Analysis of Patellar Tendinopathy Risk Factors Among Intercollegiate Athletes
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Context: Patellar tendinopathy has a prevalence as high as 50% among athletes involved in jumping sports such as basketball and volleyball. Despite this prevalence, patellar tendinopathy remains a challenging condition for clinicians and researchers alike due to the lack of understanding concerning its etiology. Objective: To evaluate the known and hypothesized risk factors for patellar tendinopathy among male and female NCAA intercollegiate athletes to determine which outcome measures are most predictive. Design: Case-Control cross-sectional study. Setting: Laboratory setting. Patients or Other Participants: 60 intercollegiate athletes participated in this study (age 20.0 ± 1.2, height 178.9 ± 9.8, body mass, 79.7 ± 12.0) A 2:1 ratio of non-injured (n = 40) to injured (n = 20) was employed with participants matched on age and sex. Interventions: None. Main Outcome Measures: Static quadriceps angle (Q-angle), body mass index (BMI), waist/hip ratio, and Landing Error Scoring System (LESS) score. Statistical Analysis: A Group (2) x Sex (2) MANOVA approach was used to identify differences between the case and control groups, and men and women (α = 0.05). Odds ratios were calculated using conditional logistic regression in an effort to identify independent risk factors for patellar tendinopathy. A secondary hypothesis investigated the extent to which a static Q- angle, increased BMI, higher LESS score were risk factors associated with the incidence of patellar tendinopathy (α = 0.05). Results: MANOVA indicated that dominant and non-dominant leg Q angle showed significant differences between the sexes. The average Q angle for female participants was 14.6 ± 3.6 deg compared to 10.1 ± 3.2 deg for male participants (P < 0.05). The LESS scores in the case group (4.4 ± 1.4 points) were nearly identical to scores in the control group (3.8 ± 1.3 points) (P > 0.05). The Cox regression analysis showed no significant increase in injury risk with the 4 factors analyzed. Conclusions: Our findings indicate that Q angle, the LESS test, or BMI were not significant predictors of patellar tendinopathy. Future studies should employ prospective, longitudinal designs with larger populations. Further investigation into the LESS test as a potential screening tool for various lower extremity injuries is warranted.