title: The prevalence of patellar tendinopathy in elite academy rugby: a clinical and imaging study.
abstract: OBJECTIVE
  Patellar tendinopathy (PT) is a challenging condition with variable outcomes. It is not commonly reported in rugby. This study was undertaken to evaluate the prevalence of PT in elite academy rugby.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Members of the rugby academies in Ireland were evaluated using blinded, standardised clinical examination, self reported questionnaires and ultrasound. Anthropometrics were examined, body mass and fat% were measured by bio-impedance. The Cincinnati Sports Activity Scale, established activity levels. The VISA-P scale evaluated symptoms. Ultrasound examination established tendon thickness, echogenicity and homogeneity including focal areas of tendinopathy in both transverse and longitudinal planes. Studies were reviewed and graded by two musculoskeletal radiologists. Statistical analysis was performed using PASW 18 and CIA software. Significance was set at p<.05.
  
  
  RESULTS
  Thirty individuals (36.1%) had US abnormalities identified with 38 abnormal tendons. The abnormalities seen were microcalculi (44.7%; N=17), thickened tendons ± large areas of cystic degenerative change (26.3%) and macrocalculi or large hypoechoic areas (28.9%; N=11). Eleven individuals (13.3%) fulfilled the clinical diagnosis of PT based on clinical examination. Combining both US and clinical the prevalence of PT in this cohort was 9.6% (N=8). There was a statistically significant difference between the prevalence of patellar tendinopathy based upon US findings (p=.027) and the combination of both clinical examination and US (p=.044) in different training academies.
  
  
  CONCLUSIONS
  This work shows that PT is a relatively common injury in elite academy rugby players and that training practices may contribute to its development.
authors.affiliation: St James's Hospital, Dublin, Ireland. Electronic address: laurajanedurcan@hotmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Durcan
authors.affiliation: Munster Rugby, Musgrave Park, Ballyphehane, Co. Cork, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Coole
authors.affiliation: St James's Hospital, Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: McCarthy
authors.affiliation: St James's Hospital, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Johnston
authors.affiliation: Ulster Rugby, Belfast, Co Antrim, Northern Ireland, United Kingdom.
authors.forename: M J
authors.initials: MJ
authors.lastname: Webb
authors.affiliation: St James's Hospital, Dublin, Ireland.
authors.forename: F D
authors.initials: FD
authors.lastname: O'Shea
authors.affiliation: St Mary's University College, Twickenham, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Gissane
authors.affiliation: School of Physiotherapy, Trinity College, Dublin, Ireland.
authors.forename: F
authors.initials: F
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D002137:Calculi / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005538:Football / Q000293:injuries*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000293:injuries*; D010808:Physical Examination; D015995:Prevalence; D012574:Schools; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000453:epidemiology*; D014463:Ultrasonography; D055815:Young Adult
keywords: Patellar tendinopathy; Rugby; Sports injury