Patellar tendinosis (PT) is common and can result in prolonged disability, especially in jumping athletes. Recently developed ultra-short-echo (UTE) MRI sequences allow for quantitative evaluation of tendon biostructure with T2* relaxometry. This study evaluated the relationships between changes over time (COT) in quantitative T2*-metrics, qualitative PT grades, and patient reported symptoms within 10 male basketball players from a single collegiate basketball team. All subjects completed weekly VISA-P symptomology questionnaires over the basketball season. Bilateral 3-Tesla MRIs (GE Healthcare) were obtained at pre- and post-season study visits. High-resolution, PD-weighted, FSE sequences were used to qualitatively grade PT. Quantitative T2*-metrics were evaluated using high-resolution, 3D, multi-echo, UTE-MRI sequences. Bilinear exponential fits of SI to corresponding echo time were used to calculate T2*-metrics. All qualitative and quantitative evaluations were region specific (proximal, middle, distal). Linear mixed effects models assessed associations of side and region with T2*-metrics. Spearman correlations evaluated relationships between outcome measures. Within and between study visits, significant side-to-side differences in T2*-metrics were found and were significantly impacted by leg dominance (p<0.05). Pre-season T2*-metrics correlated with COT in T2*-metrics, COT in T2*-metrics correlated with COT in qualitative PT grades, and post-season T2*-metrics correlated with max changes in VISA-P scores (ρ≥0.64). Quantitative T2*-metrics can detect PT and may be capable of predicting the onset of pathology. T2*-metrics could benefit the clinical management of PT: it is sensitive to changes in pathologic severity over time, and therefore can serve as a quantitative metric to guide treatment and evaluate intervention efficacy.

This investigation of elite male collegiate basketball players aims to determine 1) the change in 3D dynamic functional variables across a single season and 2) correlate cross-season changes in functional variables with changes in clinical and quantitative ultrasound measures. Eleven male college basketball players (mean age 19, range 18–21 years) from a single team underwent baseline patellar tendon shear wave (SW) elastography and dynamic function at the start of the season (Visit1) and at a late-season time point (Visit2). Players reported their VISA-P scores every two weeks across their 24-week season. Each athlete performed a box-ground-box jump five times while 3D lower extremity kinematic and kinetic variables were collected. Functional measures included for landing (LAND) and take-off (TOFF) phases: knee valgus angle, valgus torque, and peak limb force. Knee valgus angular impulse and ground contact time were also measured. Paired t-tests and Pearson correlation coefficients (r) compared Visit1 and Visit2 variables and assessed the strength of linear dependency, respectively. The mean change in VISA-P score was 15.18 (+/-8.55). No functional variables were different across the season. Clinical, quantitative ultrasound and functional variables were moderately correlated with take-off valgus moment, landing force, take-off force and contact time. Other correlations were low (< 0.4). Our analyses have shown moderate correlations between important clinical, quantitative imaging and function measurements. These correlations reflect the changes that occur between relevant time points and which relate internal structure and external function.