Description

• The pes anserinus (“goosefoot”) is the combined insertion of the sartorius, gracilis, and semitendinosus tendons on the anteromedial tibia.
• There is a bursa that lies under the pes anserinus (between the semitendinosus tendon and the tibial attachment of the medical collateral ligament).
• Pes anserine tendino-bursitis (PATB) is due to irritation of the bursa and/or tendons in this area.

Epidemiology

Prevalence
One of the most frequent soft tissue pain syndromes in the knee

Etiology and Pathophysiology

PATB is thought to occur due to:

• Overuse injury
• Excessive valgus and rotary stresses
• Mechanical forces and degenerative changes
• Direct trauma

Risk Factors

• More common in middle-aged, overweight females
• Other risk factors include:
  • Pes planus; genu valgum
  • Long-distance/hill running, cycling, swimming (“breaststroker’s knee”)
  • Sports with side-to-side/cutting activity (soccer, basketball, racquet sports)

Commonly Associated Conditions

• Osteoarthritis (OA)
  • Increased incidence of PATB in patients with symptomatic OA (1)[C]
  • Prevalence of OA and PATB reported as high as 75% (2)[C]
  • Higher grades of OA associated with a thicker pes anserine bursa and larger area of bursitis (3)[C]
• Medial meniscal tear
• Type II diabetes