Persons with Patellar Tendinopathy Exhibit Greater Patellar Tendon Stress during a Single-Leg Landing Task

Abstract

ABSTRACTPurposeThis study aimed to compare peak maximum principal stress in the patellar tendon between persons with and without patellar tendinopathy during a simulated single-leg landing task. A secondary purpose was to determine the biomechanical predictor(s) of peak maximum principal stress in the patellar tendon.MethodsUsing finite element (FE) modeling, patellar tendon stress profiles of 28 individuals (14 with patellar tendinopathy and 14 pain-free controls) were created at the time of the peak knee extensor moment during single-leg landing. Input parameters to the FE model included subject-specific knee joint geometry and kinematics, and quadriceps muscle forces. Independentt-tests were used to compare the peak maximum principal stress in the patellar tendon and biomechanical variables used as input variables to the FE model (knee flexion, knee rotation in the frontal and transverse planes and the peak knee extensor moment) between groups. A stepwise regression model was used to determine the biomechanical predictor(s) of peak maximum principal stress in the patellar tendon for both groups combined.ResultsCompared with the control group, persons with patellar tendinopathy exhibited greater peak maximum principal stress in the patellar tendon (77.4 ± 25.0 vs 60.6 ± 13.6 MPa,P= 0.04) and greater tibiofemoral joint internal rotation (4.6° ± 4.6° vs 1.1° ± 4.2°,P= 0.04). Transverse plane rotation of the tibiofemoral joint was the best predictor of peak maximum principal stress in the patellar tendon (r= 0.51,P= 0.01).ConclusionsPersons with patellar tendinopathy exhibit greater peak patellar tendon stress compared with pain-free individuals during single-leg landing. The magnitude of peak patellar tendon stress seems to be influenced by the amount of tibiofemoral rotation in the transverse plane.