Quantifying proximal patellar tendon changes during adolescence in elite ballet dancers, a 2-year study

Area of Science:

• Sports Medicine
• Orthopedics
• Pediatric Sports Medicine

Background:

• Patellar tendon pathology is common in young athletes.
• Adolescent tendon development, particularly during puberty, is not well understood.
• Understanding normal tendon maturation is crucial for injury prevention.

Purpose of the Study:

• To investigate proximal patellar tendon development during the adolescent growth spurt.
• To determine the effect of puberty (maturity offset) on tendon development in young ballet dancers.
• To identify changes in tendon size and echogenicity during maturation.

Main Methods:

• Longitudinal study of 52 ballet dancers (ages 11-18 at baseline) over 2 years.
• Ultrasound imaging every 6 months to assess tendon anterior-posterior diameter and echogenicity.
• Maturity offset calculated to estimate peak height velocity (adolescent growth spurt).

Main Results:

• After peak height velocity, maturity offset increased stable echopattern (Type I) by 4% and decreased disorganized echopattern (Type III) by 0.7% annually.
• Anterior-posterior thickness increased by 0.2 mm/year.
• Proximal patellar tendon attachment showed increased thickness and a more stable echopattern post-peak height velocity.

Conclusions:

• The proximal patellar tendon matures post-peak height velocity, developing a more stable echopattern and increased thickness.
• This maturation indicates a more aligned fibrillar structure in the adolescent tendon.
• Further research is needed to understand maturation factors and reduce patellar tendon pathology in jumping athletes.