{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:14:29Z","timestamp":1789834469470,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,22]],"date-time":"2012-12-22T00:00:00Z","timestamp":1356134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to compare ultrasonography stages of the tibial tuberosity development and physical features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study examined 200\u00a0knees in 100\u00a0male football players aged 10\u201315 years. Tibial tuberosity development on ultrasonography was divided into 3 stages: Sonolucent stage (stage S), Individual stage (stage I), and Connective stage (stage C). Age, height, quadriceps and hamstring muscle tightness, and muscle strength in knee extension and flexion were determined. These findings were compared with the respective stages of development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The tibial tuberosity was stage S in 27\u00a0knees, stage I in 69\u00a0knees, and stage C in 104\u00a0knees, with right and left sides at the same stage in 95 %. Average age and height significantly increased with advancing tibial tuberosity development. Quadriceps tightness increased with tibial tuberosity development. Hamstring tightness decreased with development. The strength of both knee extension and flexion increased with advancing development, with a greater change seen in knee extension, hamstring\/quadriceps ratio: stage C, 0.74; stage A, 0.64; stage E, 0.53.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Osgood\u2013Schlatter pathogenesis reportedly involves increased quadriceps tightness with rapidly increasing femoral length during tibial tuberosity development. In this study, it was confirmed that quadriceps tightness increased, yet hamstring tightness decreased, suggesting that quadriceps tightness is not due to femoral length alone. Other factors, including muscle strength, may be involved. The study shows that thigh muscle tightness and thigh muscle performance change with the skeletal maturation of the distal attachment of the patellar tendon. These results add new information to the pathogenesis of Osgood\u2013Schlatter disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Cross\u2010sectional study, Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-2353-3","type":"journal-article","created":{"date-parts":[[2012,12,21]],"date-time":"2012-12-21T04:12:44Z","timestamp":1356063164000},"page":"195-199","source":"Crossref","is-referenced-by-count":35,"title":["Relationship between the skeletal maturation of the distal attachment of the patellar tendon and physical features in preadolescent male football players"],"prefix":"10.1002","volume":"22","author":[{"given":"Junsuke","family":"Nakase","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery School of Medicine Kanazawa University 13\u20101 Takaramachi 920\u20108641 Kanazawa 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