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Peer-reviewedCC BY 4.0PLOS One

Association between patellar tendon-related pain and morphological abnormalities of the patellar tendon visualized using ultrasound imaging in middle school athletes

  • Yuuka Yasuura1
  • Takahiko Fukumoto2
  • Hiroaki Yamano3
  • Yuya Mawarikado
  • Daisuke Uritani
  1. 1Graduate School of Health Sciences, Kio University, Nara, Japan
  2. 2Department of Rehabilitation, Shimada Hospital, Osaka, Japan
  3. 3Graduate School of Medicine, Musculoskeletal Reconstructive Surgery, Nara Medical University, Nara, Japan
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Abstract

Background/Objective: To investigate whether morphological abnormalities of the patellar tendon, assessed using ultrasound imaging, are associated with patellar tendon-related pain in adolescent soccer players. Methods: This cross-sectional observational study was conducted at a university and enrolled 140 middle school soccer players (280 knees). Pain assessment was conducted using the visual analog scale and tenderness. Physical function assessments were also conducted. Ultrasound imaging was used to evaluate the morphology of the patellar tendon. Results: Data on a total of 211 knees were analyzed. Compared with non-painful knees, knees with patellar tendon-related pain exhibited significantly lower knee extension strength and a higher prevalence of hypoechoic and Doppler findings. The logistic regression analysis demonstrated a significant association between hypoechoic findings and patellar tendon-related pain (adjusted odds ratio = 10.65, 95% confidence interval: 3.65–31.88, p < 0.001), whereas no significant associations were observed for other morphological or physical function measures. Conclusion: Hypoechoic findings in the patellar tendon were significantly associated with patellar tendon-related pain in adolescent soccer players. These findings suggest that ultrasound imaging may be useful for identifying tendon characteristics that are associated with pain. However, longitudinal studies are needed to establish causal relationships.

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Cite

BibTeXRIS
BibTeX
@article{yasuura2026association,
  title = {{Association between patellar tendon-related pain and morphological abnormalities of the patellar tendon visualized using ultrasound imaging in middle school athletes}},
  author = {Yuuka Yasuura and Takahiko Fukumoto and Hiroaki Yamano and Yuya Mawarikado and Daisuke Uritani},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0357407},
  url = {https://doi.org/10.1371/journal.pone.0357407},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association between patellar tendon-related pain and morphological abnormalities of the patellar tendon visualized using ultrasound imaging in middle school athletes
AU  - Yuuka Yasuura
AU  - Takahiko Fukumoto
AU  - Hiroaki Yamano
AU  - Yuya Mawarikado
AU  - Daisuke Uritani
PY  - 2026
DA  - 2026/09/08
JO  - PLOS One
DO  - 10.1371/journal.pone.0357407
UR  - https://doi.org/10.1371/journal.pone.0357407
AB  - Background/Objective: To investigate whether morphological abnormalities of the patellar tendon, assessed using ultrasound imaging, are associated with patellar tendon-related pain in adolescent soccer players. Methods: This cross-sectional observational study was conducted at a university and enrolled 140 middle school soccer players (280 knees). Pain assessment was conducted using the visual analog scale and tenderness. Physical function assessments were also conducted. Ultrasound imaging was used to evaluate the morphology of the patellar tendon. Results: Data on a total of 211 knees were analyzed. Compared with non-painful knees, knees with patellar tendon-related pain exhibited significantly lower knee extension strength and a higher prevalence of hypoechoic and Doppler findings. The logistic regression analysis demonstrated a significant association between hypoechoic findings and patellar tendon-related pain (adjusted odds ratio = 10.65, 95% confidence interval: 3.65–31.88, p < 0.001), whereas no significant associations were observed for other morphological or physical function measures. Conclusion: Hypoechoic findings in the patellar tendon were significantly associated with patellar tendon-related pain in adolescent soccer players. These findings suggest that ultrasound imaging may be useful for identifying tendon characteristics that are associated with pain. However, longitudinal studies are needed to establish causal relationships.
SN  - 1932-6203
ER  -