Evidence of patellar tendon buckling during passive knee extension

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• 作者：Laura Chernak Slane^a ; ^{laura.c.slane@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Stijn Bogaerts^a ; ^b ; Irina Mihejeva^a ; Lennart Scheys^a ; ^b
• 关键词：Patellar tendon ; Buckling ; Extension ; Flexion ; Slack length ; Crimp
• 刊名：The Knee
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：23
• 期：5
• 页码：801-806
• 全文大小：591 K

文摘

The purpose of this study was to investigate and describe buckling of the patellar tendon.

Methods

Healthy young adults (28 ± 4 years, 10F/10M) underwent passive knee flexion/extension during the simultaneous measurement of knee angle and collection of cine ultrasound from the patellar tendon. Patellar tendon buckling was observed visually in ultrasound images, and the corresponding knee angle at which evidence of buckling disappeared was identified.

Results

All subjects showed evidence of distal buckling which occurred on average at 23 ± 8° flexion. Proximal buckling was only observed in fourteen subjects (10F/4M) at an average of 15 ± 8°. Buckling patterns varied between subjects, but with high within-subject consistency. Buckling magnitude increased with age (p = 0.03) and decreased with more weekly exercise (p = 0.02).

Discussion

The patellar tendon exhibited significant buckling in knee extension suggesting that buckling is a component of healthy knee function. Like tendon crimp, buckling may serve as a protective mechanism, allowing the tissue to unwrinkle prior to undergoing pure strain. The links between increased buckling magnitude and both age and reduced activity suggest that excessive buckling may be maladaptive, though future work is necessary to elucidate this relationship. Buckling is relevant to consider when estimating tendon length, as buckling can lead to significant underestimation of resting length and thus overestimation of strain.

Conclusion

This study demonstrates the complexity of tendon behavior even in healthy adults undergoing passive motion, suggesting that buckling may be relevant to an improved understanding of tendon health and pathology.