Factors associated with magnetic resonance imaging defined patellar tendinopathy in community-based middle-aged women: a prospective cohort study

Abstract

BackgroundPatellar tendinopathy identified by imaging modalities has been reported in asymptomatic athletes and associated with tendon-related symptoms. However there is little data in community-based populations. The aim of this cohort study was to examine the prevalence of magnetic resonance imaging (MRI) defined patellar tendinopathy, the factors associated with this condition, and whether it was associated with knee pain in community-based middle-aged women.MethodsOne hundred seventy six women, aged 40–67 years, with no significant knee pain or injury underwent knee MRI. Patellar tendinopathy was defined on both T1- and T2-weighted fat-saturated MRIs. The cross-sectional area of vastus medialis was measured from MRI. Height and weight were measured to calculate body mass index (BMI). Physical activity was assessed using a questionnaire. Knee pain was assessed using the Western Ontario and McMaster University Osteoarthritis Index.ResultsThe prevalence of MRI defined patellar tendinopathy was 30.1 %. Higher levels of physical activity (odds ratio 1.65, 95 % CI 1.09–2.51) and greater vastus medialis cross-sectional area (odds ratio 1.22, 95 % CI 1.04–1.43) were associated with increased prevalence of patellar tendinopathy, independent of age and BMI. The persistence of patellar tendinopathy was associated with the worsening of knee pain over 2 years (odds ratio 10.65, 95 % CI 1.14–99.77).ConclusionIn community-based middle-aged women MRI-diagnosed patellar tendinopathy is common, with higher levels of physical activity and greater vastus medialis size being risk factors suggesting a biomechanical effect. Persistent patellar tendinopathy is associated with worsening of knee pain. These findings suggest that further work is needed to determine the contribution of patellar tendinopathy on knee pain and function in older people.

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].…”

Arthroscopic patellar release for treatment of chronic symptomatic patellar tendinopathy: long-term outcome and influential factors in an athletic population

“…Patellar tendinopathy (PT) is a common pathology in athletes performing repetitive jumping sports such as basketball and volleyball [ 1 – 4 ]. Recent studies suggest PT to emerge as an overuse of the knee joint extension mechanism and prolonged repetitive mechanical stress [ 4 – 15 ]. Athletes typically complain about anterior knee pain, leading to a reduction of exercise load and decline in the level of competition [ 1 ].…”

Development of overuse tendinopathy: A new descriptive model for the initiation of tendon damage during cyclic loading

“…There is good evidence that repetitive mechanical stress plays a key role in the development of tendinopathy. The prevalence of patellar tendinopathy (jumper's knee) is greater in individuals with high levels of physical activity . For volleyball players, who have an unusually high incidence of patellar tendinopathy, the likelihood of developing jumper's knee increases significantly with increased training volume .…”