Challenging the assumption of uniformity in patellar tendon structure: Regional patellar tendon morphology and mechanical properties in vivo

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Author(s)Ito, Naoaki
Author(s)Scattone Silva, Rodrigo
Author(s)Sigurðsson, Haraldur B.
Author(s)Cortes, Daniel H.
Author(s)Silbernagel, Karin Grävare
Date Accessioned2023-05-16T18:54:11Z
Date Available2023-05-16T18:54:11Z
Publication Date2023-04-08
DescriptionThis is the peer reviewed version of the following article: Ito, N, Scattone Silva, R, Sigurðsson, HB, Cortes, DH, Silbernagel, KG. Challenging the assumption of uniformity in patellar tendon structure: regional patellar tendon morphology and mechanical properties in vivo. J Orthop Res. 2023; 1- 6. doi:10.1002/jor.25563, which has been published in final form at https://doi.org/10.1002/jor.25563. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. This article will be embargoed until 04/08/2024.
AbstractPatellar tendons are assumed to be uniform in morphology and mechanical properties despite a higher prevalence of tendinopathies observed in the medial region. The purpose of this study was to compare the thickness, length, viscosity, and shear modulus of the medial, central, and lateral regions of healthy patellar tendons of young males and females in vivo. B-mode ultrasound and continuous shear wave elastography were performed on 35 patellar tendons (17 females, 18 males) over three regions of interest. A linear mixed-effects model (α = 0.05) was used to determine differences between the three regions and sexes followed by pairwise comparisons for significant findings. The lateral region (mean [95% confidence interval] = 0.34 [0.31–0.37] cm) was thinner compared with the medial (0.41 [0.39–0.44] cm, p < 0.001), and central (0.41 [0.39–0.44] cm, p < 0.001) regions regardless of sex. Viscosity was lower in the lateral (19.8 [16.9–22.7] Pa-s) versus medial region (27.4 [24.7–30.2] Pa-s, p = 0.001). Length had a region-by-sex interaction (p = 0.003) characterized by a longer lateral (4.83 [4.54–5.13] cm) versus medial (4.42 [4.12–4.72] cm) region in males (p < 0.001), but not females (p = 0.992). Shear modulus was uniform between regions and sexes. The thinner, and less viscous lateral patellar tendon may reflect the lower load the tendon experiences explaining the differences in regional prevalence of developing tendon pathology. Statement of Clinical Significance: Healthy patellar tendons are not uniform in morphology or mechanical properties. Considering regional tendon properties may help guide targeted interventions for patellar tendon pathologies.
SponsorFunding was provided by the National Institute of Health (NIH), including the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development: R37-HD037985, R01-AR072034. The project described was also supported by the American Academy of Sports Physical Therapy Legacy Fund. The content is solely the responsibility of the authors and does not represent the official views of the American Academy of Sports Physical Therapy. Naoaki Ito's work was supported in part by the Rheumatology Research Foundation.
CitationIto, N, Scattone Silva, R, Sigurðsson, HB, Cortes, DH, Silbernagel, KG. Challenging the assumption of uniformity in patellar tendon structure: regional patellar tendon morphology and mechanical properties in vivo. J Orthop Res. 2023; 1- 6. doi:10.1002/jor.25563
ISSN1554-527X
URLhttps://udspace.udel.edu/handle/19716/32756
Languageen_US
PublisherJournal of Orthopaedic Research
Keywordsanterior cruciate ligament
Keywordselastography
Keywordsmusculoskeletal modeling
Keywordstendinopathy
Keywordsultrasound
TitleChallenging the assumption of uniformity in patellar tendon structure: Regional patellar tendon morphology and mechanical properties in vivo
TypeArticle
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