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Patellar tendon enthesis abnormalities and their association with knee pain and structural abnormalities in older adults

Mattap, SMB ORCID: 0000-0002-8202-3083, Aitken, D ORCID: 0000-0001-5685-7634, Wills, K ORCID: 0000-0003-3897-2908, Halliday, A, Ding, C ORCID: 0000-0002-9479-730X, Han, W ORCID: 0000-0003-1590-7433, Munugoda, IP ORCID: 0000-0001-5075-6760, Graves, SE, Lorimer, M, Cicuttini, F, Jones, G ORCID: 0000-0002-9814-0006 and Laslett, LL ORCID: 0000-0002-4336-0095 2018 , 'Patellar tendon enthesis abnormalities and their association with knee pain and structural abnormalities in older adults' , Osteoarthritis and Cartilage , pp. 1-10 , doi:

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Objective: To describe associations between presence of patellar tendon enthesis (PTE) abnormalities and symptoms, structural abnormalities, and total knee replacement (TKR) in older adult cohort.Methods: PTE abnormalities (presence of abnormal bone signal and/or bone erosion), were measured on T2-weighted magnetic resonance (MR) images at baseline in 961 community-dwelling older adults. Knee pain and function limitation were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Bone marrow lesions (BMLs), cartilage volume and defects score, and infrapatellar fat pad (IPFP) area were measured using validated methods. Incidence of TKR was determined by data linkage.Results: Participants with abnormal PTE bone signal and/or erosion was 20%. Cross-sectionally, presence of PTE abnormalities was associated with greater pain intensity while going up and down stairs (β = 0.22 (95% confidence interval (CI); 0.03, 0.41)), greater risk of femoral BMLs (RR = 1.46 (1.12, 1.90)) and worse tibial cartilage defects score (RR = 1.70 (1.16, 2.47), and smaller IPFP area (β = -0.27 (-0.47, -0.06) cm2), after adjustment of confounders. Longitudinally, presence of baseline PTE abnormalities was associated with a deleterious increase in tibial BML size (RR = 1.52 (1.12, 2.05)) over 10.7 years but not symptoms, other structural changes, or TKR.Conclusion: PTE abnormalities are common in older adults. Presence of cross-sectional but not longitudinal associations suggests they are commonly co-exist with other knee structural abnormalities but may not play a major role in symptom development or structural change, excepting tibial BMLs.

Item Type: Article
Authors/Creators:Mattap, SMB and Aitken, D and Wills, K and Halliday, A and Ding, C and Han, W and Munugoda, IP and Graves, SE and Lorimer, M and Cicuttini, F and Jones, G and Laslett, LL
Keywords: patellar tendon enthesis, enthesis abnormalities, enthesopathy, osteoarthritis, MRI, knee
Journal or Publication Title: Osteoarthritis and Cartilage
Publisher: W B Saunders Co Ltd
ISSN: 1063-4584
DOI / ID Number:
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© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license

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