Kerstin Sunding1, Lotta Willberg2,3, Suzanne Werner2, Håkan Alfredson3, Magnus Forssblad2, Martin Fahlström4. 1. Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden. kerstin.sunding@capio.se. 2. Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden. 3. Sports Medicine Unit, Department of Surgical and Perioperative Science, Umeå University, 901 87, Umeå, Sweden. 4. Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, 901 87, Umeå, Sweden.
Abstract
PURPOSE: Treatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections or ultrasound-guided arthroscopic shaving has shown good clinical short-term results. Former studies indicate that the tendon thickness and structure stays unaffected after successful treatment. The aim of this study was to evaluate the sonographic findings and clinical outcome 3-5 years after treatment of patellar tendinopathy with ultrasound-guided sclerosing injections or arthroscopic shaving. METHODS: Fifty-seven patellar tendons (43 patients) with chronic patellar tendinopathy were evaluated, with ultrasound, colour Doppler (CD) and visual analogue scale (VAS) for pain and satisfaction with treatment, 3-5 years after treatment. Functional status was evaluated with a single question-"Back in full loading activity?" yes or no. RESULTS: At endpoint (mean 46 months), there was a significant decrease in anteroposterior thickness of the proximal patellar tendon in patients treated with ultrasound-guided arthroscopic shaving but not after sclerosing injections. Tendon structure had improved, and CD local blood flow had diminished significantly in both groups. There were good clinical results with a significant decrease in VAS for pain after sclerosing injections (VAS 64 ± 18 → 17 ± 23) with 74 % satisfied patients and also after arthroscopic shaving (VAS 77 ± 16 → 13 ± 23) with 80 % satisfied patients. There were no significant differences in VAS between groups. A significant correlation between low local blood flow and high patient satisfaction was found. CONCLUSIONS: Tendon thickness decreased over time after ultrasound-guided arthroscopic shaving, and tendon structure and local blood flow decreased after both treatments. There were good, and similar, clinical results with both methods. LEVEL OF EVIDENCE: III.
PURPOSE: Treatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections or ultrasound-guided arthroscopic shaving has shown good clinical short-term results. Former studies indicate that the tendon thickness and structure stays unaffected after successful treatment. The aim of this study was to evaluate the sonographic findings and clinical outcome 3-5 years after treatment of patellar tendinopathy with ultrasound-guided sclerosing injections or arthroscopic shaving. METHODS: Fifty-seven patellar tendons (43 patients) with chronic patellar tendinopathy were evaluated, with ultrasound, colour Doppler (CD) and visual analogue scale (VAS) for pain and satisfaction with treatment, 3-5 years after treatment. Functional status was evaluated with a single question-"Back in full loading activity?" yes or no. RESULTS: At endpoint (mean 46 months), there was a significant decrease in anteroposterior thickness of the proximal patellar tendon in patients treated with ultrasound-guided arthroscopic shaving but not after sclerosing injections. Tendon structure had improved, and CD local blood flow had diminished significantly in both groups. There were good clinical results with a significant decrease in VAS for pain after sclerosing injections (VAS 64 ± 18 → 17 ± 23) with 74 % satisfied patients and also after arthroscopic shaving (VAS 77 ± 16 → 13 ± 23) with 80 % satisfied patients. There were no significant differences in VAS between groups. A significant correlation between low local blood flow and high patient satisfaction was found. CONCLUSIONS: Tendon thickness decreased over time after ultrasound-guided arthroscopic shaving, and tendon structure and local blood flow decreased after both treatments. There were good, and similar, clinical results with both methods. LEVEL OF EVIDENCE: III.
Authors: Toufic R Jildeh; Patrick Buckley; Muhammad J Abbas; Brendan Page; Jacob Young; Nima Mehran; Kelechi R Okoroha Journal: Orthop J Sports Med Date: 2021-09-03
Authors: Tomas Fernandez-Jaén; Guillermo Álvarez Rey; Francisco Angulo; Jordi Ardevol Cuesta; Rafael Arriaza Loureda; Fernando Ávila España; Juan Ayala; Ramón Balius Matas; Fernando Baró Pazos; Juan de Dios Beas Jiménez; Jorge Candel Rosell; César Cobián Fernandez; M Del Pilar Doñoro Cuevas; Francisco Esparza Ros; Josefina Espejo Colmenero; Jorge Fernández de Prado; Juan José García Cota; Jose Ignacio Garrido González; Carlos Gonzalez de Vega; Manuela González Santander; Miguel Ángel Herrador Munilla; Francisco Ivorra Ruiz; Fernando Jiménez Díaz; Antonio Maestro Fernandez; Pedro Manonelles Marqueta; Juan José Muñoz Benito; Ramón Olivé Vilás; Carles Pedret; Xavier Peirau Teres; José Peña Amaro; Jordi Puigdellivoll Grifell; Juan Pérez San Roque; Christophe Ramírez Parenteu; Juan Ribas Serna; Gil Rodas; Mikel Sánchez Álvarez; Carlos Sanchez Marchori; Lluis Til Perez; Rosario Ureña Durán; Miguel Del Valle Soto; José María Villalón Alonso; Pedro Guillen García Journal: Orthop J Sports Med Date: 2017-10-31
Authors: F Abat; H Alfredson; M Cucchiarini; H Madry; A Marmotti; C Mouton; J M Oliveira; H Pereira; G M Peretti; C Spang; J Stephen; C J A van Bergen; L de Girolamo Journal: J Exp Orthop Date: 2018-09-24