Patellar Tendinopathy

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Patellar tendinopathy is a common cause of pain in athletes' knees. Historically, it has been related to jumping sports, such as volleyball and basketball. Repetitive jumping generates a considerable load of energy in the extensor mechanism, leading to symptoms. The main pathophysiologic phenomenon in patellar tendinopathy is tendinosis, which is a degenerative disorder rather than an inflammatory disorder; therefore, the other popular term for this disease, tendinitis, is not appropriate. The nonsurgical treatment of patellar tendinopathy is focused on eccentric exercises and often has good results. Other experimental options, with variable levels of evidence, are available for recalcitrant cases. Surgical treatment is indicated for cases that are refractory to nonsurgical treatment. Open or arthroscopic surgery can be performed; the two methods are comparable, but arthroscopic surgery results in a faster recovery time.

Related collections

Most cited references 45

Record: found
Abstract: found
Article: not found

Risk factors for patellar tendinopathy: a systematic review of the literature.

Henk van der Worp, Mathijs van Ark, Saskia Roerink … (2011)

Patellar tendinopathy (PT) is an injury with a high prevalence in sports. Knowledge of risk factors is essential for developing preventive measures and rehabilitation programmes. However, risk factors associated with PT have not yet been systematically studied. This review was undertaken to identify risk factors associated with PT. The literature was systematically searched to identify articles that investigated risk factors for PT. There was no strong or moderate evidence that any investigated risk factor was associated with PT. For nine risk factors there was some evidence: weight, body mass index, waist-to-hip ratio, leg-length difference, arch height of the foot, quadriceps flexibility, hamstring flexibility, quadriceps strength and vertical jump performance. Based on the present evidence, reducing body weight, increasing upper-leg flexibility and quadriceps strength and the use of orthotics may be beneficial treatment options. However, it should be stressed that the evidence for the nine identified risk factors was only limited. Therefore, there is a clear need for high-quality studies in order to identify the exact risk factors associated with PT.

0 comments Cited 57 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee: a prospective randomised study.

H Alfredson, P Jonsson (2005)

A recent study reported promising clinical results using eccentric quadriceps training on a decline board to treat jumper's knee (patellar tendinosis). In this prospective study, athletes (mean age 25 years) with jumper's knee were randomised to treatment with either painful eccentric or painful concentric quadriceps training on a decline board. Fifteen exercises were repeated three times, twice daily, 7 days/week, for 12 weeks. All patients ceased sporting activities for the first 6 weeks. Age, height, weight, and duration of symptoms were similar between groups. Visual analogue scales (VAS; patient estimation of pain during exercise) and Victorian Institute of Sport Assessment (VISA) scores, before and after treatment, and patient satisfaction, were used for evaluation. In the eccentric group, for 9/10 tendons patients were satisfied with treatment, VAS decreased from 73 to 23 (p<0.005), and VISA score increased from 41 to 83 (p<0.005). In the concentric group, for 9/9 tendons patients were not satisfied, and there were no significant differences in VAS (from 74 to 68, p<0.34) and VISA score (from 41 to 37, p<0.34). At follow up (mean 32.6 months), patients in the eccentric group were still satisfied and sports active, but all patients in the concentric group had been treated surgically or by sclerosing injections. In conclusion, eccentric, but not concentric, quadriceps training on a decline board, seems to reduce pain in jumper's knee. The study aimed to include 20 patients in each group, but was stopped at the half time control because of poor results achieved in the concentric group.

0 comments Cited 56 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

ESWT for tendinopathy: technology and clinical implications

Henk van der Worp, Inge van den Akker-Scheek, Hans van Schie … (2012)

Purpose The general consensus that tendinopathy, at least in the chronic stage, is mainly a degenerative condition and inflammation plays a minor role has led to a shift from treatments that target inflammation towards treatment options that promote regeneration. One of these treatments is extracorporeal shockwave therapy (ESWT), a physical therapy modality that uses pressure waves to treat tendinopathy. This review was undertaken to give an overview of the literature concerning this treatment, and special attention is given to the differences between focused and radial ESWT. Methods A narrative description of wave characteristics, generation methods and in vitro effects of ESWT is given. The literature on ESWT as a treatment for one common tendinopathy, patellar tendinopathy, was systematically reviewed. Results Waves that are generated for focused and radial ESWT have very different physical characteristics. It is unclear how these characteristics are related to clinical effectiveness. Studies into the biological effects of ESWT have mainly used focused shockwave therapy, showing a number of effects of shockwaves on biological tissue. The systematic review of studies into the clinical effects of ESWT for patellar tendinopathy showed conflicting evidence for its effectiveness. Conclusion Physical characteristics of focused and radial waves differ substantially, but effect on clinical effectiveness is unclear. Whereas in vitro studies often show the effects of ESWT on tendon tissue, results of clinical studies are inconsistent. Based on the review of the literature, suggestions are given for the use of ESWT in clinical practice regarding timing and treatment parameters. Level of evidence IV. Electronic supplementary material The online version of this article (doi:10.1007/s00167-012-2009-3) contains supplementary material, which is available to authorized users.

0 comments Cited 51 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Title: Journal of the American Academy of Orthopaedic Surgeons

Abbreviated Title: Journal of the American Academy of Orthopaedic Surgeons

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Print): 1067-151X

Publication date Created: 2016

Publication date (Print): December 2016

Volume: 24

Issue: 12

Pages: e184-e192

Article

DOI: 10.5435/JAAOS-D-15-00703

PubMed ID: 27855131

SO-VID: ca1ef8b2-57e5-4bf3-b862-20f9a44ccaf9

History

Data availability:

Comments

Comment on this article

scite_

Cited by 27

See all cited by

Most referenced authors 334

See all reference authors

Patellar Tendinopathy : Diagnosis and Treatment

Read this article at

Abstract

Related collections

ScienceOpen Research

Most cited references 45

Risk factors for patellar tendinopathy: a systematic review of the literature.

Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee: a prospective randomised study.

ESWT for tendinopathy: technology and clinical implications

Author and article information

Journal

Article

History

Comments

Comment on this article

Similar content 1,967

Cited by 27

Most referenced authors 334