Association between obesity and magnetic resonance imaging defined patellar tendinopathy in community-based adults: a cross-sectional study

Abstract

BackgroundPatellar tendinopathy is a common cause of activity-related anterior knee pain. Evidence is conflicting as to whether obesity is a risk factor for this condition. The aim of this study was to determine the relationship between obesity and prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy in community-based adults.Methods297 participants aged 50–79 years with no history of knee pain or injury were recruited from an existing community-based cohort. Measures of obesity included measured weight and body mass index (BMI), self-reported weight at age of 18–21 years and heaviest lifetime weight. Fat-free mass and fat mass were measured using bioelectrical impedance. Participants underwent MRI of the dominant knee. Patellar tendinopathy was defined on both T1- and T2-weighted images.ResultsThe prevalence of MRI defined patellar tendinopathy was 28.3%. Current weight (OR per kg = 1.04, 95% CI 1.01-1.06, P = 0.002), BMI (OR per kg/m2 = 1.10, 95% CI 1.04-1.17, P = 0.002), heaviest lifetime weight (OR per kg = 1.03, 95% CI 1.01-1.05, P = 0.007) and weight at age of 18–21 years (OR per kg = 1.03, 95% CI 1.00-1.07, P = 0.05) were all positively associated with the prevalence of patellar tendinopathy. Neither fat mass nor fat-free mass was associated with patellar tendinopathy.ConclusionMRI defined patellar tendinopathy is common in community-based adults and is associated with current and past history of obesity assessed by BMI or body weight, but not fat mass. The findings suggest a mechanical pathogenesis of patellar tendinopathy and patellar tendinopathy may be one mechanism for obesity related anterior knee pain.

Prognostic value of MRI in arthroscopic treatment of chronic patellar tendinopathy: a prospective cohort study

“…Multiple studies focused on risk factors of PT [9, 34, 37, 41]. However, no previous study identified evidence-based prognostic outcome factors.…”

“…Reduced muscular flexibility has been determined as an intrinsic risk factor for PT in athletes [2, 41]. Additionally, PT is commonly observed in older and obese patients as well as in subjects exhibiting an increased vastus medialis muscle size [9, 33, 34]. Some investigators believe that the inferior pole of the patella has a propensity to impinge upon the deep surface of the proximal patellar tendon during knee flexion [14, 21, 33].…”

Obesity and Chronic Pain

“…The difference was explained by a mechanical pathogenesis of patellar tendinopathy. 67 According to a recent systematic review, good evidence supports obesity as an overall risk factor for tendinopathy. 68 Upper-extremity pain is a common complaint contributing to decreased HRQL, an important cause of occupational disability, and a substantial contributor to health care spending.…”

Patellar and quadriceps tendon abnormalities in obese patients with knee osteoarthritis: a preliminary ultrasonographic study

“…The presence of intramuscular fat in obese subjects could also be related to the evidence that metabolic dysregulation, through an adipose tissue-associated inflammation process, could also play a role in knee OA 12 . Recently, some interest has been devoted to the relationships between obesity, metabolic diseases and tendinopathies [13][14][15][16][17] . There is some evidence that obesity is a risk factor also for tendinopathy at different districts in community based adults, including the patellar tendon 15 .…”