Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Jason Toppi, Jessica Fairley, Flavia M. Cicuttini, Jill Cook, Susan R. Davis, Robin J. Bell, Fahad Hanna, Yuanyuan Wang

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Login to get access

Abstract

Background

Patellar 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.

Methods

One 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.

Results

The 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).

Conclusion

In 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.
Literature
1.
McAlindon TE, Snow S, Cooper C, Dieppe PA. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis. 1992;51(7):844–9.CrossRefPubMedPubMedCentral
2.
Crossley KM, Thancanamootoo K, Metcalf BR, Cook JL, Purdam CR, Warden SJ. Clinical features of patellar tendinopathy and their implications for rehabilitation. J Orthop Res. 2007;25(9):1164–75.CrossRefPubMed
3.
4.
Cook JL, Khan KM, Harcourt PR, Grant M, Young DA, Bonar SF. A cross sectional study of 100 athletes with jumper’s knee managed conservatively and surgically. The Victorian Institute of Sport Tendon Study Group. Br J Sports Med. 1997;31(4):332–6.CrossRefPubMedPubMedCentral
5.
Khan KM, Bonar F, Desmond PM, Cook JL, Young DA, Visentini PJ, et al. Patellar tendinosis (jumper’s knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group. Radiology. 1996;200(3):821–7.CrossRefPubMed
6.
Lian OB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med. 2005;33(4):561–7.CrossRefPubMed
7.
Zwerver J, Bredeweg SW, van den Akker-Scheek I. Prevalence of Jumper’s knee among nonelite athletes from different sports: a cross-sectional survey. Am J Sports Med. 2011;39(9):1984–8.CrossRefPubMed
8.
Lian O, Holen KJ, Engebretsen L, Bahr R. Relationship between symptoms of jumper’s knee and the ultrasound characteristics of the patellar tendon among high level male volleyball players. Scand J Med Sci Sports. 1996;6(5):291–6.CrossRefPubMed
9.
Popp JE, Yu JS, Kaeding CC. Recalcitrant patellar tendinitis. Magnetic resonance imaging, histologic evaluation, and surgical treatment. Am J Sports Med. 1997;25(2):218–22.CrossRefPubMed
10.
Yu JS, Popp JE, Kaeding CC, Lucas J. Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis. AJR Am J Roentgenol. 1995;165(1):115–8.CrossRefPubMed
11.
Reiff DB, Heenan SD, Heron CW. MRI appearances of the asymptomatic patellar tendon on gradient echo imaging. Skeletal Radiol. 1995;24(2):123–6.CrossRefPubMed
12.
Cook JL, Khan KM, Kiss ZS, Purdam CR, Griffiths L. Prospective imaging study of asymptomatic patellar tendinopathy in elite junior basketball players. J Ultrasound Med. 2000;19(7):473–9.PubMed
13.
Comin J, Cook JL, Malliaras P, McCormack M, Calleja M, Clarke A, et al. The prevalence and clinical significance of sonographic tendon abnormalities in asymptomatic ballet dancers: a 24-month longitudinal study. Br J Sports Med. 2013;47(2):89–92.CrossRefPubMed
14.
Kettunen JA, Kvist M, Alanen E, Kujala UM. Long-term prognosis for jumper’s knee in male athletes. A prospective follow-up study. Am J Sports Med. 2002;30(5):689–92.PubMed
15.
Fairley J, Toppi J, Cicuttini FM, Wluka AE, Giles GG, Cook J, et al. Association between obesity and magnetic resonance imaging defined patellar tendinopathy in community-based adults: a cross-sectional study. BMC Musculoskelet Disord. 2014;15:266.CrossRefPubMedPubMedCentral
16.
17.
van der Worp H, van Ark M, Roerink S, Pepping GJ, van den Akker-Scheek I, Zwerver J. Risk factors for patellar tendinopathy: a systematic review of the literature. Br J Sports Med. 2011;45(5):446–52.CrossRefPubMed
18.
19.
Bamman MM, Newcomer BR, Larson-Meyer DE, Weinsier RL, Hunter GR. Evaluation of the strength-size relationship in vivo using various muscle size indices. Med Sci Sports Exerc. 2000;32(7):1307–13.CrossRefPubMed
20.
Davison SL, Bell R, Donath S, Montalto JG, Davis SR. Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab. 2005;90(7):3847–53.CrossRefPubMed
21.
Hanna FS, Bell RJ, Cicuttini FM, Davison SL, Wluka AE, Davis SR. The Relationship between endogenous testosterone, preandrogens, and sex hormone binding globulin and knee joint structure in women at midlife. Semin Arthritis Rheum. 2007;37(1):56–62.CrossRefPubMed
22.
Spector TD, Harris PA, Hart DJ, Cicuttini FM, Nandra D, Etherington J, et al. Risk of osteoarthritis associated with long-term weight-bearing sports: a radiologic survey of the hips and knees in female ex-athletes and population controls. Arthritis Rheum. 1996;39(6):988–95.CrossRefPubMed
23.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833–40.PubMed
24.
Karantanas AH, Zibis AH, Papanikolaou N. Increased signal intensity on fat-suppressed three-dimensional T1-weighted pulse sequences in patellar tendon: magic angle effect? Skeletal Radiol. 2001;30(2):67–71.CrossRefPubMed
25.
McLoughlin RF, Raber EL, Vellet AD, Wiley JP, Bray RC. Patellar tendinitis: MR imaging features, with suggested pathogenesis and proposed classification. Radiology. 1995;197(3):843–8.CrossRefPubMed
26.
Wang Y, Wluka AE, Berry PA, Siew T, Teichtahl AJ, Urquhart DM, et al. Increase in vastus medialis cross-sectional area is associated with reduced pain, cartilage loss, and joint replacement risk in knee osteoarthritis. Arthritis Rheum. 2012;64(12):3917–25.CrossRefPubMed
27.
Witvrouw E, Bellemans J, Lysens R, Danneels L, Cambier D. Intrinsic risk factors for the development of patellar tendinitis in an athletic population. A two-year prospective study. Am J Sports Med. 2001;29(2):190–5.PubMed
28.
Gaida JE, Cook JL, Bass SL, Austen S, Kiss ZS. Are unilateral and bilateral patellar tendinopathy distinguished by differences in anthropometry, body composition, or muscle strength in elite female basketball players? Br J Sports Med. 2004;38(5):581–5.CrossRefPubMedPubMedCentral
Metadata
Title
Factors associated with magnetic resonance imaging defined patellar tendinopathy in community-based middle-aged women: a prospective cohort study
Authors
Jason Toppi
Jessica Fairley
Flavia M. Cicuttini
Jill Cook
Susan R. Davis
Robin J. Bell
Fahad Hanna
Yuanyuan Wang
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0645-8

Other articles of this Issue 1/2015

BMC Musculoskeletal Disorders 1/2015 Go to the issue

Research article

The effect of Astym® Therapy on muscle strength: a blinded, randomized, clinically controlled trial

Research article

Inhibition of interleukin-1beta-stimulated dedifferentiation of chondrocytes via controlled release of CrmA from hyaluronic acid-chitosan microspheres

Case report

Giant cell tumor of the clavicle: report of a case in a rare location with consideration of surgical method

Research article

Malignancy risk in Australian rheumatoid arthritis patients treated with anti-tumour necrosis factor therapy: analysis of the Australian Rheumatology Association Database (ARAD) prospective cohort study

Research article

Influence of pelvic incidence-lumbar lordosis mismatch on surgical outcomes of short-segment transforaminal lumbar interbody fusion

Research article

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach