title: Factors associated with the presence of patellar tendon abnormalities in male athletes.
abstract: OBJECTIVE
  To investigate the association between lower limb alignment, range of motion/flexibility and muscle strength with the presence of patellar tendon abnormalities in male athletes.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  Thirty-one male basketball and volleyball athletes were assessed for ankle dorsiflexion range of motion, shank-forefoot alignment, iliotibial band flexibility, hip external rotators and abductors isometric torque, passive hip internal rotation range of motion and frontal plane knee and patellar alignment (McConnell and Arno angles). Ultrasonographic evaluations of hypoechoic areas of the patellar tendons were performed in longitudinal and transverse planes. A receiver operating characteristic curve was used to determine clinically relevant cut-off point for each variable. When the area under the curve was statistically significant, Prevalence Ratio (PR) and 95% confidence intervals were calculated to indicate the strength of the association between the independent variable and the presence of patellar tendon abnormalities.
  
  
  RESULTS
  Receiver operating characteristic curve showed that iliotibial band flexibility (p=0.006), shank-forefoot alignment (p=0.013) and Arno angle (p=0.046) were associated with patellar tendon abnormalities. Cut-off points were established and only the Prevalence Ratio of iliotibial band flexibility (cut-off point=-0.02°/kg; PR=5.26) and shank-forefoot alignment (cut-off point=24°; PR=4.42) were statistically significant.
  
  
  CONCLUSIONS
  Athletes with iliotibial band or shank-forefoot alignment above the clinically relevant cut-off point had more chance to have patellar tendon abnormalities compared to athletes under the cut-off point values. These results suggest that such factors could contribute to patellar tendon overload, since patellar tendon abnormalities indicate some level of tissue damage. Both factors might be considered in future prospective studies.
authors.affiliation: Laboratory of Sport Injury Prevention and Rehabilitation (LAPREV) - Universidade Federal de Minas Gerais, Brazil; Departamento de Fisioterapia - Faculdade de Ciências Biológicas e da Saúde - Universidade Federal dos Vales do Jequitinhonha e do Mucuri, Brazil.
authors.forename: Luciana D
authors.initials: LD
authors.lastname: Mendonça
authors.affiliation: Department of Public and Occupational Health, EMGO(+) Institute for Health and Care Research, VU University Medical Center, The Netherlands.
authors.forename: Evert
authors.initials: E
authors.lastname: Verhagen
authors.affiliation: Laboratory of Sport Injury Prevention and Rehabilitation (LAPREV) - Universidade Federal de Minas Gerais, Brazil; Minas Tenis Clube, Brazil.
authors.forename: Natália F N
authors.initials: NF
authors.lastname: Bittencourt
authors.affiliation: Minas Tenis Clube, Brazil.
authors.forename: Gabriela G P
authors.initials: GG
authors.lastname: Gonçalves
authors.affiliation: Laboratory of Sport Injury Prevention and Rehabilitation (LAPREV) - Universidade Federal de Minas Gerais, Brazil; Departamento de Fisioterapia - Escola de Educação Física, Fisioterapia e Terapia Ocupacional - Universidade Federal de Minas Gerais, Brazil.
authors.forename: Juliana M
authors.initials: JM
authors.lastname: Ocarino
authors.affiliation: Laboratory of Sport Injury Prevention and Rehabilitation (LAPREV) - Universidade Federal de Minas Gerais, Brazil; Departamento de Fisioterapia - Escola de Educação Física, Fisioterapia e Terapia Ocupacional - Universidade Federal de Minas Gerais, Brazil. Electronic address: sergioteixeirafonseca@gmail.com.
authors.forename: Sérgio T
authors.initials: ST
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000473:pathology* / Q000503:physiopathology; D001490:Basketball / Q000293:injuries; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D053580:Muscle Strength; D017847:Patellar Ligament / Q000293:injuries / Q000473:pathology* / Q000503:physiopathology; D016059:Range of Motion, Articular; D054798:Volleyball / Q000293:injuries; D055815:Young Adult
keywords: Alignment; Flexibility; Injury; Patellar tendinopathy; Sport; Ultrasonography