Mechanical properties of the patellar tendon in adults and children

O’Brien, Thomas D.; Reeves, Neil D.; Baltzopoulos, Vasilios; Jones, David A.; Maganaris, Constantinos N.

doi:10.1016/j.jbiomech.2009.11.028

Cited by 153 publications

(168 citation statements)

References 58 publications

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“…However, decreased tissue elasticity and increased stiffness have been reported in connection with age in relation to ligaments and tendons [31][32][33]. Older age could thus be one of the explanations of decreased risk of recurrent dislocation [34].…”

Section: Discussionmentioning

confidence: 99%

Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

Lubiatowski

Długosz

Ślęzak

et al. 2016

International Orthopaedics (SICOT)

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Purpose The evaluation of glenohumeral joint volume in both unstable (with/without laxity) and stable shoulders (subacromial impingement) and volume reduction potential of arthroscopic techniques: (labral anchor repair vs. capsular shift). Methods Material was based on 133 patients: anterior shoulder instability without laxity (group I, n = 49), with laxity (group II, n = 22) and subacromial impingement (control group, n = 62) operated in 2010-2011. Group I received arthroscopic Bankart repair, group; II -arthroscopic anterior capsular plication, control group -subacromial decompression. Joint volume was measured by fluid aspiration into the syringe via arthroscope, before and after procedure. Then volume reduction potential was calculated. Results The following average values of initial joint volume were recorded: group I -26.8 ml group II -43.7 ml and the control group -25.6 ml with significant differences: impingement vs. instability + laxity (p < 0.00001), impingement vs. instability without laxity (p = 0.0001). There was no significant difference between groups I and II. Joint volume was significantly reduced after labral repair (by average of 37 %, 13.8 ml, p < 0.0001). Capsular shift led to an even greater and more significant volume decrease (61 %, 26.7 ml, p < 0.001). Joint volume in the control group was reduced only by 11 %, 3.8 ml (p = 0.046).Conclusions Patients with unstable shoulders have enlarged joint volume as compared to patients with subacromial impingement. Arthroscopic techniques lead to a significant joint volume reduction, with the most powerful effect for capsular shift. Level of Evidence -Level 2.

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Section: Discussionmentioning

confidence: 99%

Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

Lubiatowski

Długosz

Ślęzak

et al. 2016

International Orthopaedics (SICOT)

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“…Ultrasound studies reported that patellar tendon strain during in vivo isometric knee extension at 908 of flexion was within 7%. 13,26 DeFrate et al 18 reported patellar tendon elongation during in vivo weight-bearing knee flexion from 08 to 1108, where the patellar tendon increased its length from 50 to 56 mm in the central portion. Gejo et al 17 used foil strain gages to measure tendon strain during intra-operative passive flexion from 458 to 1358, and found that the maximum strain was within 300 microstrain at 1358.…”

Section: Discussionmentioning

confidence: 99%

In‐vivo patellar tendon kinematics during weight‐bearing deep knee flexion

Kobayashi

Sakamoto

Hosseini

et al. 2012

Journal Orthopaedic Research

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This study quantified in-vivo 3D patellar tendon kinematics during weight-bearing deep knee bend beyond 1508. Each knee was MRI scanned to create 3D bony models of the patella, tibia, femur, and the attachment sites of the patellar tendon on the distal patella and the tibial tubercle. Each attachment site was divided into lateral, central, and medial thirds. The subjects were then imaged using a dual fluoroscopic image system while performing a deep knee bend. The knee positions were determined using the bony models and the fluoroscopic images. The patellar tendon kinematics was analyzed using the relative positions of its patellar and tibial attachment sites. The relative elongations of all three portions of the patellar tendon increased similarly up to 608. Beyond 608, the relative elongation of the medial portion of the patellar tendon decreased as the knee flexed from 608 to 1508 while those of the lateral and central portions showed continuous increases from 1208 to 1508. At 1508, the relative elongation of the medial portion was significantly lower than that of the central portion. In four of seven knees, the patellar tendon impinged on the tibial bony surface at 1208 and 1508 of knee flexion. These data may provide useful insight into the intrinsic patellar tendon biomechanics during a weight-bearing deep knee bend and could provide biomechanical guidelines for future development of total knee arthroplasties that are intended to restore normal knee function. ß 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30: [1596][1597][1598][1599][1600][1601][1602][1603] 2012 Keywords: patellar tendon elongation; patellar tendon orientation; deep knee flexion; weight-bearing activity; knee kinematics Maximum flexion of the knee reaches beyond 1508. 12 Restoration of knee function in the entire flexion range after total knee arthroplasty (TKA) has been challenging. 3 While most follow-up studies reported that knee flexion after TKA of between 110 to 1208, 4 many studies investigated knee biomechanics in deep flexion to understand the biomechanical factors that may affect flexion capabilities. 1,2,5-9 Among these factors, the function of the patellar tendon, an essential component of the extensor mechanism, plays a critical role.Numerous in vitro studies reported the material properties, 10,11 orientation, and/or moment arms of the patellar tendon. 12 In vivo studies measured patellar tendon elongation using ultrasound 13 and MRI. 14 MRI was also used to determine the orientation and moment arms of the patellar tendon. 15,16 Foil strain gages were used to measure the mid-point patellar tendon strain intra-operatively. 17 Recently, DeFrate et al. 18 investigated patellar tendon kinematics using a combined MRI and dual fluoroscopic image technique. However, most of these studies examined patellar tendon biomechanics within the range of knee flexion up to 1108. 18,19 Quantitative data on the patellar tendon function in deep knee flexion are still unclear.Our objective was ...

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“…Previous studies on both human and animal cadavers have shown that there are changes in the elastic properties across ages (38,(55)(56)(57)(58)(59). Differences in mechanical stiffness between maturational groups can differ from 84% to as much as 334% (56,57).…”

Section: Contribution Of the Elastic Component And Changes With Maturmentioning

confidence: 99%

“…Elliot in 1965 observed that the tensile strength of the male human tendon for infants was 30MPa and 100MPa in adults, a difference of about 334% (57). This difference in tendon stiffness (patella) reduces as the child matures and by the age of 8 to 9 years has reduced to 94% between men and boys and 84% between women and girls (56). The same pattern was also observed for the Young's modulus with a difference of 99% between men and boys and 66% between women and girls.…”

Section: Contribution Of the Elastic Component And Changes With Maturmentioning

confidence: 99%

“…This combined with other normal growth changes such as increases in muscle size and mass leads to an increase in the loading on the tendon itself. This combination of growth and loading in turn leads to an increase in tendon stiffness during maturation (55,56). Other than pure increase in overall mass, other changes have also been noted such as micro structural changes in the tendon (63)(64)(65)(66)(67)(68), increases in the fibril density or packing and increases in the cross-linking within the collagen (65,67).…”

Section: Kubo Et Al (59) Investigated Tendon Compliance Of Three Difmentioning

confidence: 99%

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Understanding Stretch Shortening Cycle Ability in Youth

Sahrom¹,

Cronin²,

Harris³

2013

Strength &Amp; Conditioning Journal

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Extensive research has investigated stretch-shorten cycle (SSC) performance in adults, however to date, only a few studies have investigated SSC ability in youths.Youths undergoing puberty experience many physiological changes, which include changes to neuromuscular and musculotendinous systems. To understand the possible differences in SSC ability, this review will: 1) briefly discuss maturation (biological vs. chronological), 2) discuss the contribution of the active and passive components to SSC ability and how these components may change with maturation; and, 3) review literature that has quantified SSC ability across maturation via comparison of countermovement and squat jump performance.

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Mechanical properties of the patellar tendon in adults and children

Cited by 153 publications

References 58 publications

Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

Effect of arthroscopic techniques on joint volume in shoulder instability: Bankart repair versus capsular shift

In‐vivo patellar tendon kinematics during weight‐bearing deep knee flexion

Understanding Stretch Shortening Cycle Ability in Youth

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