Proximal patellar tendon abnormalities on ultrasound can develop in male adolescent basketball players: A longitudinal study.

Introduction: Adolescent patellar tendinopathy is reported but the pubertal-stage of onset of abnormal tendon structure has not been investigated with grayscale ultrasound.

Aims: To investigate abnormal tendon structure using grayscale ultrasound and its association with pubertal-stage and pain.

Methods: Forty-three male basketball players aged 13.7 years (SD 1.0) had patellar tendon ultrasound scans every 6 months for 2.5 years. Pubertal-stage (peak height velocity) was calculated using the Mirwauld equation. Tendon thickness, hypoechogenicity and pain during single leg decline squat (SLDS) were recorded. Tendons were classified: hypoechoic, normal or immature.

Results: Two tendons were hypoechoic at baseline. Six developed hypoechogenicity over 2.5 years (eight tendons [9%], six participants [14%]), all in peri and post-PHV players. Twenty-six tendons (17 participants) were classified as immature during the study. Hypoechoic tendons were thicker (5.3 mm SD 1.2) than normal (3.9 mm SD 0.7) tendons (p < 0.001). There was no difference in the proportion of participants reporting pain during SLDS in the hypoechoic (N = 3) and normal (N = 11) groups (p = 0.33), or in hypoechoic tendon thickness between those reporting pain (6.5 mm, SD 1.7) or not (5.2 mm, SD 0.9, p = 0.17).

Discussion: This study using grayscale ultrasound found that basketball players with hypoechogenicity were peri or post-PHV. Abnormal structure was not always associated with pain.