lastname: Takahashi
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Toratani
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kosaka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D002648:Child; D005538:Football / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000502:physiology; D008297:Male; D024510:Muscle Development / Q000502:physiology*; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000254:growth & development* / Q000503:physiopathology; D055034:Osteochondrosis / Q000209:etiology / Q000503:physiopathology; D017847:Patellar Ligament / Q000502:physiology; D016059:Range of Motion, Articular; D012916:Soccer; D013710:Tendons / Q000503:physiopathology; D013848:Thigh / Q000502:physiology; D013977:Tibia / Q000000981:diagnostic imaging*; D014463:Ultrasonography