Skip to main content
PMC home page
British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 2005 May;39(5):298–301. doi: 10.1136/bjsm.2004.014290

High prevalence of jumper's knee and sonographic changes in Swedish elite junior volleyball players compared to matched controls

K Gisslen 1, C Gyulai 1, K Soderman 1, H Alfredson 1
PMCID: PMC1725221  PMID: 15849296

Abstract

Background: Jumper's knee is a common and troublesome condition among senior volleyball players, but its prevalence among elite junior players compared to matched non-sports active controls is not known.

Objective: To clinically, and by sonography, examine the patellar tendons in elite junior volleyball players (15–19 years) at the Swedish National Centre for volleyball and in matched controls.

Methods: The patellar tendons in the 57 students at the Swedish National Centre for high school volleyball and in 55 age, height, and weight matched not regularly sports active controls were evaluated clinically and by grey scale ultrasonography (US) and power Doppler (PD) sonography.

Results: There were no significant differences in mean age, height, and weight between the volleyball players and the controls. In the volleyball group, jumper's knee was diagnosed clinically and by US in 12 patellar tendons (10 male and two female). In 12/12 tendons, PD sonography demonstrated a neovascularisation in the area with structural tendon changes. In another 10 pain free tendons, there were structural tendon changes and neovessels. In the control group, no individual had a clinical diagnosis of jumper's knee. US demonstrated structural tendon changes in 11 tendons, but there was no neovascularisation on PD sonography.

Conclusions: A clinical diagnosis of jumper's knee, together with structural tendon changes and neovascularisation visualised with sonography, was seen among Swedish elite junior volleyball players but not in matched not regularly sports active controls. Structural tendon change alone was seen in 10% of the control tendons.

Full Text

The Full Text of this article is available as a PDF (59.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alfredson Håkan, Ohberg Lars, Forsgren Sture. Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? An investigation using ultrasonography and colour Doppler, immunohistochemistry, and diagnostic injections. Knee Surg Sports Traumatol Arthrosc. 2003 Aug 9;11(5):334–338. doi: 10.1007/s00167-003-0391-6. [DOI] [PubMed] [Google Scholar]
  2. Aström M., Gentz C. F., Nilsson P., Rausing A., Sjöberg S., Westlin N. Imaging in chronic achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases. Skeletal Radiol. 1996 Oct;25(7):615–620. doi: 10.1007/s002560050146. [DOI] [PubMed] [Google Scholar]
  3. Blazina M. E., Kerlan R. K., Jobe F. W., Carter V. S., Carlson G. J. Jumper's knee. Orthop Clin North Am. 1973 Jul;4(3):665–678. [PubMed] [Google Scholar]
  4. Bobbert M. F., Huijing P. A., van Ingen Schenau G. J. Drop jumping. II. The influence of dropping height on the biomechanics of drop jumping. Med Sci Sports Exerc. 1987 Aug;19(4):339–346. [PubMed] [Google Scholar]
  5. Coleman B. D., Khan K. M., Maffulli N., Cook J. L., Wark J. D. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000 Feb;10(1):2–11. doi: 10.1034/j.1600-0838.2000.010001002.x. [DOI] [PubMed] [Google Scholar]
  6. Cook J. L., Khan K. M., Harcourt P. R., Grant M., Young D. A., Bonar S. F. A cross sectional study of 100 athletes with jumper's knee managed conservatively and surgically. The Victorian Institute of Sport Tendon Study Group. Br J Sports Med. 1997 Dec;31(4):332–336. doi: 10.1136/bjsm.31.4.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cook J. L., Khan K. M., Kiss Z. S., Griffiths L. Patellar tendinopathy in junior basketball players: a controlled clinical and ultrasonographic study of 268 patellar tendons in players aged 14-18 years. Scand J Med Sci Sports. 2000 Aug;10(4):216–220. doi: 10.1034/j.1600-0838.2000.010004216.x. [DOI] [PubMed] [Google Scholar]
  8. Cook J. L., Khan K. M., Kiss Z. S., Purdam C. R., Griffiths L. Prospective imaging study of asymptomatic patellar tendinopathy in elite junior basketball players. J Ultrasound Med. 2000 Jul;19(7):473–479. doi: 10.7863/jum.2000.19.7.473. [DOI] [PubMed] [Google Scholar]
  9. Cook J. L., Khan K. M., Kiss Z. S., Purdam C. R., Griffiths L. Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players. Victorian Institute of Sport tendon study group. Br J Sports Med. 2001 Feb;35(1):65–69. doi: 10.1136/bjsm.35.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cook J. L., Khan K. M. What is the most appropriate treatment for patellar tendinopathy? Br J Sports Med. 2001 Oct;35(5):291–294. doi: 10.1136/bjsm.35.5.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ferretti A. Epidemiology of jumper's knee. Sports Med. 1986 Jul-Aug;3(4):289–295. doi: 10.2165/00007256-198603040-00005. [DOI] [PubMed] [Google Scholar]
  12. Ferretti A., Puddu G., Mariani P. P., Neri M. The natural history of jumper's knee. Patellar or quadriceps tendonitis. Int Orthop. 1985;8(4):239–242. doi: 10.1007/BF00266866. [DOI] [PubMed] [Google Scholar]
  13. Fredberg Ulrich, Bolvig Lars. Significance of ultrasonographically detected asymptomatic tendinosis in the patellar and achilles tendons of elite soccer players: a longitudinal study. Am J Sports Med. 2002 Jul-Aug;30(4):488–491. doi: 10.1177/03635465020300040701. [DOI] [PubMed] [Google Scholar]
  14. Kettunen Jyrki A., Kvist Martti, Alanen Erkki, Kujala Urho M. Long-term prognosis for jumper's knee in male athletes. A prospective follow-up study. Am J Sports Med. 2002 Sep-Oct;30(5):689–692. doi: 10.1177/03635465020300051001. [DOI] [PubMed] [Google Scholar]
  15. Khan K. M., Maffulli N., Coleman B. D., Cook J. L., Taunton J. E. Patellar tendinopathy: some aspects of basic science and clinical management. Br J Sports Med. 1998 Dec;32(4):346–355. doi: 10.1136/bjsm.32.4.346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Langberg H., Skovgaard D., Petersen L. J., Bulow J., Kjaer M. Type I collagen synthesis and degradation in peritendinous tissue after exercise determined by microdialysis in humans. J Physiol. 1999 Nov 15;521(Pt 1):299–306. doi: 10.1111/j.1469-7793.1999.00299.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lian O., Engebretsen L., Ovrebø R. V., Bahr R. Characteristics of the leg extensors in male volleyball players with jumper's knee. Am J Sports Med. 1996 May-Jun;24(3):380–385. doi: 10.1177/036354659602400322. [DOI] [PubMed] [Google Scholar]
  18. Lian O., Holen K. J., Engebretsen L., Bahr R. Relationship between symptoms of jumper's knee and the ultrasound characteristics of the patellar tendon among high level male volleyball players. Scand J Med Sci Sports. 1996 Oct;6(5):291–296. doi: 10.1111/j.1600-0838.1996.tb00473.x. [DOI] [PubMed] [Google Scholar]
  19. Ohberg L., Lorentzon R., Alfredson H. Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc. 2001 Jul;9(4):233–238. doi: 10.1007/s001670000189. [DOI] [PubMed] [Google Scholar]
  20. Ohberg Lars, Alfredson Håkan. Sclerosing therapy in chronic Achilles tendon insertional pain-results of a pilot study. Knee Surg Sports Traumatol Arthrosc. 2003 Aug 19;11(5):339–343. doi: 10.1007/s00167-003-0402-7. [DOI] [PubMed] [Google Scholar]
  21. Paavola M., Paakkala T., Kannus P., Järvinen M. Ultrasonography in the differential diagnosis of Achilles tendon injuries and related disorders. A comparison between pre-operative ultrasonography and surgical findings. Acta Radiol. 1998 Nov;39(6):612–619. doi: 10.3109/02841859809175485. [DOI] [PubMed] [Google Scholar]
  22. Richards D. P., Ajemian S. V., Wiley J. P., Zernicke R. F. Knee joint dynamics predict patellar tendinitis in elite volleyball players. Am J Sports Med. 1996 Sep-Oct;24(5):676–683. doi: 10.1177/036354659602400520. [DOI] [PubMed] [Google Scholar]
  23. Roels J., Martens M., Mulier J. C., Burssens A. Patellar tendinitis (jumper's knee). Am J Sports Med. 1978 Nov-Dec;6(6):362–368. doi: 10.1177/036354657800600609. [DOI] [PubMed] [Google Scholar]
  24. Stanish W. D., Rubinovich R. M., Curwin S. Eccentric exercise in chronic tendinitis. Clin Orthop Relat Res. 1986 Jul;(208):65–68. [PubMed] [Google Scholar]
  25. Terslev L., Qvistgaard E., Torp-Pedersen S., Laetgaard J., Danneskiold-Samsøe B., Bliddal H. Ultrasound and Power Doppler findings in jumper's knee - preliminary observations. Eur J Ultrasound. 2001 Jul;13(3):183–189. doi: 10.1016/s0929-8266(01)00130-6. [DOI] [PubMed] [Google Scholar]
  26. Weinberg E. P., Adams M. J., Hollenberg G. M. Color Doppler sonography of patellar tendinosis. AJR Am J Roentgenol. 1998 Sep;171(3):743–744. doi: 10.2214/ajr.171.3.9725308. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES