Literature DB >> 21461867

Can arthroscopically assisted treatment of chronic patellar tendinopathy reduce pain and restore function?

Jorge Santander1, Eduardo Zarba, Horacio Iraporda, Sebastián Puleo.   

Abstract

BACKGROUND: Patellar tendinopathy is a common source of pain in athletes, especially those involved in sports with a high incidence of jumping and cutting. Changes in training programs and exercises based on eccentric quadriceps contractions often relieve patients' symptoms. For athletes unresponsive to this treatment, some authors suggest open and arthroscopic procedures débriding either the tendon alone, or the tendon and bone. QUESTIONS/PURPOSES: We asked whether an arthroscopically assisted approach to débride not only the tendon, bone, but also the peritenon could relieve pain and allow athletes to return to their former activities. PATIENTS AND METHODS: We retrospectively reviewed 23 patients with a history of at least 6 months of painful patellar tendinopathy unresponsive to nonoperative treatment treated with an arthroscopic technique that débrided the tendon, inferior pole of the patella, and peritenon: 22 males and one female. Mean age was 29 years. Patients were evaluated using the anterior knee pain score of Kujala et al. The minimum followup was 12 months (mean, 58 months; range, 12-121 months).
RESULTS: Twelve patients scored 100, one 99, one 98, five 97, two 94, one 90, and one 64. The Kujala et al. mean score was 96 (range, 64-100). All but four patients returned to their former sports activities. We observed no complications.
CONCLUSIONS: Arthroscopic treatment can relieve the pain of refractory chronic patellar tendinopathy. Our observations were comparable with those previously reported for open techniques and a high percentage of patients returned to their previous activity level. LEVEL OF EVIDENCE: Level IV, observational study. See Guidelines for Authors for a complete description of levels of evidence.

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Year:  2012        PMID: 21461867      PMCID: PMC3293969          DOI: 10.1007/s11999-011-1886-y

Source DB:  PubMed          Journal:  Clin Orthop Relat Res        ISSN: 0009-921X            Impact factor:   4.176


  13 in total

1.  Patellar tendinosis: a follow-up study of surgical treatment.

Authors:  Andrea Ferretti; Fabio Conteduca; Emanuela Camerucci; Federico Morelli
Journal:  J Bone Joint Surg Am       Date:  2002-12       Impact factor: 5.284

2.  Jumper's knee.

Authors:  M E Blazina; R K Kerlan; F W Jobe; V S Carter; G J Carlson
Journal:  Orthop Clin North Am       Date:  1973-07       Impact factor: 2.472

3.  Arthroscopic treatment of infrapatellar tendonitis.

Authors:  A A Romeo; R V Larson
Journal:  Arthroscopy       Date:  1999-04       Impact factor: 4.772

Review 4.  Tendon injury and tendinopathy: healing and repair.

Authors:  Pankaj Sharma; Nicola Maffulli
Journal:  J Bone Joint Surg Am       Date:  2005-01       Impact factor: 5.284

5.  Open and arthroscopic patellar tenotomy for chronic patellar tendinopathy. A retrospective outcome study. Victorian Institute of Sport Tendon Study Group.

Authors:  B D Coleman; K M Khan; Z S Kiss; J Bartlett; D A Young; J D Wark
Journal:  Am J Sports Med       Date:  2000 Mar-Apr       Impact factor: 6.202

6.  Recalcitrant patellar tendinitis. Magnetic resonance imaging, histologic evaluation, and surgical treatment.

Authors:  J E Popp; J S Yu; C C Kaeding
Journal:  Am J Sports Med       Date:  1997 Mar-Apr       Impact factor: 6.202

7.  A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy.

Authors:  C R Purdam; P Jonsson; H Alfredson; R Lorentzon; J L Cook; K M Khan
Journal:  Br J Sports Med       Date:  2004-08       Impact factor: 13.800

8.  Scoring of patellofemoral disorders.

Authors:  U M Kujala; L H Jaakkola; S K Koskinen; S Taimela; M Hurme; O Nelimarkka
Journal:  Arthroscopy       Date:  1993       Impact factor: 4.772

9.  Operative treatment and arthroscopic findings in chronic patellar tendinitis.

Authors:  G P Griffiths; F H Selesnick
Journal:  Arthroscopy       Date:  1998 Nov-Dec       Impact factor: 4.772

10.  Patellar tendinitis (jumper's knee).

Authors:  J Roels; M Martens; J C Mulier; A Burssens
Journal:  Am J Sports Med       Date:  1978 Nov-Dec       Impact factor: 6.202

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  10 in total

1.  Surgical Technique: Jumper's Knee-Arthroscopic Treatment of Chronic Tendinosis of the Patellar Tendon.

Authors:  Matthias Brockmeyer; Alexander Haupert; Dieter Kohn; Olaf Lorbach
Journal:  Arthrosc Tech       Date:  2016-12-12

2.  The Value of Visa-Score and Colour Flow Imaging in the Follow-Up of Non-Athletes Operated for Jumpers Knee.

Authors:  Eirik S Salvesen; Ketil J Holen
Journal:  J Sports Sci Med       Date:  2016-12-01       Impact factor: 2.988

Review 3.  Treatment of patellar tendinopathy--a systematic review of randomized controlled trials.

Authors:  Maria E H Larsson; Ingela Käll; Katarina Nilsson-Helander
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2011-12-21       Impact factor: 4.342

4.  Arthroscopic Treatment of Patellar Tendinopathy: Use of 70° Arthroscope and Superolateral Portal.

Authors:  Orestis Karargyris; Vipul Mandalia
Journal:  Arthrosc Tech       Date:  2016-09-26

5.  Open Patellar Tendon Tenotomy, Debridement, and Repair Technique Augmented With Platelet-Rich Plasma for Recalcitrant Patellar Tendinopathy.

Authors:  Bradley M Kruckeberg; Jorge Chahla; Marcio B Ferrari; George Sanchez; Gilbert Moatshe; Robert F LaPrade
Journal:  Arthrosc Tech       Date:  2017-04-17

6.  Women Have Tendons… and Tendinopathy: Gender Bias is a "Gender Void" in Sports Medicine with a Lack of Women Data on Patellar Tendinopathy-A Systematic Review.

Authors:  Camilla Mondini Trissino da Lodi; Maria Paola Landini; Emanuela Asunis; Giuseppe Filardo
Journal:  Sports Med Open       Date:  2022-06-07

7.  Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy.

Authors:  F Abat; P E Gelber; F Polidori; J C Monllau; J M Sanchez-Ibañez
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2014-01-30       Impact factor: 4.342

8.  Arthroscopic treatment of chronic patellar tendinopathy in high-level athletes.

Authors:  Dimosthenis Artemis Alaseirlis; George Athanasios Konstantinidis; Nikolaos Malliaropoulos; Lamprini Stefanos Nakou; Anastasios Korompilias; Nicola Maffulli
Journal:  Muscles Ligaments Tendons J       Date:  2013-01-21

9.  Arthroscopic patellar release for treatment of chronic symptomatic patellar tendinopathy: long-term outcome and influential factors in an athletic population.

Authors:  Gernot Lang; Jan M Pestka; Dirk Maier; Kaywan Izadpanah; Norbert Südkamp; Peter Ogon
Journal:  BMC Musculoskelet Disord       Date:  2017-11-22       Impact factor: 2.362

Review 10.  Patellar Tendinopathy.

Authors:  Aaron Schwartz; Jonathan N Watson; Mark R Hutchinson
Journal:  Sports Health       Date:  2015-01-23       Impact factor: 3.843

  10 in total

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