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Type: Journal article
Title: Patellar tendon enthesis abnormalities and their association with knee pain and structural abnormalities in older adults
Author: Mattap, S.M.
Aitken, D.
Wills, K.
Halliday, A.
Ding, C.
Han, W.
Munugoda, I.
Graves, S.E.
Lorimer, M.
Cicuttini, F.
Jones, G.
Laslett, L.L.
Citation: Osteoarthritis and Cartilage, 2019; 27(3):449-458
Publisher: Elsevier
Issue Date: 2019
ISSN: 1063-4584
1522-9653
Statement of
Responsibility: 
S.M.Mattap, D.Aitken, K.Wills, A.Halliday, C.Ding, W.Han ... et al.
Abstract: 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.
Keywords: Enthesis abnormalities
Enthesopathy
Knee
MRI
Osteoarthritis
Patellar tendon enthesis
Rights: © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd.
DOI: 10.1016/j.joca.2018.11.009
Grant ID: NHMRC
Published version: http://dx.doi.org/10.1016/j.joca.2018.11.009
Appears in Collections:Medicine publications

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