title: Association between obesity and magnetic resonance imaging defined patellar tendinopathy in community-based adults: a cross-sectional study.
abstract: BACKGROUND
  Patellar 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.
  
  
  METHODS
  297 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  MRI 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.
authors.forename: Jessica
authors.initials: J
authors.lastname: Fairley
authors.forename: Jason
authors.initials: J
authors.lastname: Toppi
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
authors.forename: Anita E
authors.initials: AE
authors.lastname: Wluka
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Jill
authors.initials: J
authors.lastname: Cook
authors.forename: Richard
authors.initials: R
authors.lastname: O'Sullivan
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne VIC 3004, Australia. yuanyuan.wang@monash.edu.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
mesh_terms: D050154:Adiposity; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D010147:Pain Measurement; D017847:Patellar Ligament / Q000473:pathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D052256:Tendinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D014739:Victoria / Q000453:epidemiology
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