RESUMO
BACKGROUND: The original version of Victorian Institute of Sport Assessment-Patella Questionnaire (VISA-P) is developed in English, and aimed to assess the severity of patellar tendinopathy symptoms. Before used in China, it should be translated to Chinese version. OBJECTIVES: Our aim is to make a translation/cross-culturally adaption for the VISA-P into simplified Chinese version (VISA-PC). And primarily validate the VISA-PC in Chinese speaking population. METHODS: The translation process of VISA-P questionnaire into simplified Chinese version (VISP-PC) followed the International recognized guideline. Cross-cultural adaptation was carried out with a clinical measurement study. A total of 128 projects which consisted 33 healthy students, 39 patients with patellar tendinopathy and 56 military students (receive military training as at-risk population) were included into this study. Internal consistency was evaluated with Cronbach's alpha, and test-retest reliability was assessed with intraclass correlation coefficients (ICCs). Construct validity and floor and ceiling effects were also tested. RESULTS: The scores were 95.84 ± 5.97 of healthy group, 91.87 ± 9.03 of at-risk group, 62.49 ± 11.39 of pathological group. There is no ceiling and floor effect of VISA-PC. The Cronbach's alpha (0.895) and ICC (0.986) values showed good internal consistency and reliability. There were high correlations between VISA-PC and Kujala patellofemoral score (r = 0.721). VISA-PC score also had good correlation with the relevant SF-36 items. CONCLUSION: The VISA-PC was well translated into simplified Chinese version (VISA-PC), which is reliable and valid for Chinese-speaking patients with patellar tendinopathy. LEVEL OF EVIDENCE: II.
Assuntos
Ligamento Patelar/fisiopatologia , Inquéritos e Questionários/normas , Tendinopatia/fisiopatologia , Adaptação Fisiológica , Adulto , Traumatismos em Atletas/fisiopatologia , Estudos de Casos e Controles , China , Comparação Transcultural , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Reprodutibilidade dos Testes , Tendinopatia/diagnóstico , Adulto JovemRESUMO
OBJECTIVE: To investigate the correlation of patellar tendon-lateral femoral condyle friction syndrome (PTLFCFS) with subtle patellofemoral instability to explore its pathogenesis. MATERIALS AND METHODS: One hundred knees of 80 patients with PTLFCFS were analyzed retrospectively by retrieving magnetic resonance imaging (MRI) data over a 3-year period from our database. Seven quantitative parameters for evaluating patellofemoral stability were measured on MR images, including the Insall-Salvati ratio, tibial tuberosity-trochlear groove (TT-TG) distance, trochlear groove depth, medial trochlear/lateral trochlear length (MT/LT) ratio, medial trochlear/lateral trochlear height (MH/LH) ratio, lateral patellofemoral angle (LPA), and lateral trochlear inclination (LTI) angle. These patellofemoral parameters of the PTLFCFS group and the normal control group were compared (n = 88), and receiving-operator characteristic (ROC) curve analysis was conducted to determine the specificity and sensitivity of these parameters. RESULTS: The trochlear depth, MT/LT, LPA, and LTI angle were significantly lower (p < 0.001) and the Insall-Salvati ratio was significantly higher (p < 0.001) in the PTLFCFS group. However, the TT-TG distance and MH/LH ratio showed no significant difference (p = 0.231 and 0.073 respectively). The area under the ROC curve of the Insall-Salvati ratio, trochlear depth, MT/LT, LPA, and LTI angle were 0.925, 0.784, 0.8, 0.731, and 0.675 respectively. The efficiency of the Insall-Salvati ratio was the highest among those five parameters. CONCLUSION: This study verified the presence of subtle patellofemoral instability by measuring various patellofemoral parameters in patients with PTLFCFS. It confirmed that PTLFCFS is associated with subtle patellofemoral instability and could largely explain the pathogenesis of PTLFCFS.
Assuntos
Instabilidade Articular/diagnóstico por imagem , Articulação do Joelho , Imageamento por Ressonância Magnética , Articulação Patelofemoral , Adolescente , Adulto , Feminino , Fricção , Humanos , Instabilidade Articular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Ligamento Patelar/diagnóstico por imagem , Ligamento Patelar/fisiopatologia , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Síndrome , Adulto JovemRESUMO
Crouch gait deformity is common in children with cerebral palsy and often is associated with patella alta. Patellar tendon advancement typically is used to correct patella alta and restore normal knee mechanics. The purpose of this study was to determine the mechanical strength of surgical constructs used for fixation during patellar advancement procedures. This study used a cadaveric model to determine which of 3 surgical techniques is biomechanically optimal for patellar tendon advancement in treating patella alta. Twenty-four human cadaveric knees (8 per group) were prepared using 1 of 3 different common surgical techniques: tibial tubercle osteotomy, patellar tendon partial resection and repair at the distal patella, and patellar tendon imbrication. The patella was loaded from 25 to 250 N at 1 Hz for 1000 cycles. A significant difference in patella displacement under cyclical loading was found between surgical techniques. Tibial tubercle osteotomy exhibited significantly less displacement under cyclical loading than distal patella excision and repair (P<.0001) or imbrication (P=.0088). Imbrication exhibited significantly less displacement than distal patella excision and repair (P=.0006). Tibial tubercle osteotomy survived longest. Based on failure criteria of 5 mm of displacement, tibial tubercle osteotomy lasted between 250 and 500 cycles. The other 2 techniques failed by 25 cycles. This study offers quantitative evidence regarding the relative mechanical strength of each construct and may influence choice of surgical technique. [Orthopedics. 2016; 39(3):e492-e497.].
Assuntos
Articulação do Joelho/cirurgia , Osteotomia/métodos , Patela/cirurgia , Luxação Patelar/cirurgia , Ligamento Patelar/cirurgia , Transferência Tendinosa , Fenômenos Biomecânicos , Cadáver , Humanos , Articulação do Joelho/fisiopatologia , Patela/patologia , Luxação Patelar/fisiopatologia , Ligamento Patelar/lesões , Ligamento Patelar/fisiopatologiaRESUMO
How aging affects the elasticity of tendons has long been debated, partly because of the limited methods for in vivo evaluation, which differ vastly from those for in vitro animal studies. In this study, we tested the reliability of shear wave elastography (SWE) in the evaluation of patellar tendons and their change in elasticity with age. We recruited 62 healthy participants in three age groups: 20-30 years (group 1), 40-50 years (group 2) and 60-70 years (group 3). Shear wave velocity and elastic modulus were measured at the proximal, middle and distal areas of the patellar tendon. Reliability was excellent at the middle area and fair to good at both ends. Compared with the other groups, group 3 had significantly decreased elastic modulus and shear wave velocity values (p ≤ 0.001 vs. group 1 or 2), with significant increased side-to-side differences. SWE may be valuable in detecting aging tendons before visible abnormalities are observed on B-mode ultrasonography.
Assuntos
Envelhecimento/fisiologia , Módulo de Elasticidade/fisiologia , Técnicas de Imagem por Elasticidade , Elasticidade/fisiologia , Ligamento Patelar/diagnóstico por imagem , Ligamento Patelar/fisiopatologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
PURPOSE: Patellar tendon abnormality (PTA) on diagnostic imaging is part of the diagnostic criteria for patellar tendinopathy. PTA and altered landing strategies are primary risk factors that increase the likelihood of asymptomatic athletes developing patellar tendinopathy. Therefore, the aim of this study was to examine the risk factors that are predictors of the presence and severity of a PTA in junior pre-elite athletes. METHODS: Ten junior pre-elite male basketball athletes with a PTA were matched with 10 athletes with normal patellar tendons. Participants had patellar tendon morphology, Victorian Institute of Sport Assessment (VISA) score, body composition, lower limb flexibility, and maximum vertical jump height measured before performing five successful stop-jump tasks. During each stop-jump task, both two-dimensional and three-dimensional kinematics and ground reaction forces were recorded. Multiple regression analyses were used to identify factors for estimating PTA presence and severity, and discriminate analysis was used to classify PTA presence. RESULTS: Sixty-eight percent of variance for presence of a PTA was accounted for by hip joint range of motion (ROM) and knee joint angle at initial foot-ground contact (IC) during stop-jump task and quadriceps flexibility, whereas hip joint ROM during stop-jump task and VISA score accounted for 62% of variance for PTA severity. Prediction of the presence of a PTA was achieved with 95% accuracy and 95% cross-validation. CONCLUSIONS: An easily implemented, reliable, and valid movement screening tool composed of three criteria enables coaches and/or clinicians to predict the presence and severity of a PTA in asymptomatic athletes. This enables identification of asymptomatic athletes at higher risk of developing patellar tendinopathy, which allows the development of effective preventative measures to aid in the reduction of patellar tendinopathy injury prevalence.
Assuntos
Articulação do Quadril/fisiologia , Articulação do Joelho/fisiologia , Extremidade Inferior/fisiologia , Ligamento Patelar/fisiopatologia , Tendinopatia/etiologia , Adolescente , Adulto , Fenômenos Biomecânicos , Humanos , Masculino , Conceitos Matemáticos , Movimento , Amplitude de Movimento Articular , Análise de Regressão , Medição de Risco/métodos , Fatores de Risco , Tendinopatia/prevenção & controle , Gravação em Vídeo , Adulto JovemRESUMO
The effect of postoperative immobilization on the length, stiffness, and structure of connective tissue after radiofrequency probe shrinkage was examined in a rabbit patellar tendon model. Tendon lengths were measured before, immediately following, and 2, 4, and 8 weeks following heat application, with the contralateral tendon as a control. The animals were randomly assigned to three groups. In Group I, the controls, the animals were allowed free caged activity for 8 weeks. In Groups II and III, the experimental limb was immobilized at 15 degrees of knee flexion for 2 and 4 weeks, respectively, after which the animals were allowed 6 and 4 weeks of free caged activity. Changes in tendon length, stiffness, and cross-sectional area were compared using repeated measures ANOVA and differences between groups examined using Tukey's post-hoc analysis. Patellar tendon lengths were increased in all 3 groups at 8 weeks (P< .001). Tissue elongation was less extensive in group III compared to group I at 8 weeks (P< .001), while tissue cross-sectional area was decreased in both groups II and III compared to group I at 8 weeks (P< .001). All groups demonstrated decreases in tensile strength when compared to controls (P< .001). These findings suggest that postoperative immobilization is important following thermal shrinkage of connective tissue, as early activity can lead to stretching of the heat-modified tissue.
Assuntos
Ablação por Cateter/métodos , Imobilização/métodos , Ligamento Patelar/fisiopatologia , Ligamento Patelar/cirurgia , Cicatrização , Animais , Módulo de Elasticidade , Ligamento Patelar/patologia , Coelhos , Estresse Mecânico , Resultado do TratamentoRESUMO
Se realizó un estudio prospectivo en 60 rodillas (30 pacientes) con síndrome doloroso patelo-femoral de marzo a noviembre de 1993, que se dividieron en dos grupos, 30 sintomáticas y 30 en términos generales asintomáticas. Todos tenían historia clínica de dolor retro-patelar con actividades físicas, crepitación rotuliana y fugas periódicas y signos como la prueba de aprensión positiva. Los radiológicos que se ralizaron a cada paciente fueron: proyección panorámica del miembro pélvico para medición del eje mecánico, proyección AP de rodilla para medición indirecta de varo o valgo. Proyección lateral a 30 grados para medir LP/LT. Proyección axial a 20 grados para visualizar el estado articular patelo-femoral y medir ASI, APL, IPF, DPL. El promedio de edad fue 30.5 años; fueron 21 mujeres y nueve hombres. Los resultados radiológicos mostraron desviación medial del eje de 2 a 56 mm en 17 casos, desviación lateral en 11, de 2 a 15 mm y en dos estuvo alineado a 0 grados. El ángulo alfa fue de 5 grados de varo en promedio, en 15 casos; 5.5 de valgo en 14 y 0 en una rodilla. La línea de Blumensaat se encontró por abajo del polo inferior de la rótula en promedio a 16.3 mm en las rodillas sintomáticas y a 14.3 mm en las asintomáticas. En la proyección axial a 20 grados (Laurin) el ángulo de la escotadura intercondílea fue de 131 grados contra 137. Se concluye que hay diferencias significativas en las mediciones radiológicas entre pacientes sintomáticos y asintomáticos