Doppler ultrasonography of the anterior knee tendons in elite badminton players: colour fraction before and after match

Abstract

Background Anterior knee tendon problems are seldom reported in badminton players although the game is obviously stressful to the lower extremities. Hypotheses Painful anterior knee tendons are common among elite badminton players. The anterior knee tendons exhibit colour Doppler activity. This activity increases after a match. Painful tendons have more Doppler activity than tendons without pain. Study design Cohort study. Methods 72 elite badminton players were interviewed about training, pain and injuries. The participants were scanned with high-end ultrasound equipment. Colour Doppler was used to examine the tendons of 64 players before a match and 46 players after a match. Intratendinous colour Doppler flow was measured as colour fraction (CF). The tendon complex was divided into three loci: the quadriceps tendon, the proximal patellar tendon and the insertion on the tibial tuberosity. Results Interview: Of the 72 players, 62 players had problems with 86 tendons in the lower extremity. Of these 86 tendons, 48 were the anterior knee tendons. Ultrasound: At baseline, the majority of players (87%) had colour Doppler flow in at least one scanning position. After a match, the percentage of the knee complexes involved did not change. CF increased significantly in the dominant leg at the tibial tuberosity; single players had a significantly higher CF after a match at the tibial tuberosity and in the patellar tendon both before and after a match. Painful tendons had the highest colour Doppler activity. Conclusions Most elite badminton players had pain in the anterior knee tendons and intratendinous Doppler activity both before and after match. High levels of Doppler activity were associated with self-reported ongoing pain.

Ultrasound characteristics of the patellar and quadriceps tendons among young elite athletes

“…They concluded that intratendinous blood flow did not predict injury and that the level of intratendinous blood flow more likely represents a physiological response. Previous studies have also shown that there is some degree of color Doppler activity in the tendon after exercise (Boesen et al., ; Malliaras et al., ; Koenig et al., ). In our study, we had no control of the activity level of the athletes even though they did not come directly from training.…”

“…Two ultrasound machines with similar specifications were used for all examinations over the study period (GE Logiq e, 12L‐RS probe and GE Logic Book XP, 12L‐RS probe, GE Vingmed ultrasound AS, Horten, Norway). Recent studies have shown that intratendinous flow can be increased during exercise (Malliaras et al., ; Koenig et al., ), and none of the athletes came straight from training, but we had no information about their activity during the previous 24 h. Ultrasound examination of both the patellar and quadriceps tendon was carried out with the patient supine, with the knee in slight flexion (20°). The quadriceps muscles were relaxed to avoid underestimating color Doppler flow (Koenig et al., ).…”

Treatment of Chronic Tendinopathy with Ultrasound‐Guided Needle Tenotomy and Platelet‐Rich Plasma Injection

“…Further study is required to determine the reliability, sensitivity, specificity, and validity of this scale. Although several neovascularization scales have been published previously [25‐31], including the one used in this study [25], none has been validated. Future studies are required to validate existing or new neovascularization scales.…”

“…Although the neovascularization scale used in this study has been used in previous studies [25], the echotexture and the neovascularization scales used in this study have not been validated. However, to our knowledge, no validated tendon echotexture or neovascularization grading scales exist [25‐31]. Subjects were not charged for the follow‐up diagnostic US examination, and received $30 remuneration for participating in part B of the study.…”

Classification of Tendon Matrix Change Using Ultrasound Imaging: A Systematic Review and Meta-analysis

“…Published full-length research articles in English with the full text available Human participants (male or female) of any age, from any athletic or community background Longitudinal (randomised or non-randomised) or observational (retrospective or prospective) study design Minimum clinical follow-up over 24 h as tendons exhibit an immediate response to load on imaging (Koenig et al 2010;Rosengarten et al 2015) Tendinopathy in any location US as an outcome measure to assess tendon matrix changes (e.g., tendon thickness, echogenicity, collagen organisation, fibrillar pattern, vascularisation) Graded or classified tendinopathy stage using either a nominal or ordinal scale.…”