Quantitative analysis of patellar tendon size and structure in asymptomatic professional players: sonographic study

Abstract

Background: Ultrasonographic abnormalities of the patellar tendon frequently occur in asymptomatic athletes and it is not always clear whether they precede (and may predict) the development of tendinopathy. Objective: This study aimed to investigate by ultrasonography the prevalence of patellar tendon abnormalities in players of "pallapugno" and to establish whether structural tendon abnormalities predict tendinopathy development. Methods: Ultrasound B-mode images of the patellar tendon of both sides were acquired in fourteen throwers. Qualitative assessments of tendon structure and neovascularization and quantitative assessments of tendon thickness, cross sectional area (CSA), and echo-intensity were performed. Results: Qualitative assessments showed a subclinical tendinopathy of the non-dominant tendon in 5 out of 14 throwers (35% of cases), while quantitative assessments showed abnormalities of the non-dominant tendon in 8 out of 14 players (57% of cases). Echo-intensity and CSA were the quantitative variables most discriminant between asymptomatic players without structural tendon abnormalities and those with tendon abnormalities. Two players (2 out of 8 cases: 25%) developed a clinical tendinopathy after a follow-up of six months. Conclusion: The prevalence of subclinical tendinopathy in the non-dominant patellar tendon of throwers was high. Patellar tendon abnormalities at baseline seem to increase the risk of development of subsequent patellar tendinopathy. Level of evidence: II b (individual cohort study).