Enthesopathies in injured individuals: A study using modern radiographs to identify the importance of ligament entheses and to evaluate current assumptions of entheses on skeletal remains
Fabian, Mercedes Lynn
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The goal of this study was to determine if a relationship exists between the development of ligament enthesopathies and athletic participation as well as discover if current assumptions about entheses are accurate. Wolff's law about bone adapting to stress has caused physical anthropologists to assume that entheses can correctly determine the behavior or occupation of an individual due to changes in bone as a result of particular movement patterns. Recent studies have produced mixed results. The acromioclavicular and coracoclavicular ligaments of the shoulder were examined and the patellar ligament of the knee was also observed. This research used modern radiographs and medical records of 22 to 25 year old injured athletes and injured non-athletic male patients at the University at Buffalo Orthopedics Department. Each ligament insertion and origin was scored either zero or one. A score of zero was given for a healthy or normal enthesis while a score of one was given to enthesopathies. Using the chi squared test for independence the data were analyzed. It was determined that no relationship exists between athletic participation and pathologies at the insertion and origin of the acromioclavicular ligament, the coracoclavicular ligament, and the patellar ligament. Within the patellar ligament data, statistical analyses demonstrated a trend toward a relationship between athletic participation and pathologies at the patellar ligament insertion. As shown in this research, acromioclavicular, coracoclavicular, and patellar ligament entheses are complex anatomical structures that are not reliable skeletal markers for determining athletic participation or injury. More studies are needed, however, on the affect other variables have on enthesopathies and what exactly causes the enthesopathies witnessed on some individual skeletons.