TY - JOUR
T1 - Physical activity and investigation with magnetic resonance imaging partly explain variability in the prevalence of patellar tendon abnormalities
T2 - A systematic review with meta-analysis of imaging studies in asymptomatic individuals
AU - Docking, Sean Iain
AU - Rio, Ebonie
AU - Girdwood, Michael Alan
AU - Hannington, Madeline Claire
AU - Cook, Jill L.
AU - Culvenor, Adam G.
N1 - Funding Information:
1La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia. 2Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia. 3Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia. ORCID: Docking, https://orcid. org/0000-0001-7051-7548; Rio, https://orcid.org/0000-0002-6854-929X; Girdwood, https://orcid.org/0000-0001-6477-7263; Hannington, https://orcid.org/0000-0002-1305-1363; Culvenor, https://orcid.org/0000-0001-9491-0264. This review was registered with PROSPERO (CRD42018088087). This manuscript was partly supported by the National Basketball Association and GE Healthcare Orthopedics and Sports Medicine Collaboration. Aspects of this research are related to the work of the Australian Centre for Research into Injury in Sport and its Prevention, which is one of the International Olympic Committee centers of research excellence for the prevention of injuries and promotion of health in athletes. The funders had no involvement in the development, analysis, or reporting of this research. Dr Rio is a recipient of a National Health and Medical Research Council (Australia) Early Career Fellowship (APP1142339). Madeline Claire Hannington is a recipient of a La Trobe University Postgraduate Research Scholarship. Dr Culvenor is a recipient of a National Health and Medical Research Council Early Career Fellowship (Neil Hamilton Fairley Clinical Fellowship, APP1121173). The sponsors had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication. The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Dr Sean Docking, Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, VIC 3144 Australia. E-mail: [email protected] U Copyright ©2021 JOSPT ®, Inc
Publisher Copyright:
© 2021 Movement Science Media. All rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - OBJECTIVE: To estimate the pooled prevalence of, and factors associated with, the presence of patellar tendon abnormalities observed on imaging in people without symptoms. DESIGN: Systematic review with stratified meta-analysis and meta-regression. LITERATURE SEARCH: We searched Embase, Scopus, MEDLINE, CINAHL, SPORTDiscus, and Web of Science from 1980 to August 2020. STUDY SELECTION CRITERIA: We included studies that reported the prevalence of asymptomatic patellar tendon abnormalities on imaging. We excluded studies of participants with current tendon pain, a history of tendon pain, or other systemic conditions. DATA SYNTHESIS: Stratification and meta-regression of studies based on study-level descriptive statistics (mean age, body mass index, proportion of female participants, physical activity participation, imaging modality) were performed using a random-effects model to account for between-study heterogeneity. Risk of bias was assessed using the modified Newcastle-Ottawa scale. RESULTS: Meta-analysis of 64 studies (7125 limbs from 4616 participants) found significant between-study heterogeneity (I2≥90%, P<.01), which precluded a summary prevalence estimate. Heterogeneity was partially explained by studies that included participants who were physically active and studies that assessed tendon abnormalities using magnetic resonance imaging compared to ultrasound (P<.05). Mean age, body mass index, proportion of female participants, and sample size did not explain the remaining heterogeneity. CONCLUSION: There was substantial variability in the reported prevalence of asymptomatic patellar tendon abnormalities. A clear and valid method is needed to assess and report the presence of patellar tendon abnormalities to increase research capacity and establish the clinical value of imaging the patellar tendon.
AB - OBJECTIVE: To estimate the pooled prevalence of, and factors associated with, the presence of patellar tendon abnormalities observed on imaging in people without symptoms. DESIGN: Systematic review with stratified meta-analysis and meta-regression. LITERATURE SEARCH: We searched Embase, Scopus, MEDLINE, CINAHL, SPORTDiscus, and Web of Science from 1980 to August 2020. STUDY SELECTION CRITERIA: We included studies that reported the prevalence of asymptomatic patellar tendon abnormalities on imaging. We excluded studies of participants with current tendon pain, a history of tendon pain, or other systemic conditions. DATA SYNTHESIS: Stratification and meta-regression of studies based on study-level descriptive statistics (mean age, body mass index, proportion of female participants, physical activity participation, imaging modality) were performed using a random-effects model to account for between-study heterogeneity. Risk of bias was assessed using the modified Newcastle-Ottawa scale. RESULTS: Meta-analysis of 64 studies (7125 limbs from 4616 participants) found significant between-study heterogeneity (I2≥90%, P<.01), which precluded a summary prevalence estimate. Heterogeneity was partially explained by studies that included participants who were physically active and studies that assessed tendon abnormalities using magnetic resonance imaging compared to ultrasound (P<.05). Mean age, body mass index, proportion of female participants, and sample size did not explain the remaining heterogeneity. CONCLUSION: There was substantial variability in the reported prevalence of asymptomatic patellar tendon abnormalities. A clear and valid method is needed to assess and report the presence of patellar tendon abnormalities to increase research capacity and establish the clinical value of imaging the patellar tendon.
KW - Diagnostic ultrasound imaging
KW - Incidental findings
KW - Magnetic resonance imaging
KW - Patellar tendon
UR - https://www.scopus.com/pages/publications/85105682095
U2 - 10.2519/jospt.2021.10054
DO - 10.2519/jospt.2021.10054
M3 - Review Article
C2 - 33779217
AN - SCOPUS:85105682095
SN - 0190-6011
VL - 51
SP - 216
EP - 231
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 5
ER -