Management of Patellar Tendinopathy

Area of Science:

• Orthopedics
• Sports Medicine
• Regenerative Medicine

Background:

• Patellar tendinopathy, commonly known as jumpers' knee, affects athletes engaging in repetitive jumping and running.
• It is characterized by microinjury to tendon fibers, potentially progressing to partial tears, causing prolonged recovery and performance decline.
• The condition typically involves mucoid degeneration and necrosis rather than inflammation.

Purpose of the Study:

• To review the pathology and evolving treatment strategies for patellar tendinopathy.
• To discuss nonoperative and operative management options, including emerging biologic and minimally invasive techniques.
• To provide insights into surgical indications and techniques for refractory cases.

Main Methods:

• Review of current literature on patellar tendinopathy pathology and treatment.
• Discussion of nonoperative treatments: activity modification, NSAIDs, eccentric physical therapy, shock wave therapy, and injections (PRP, bone marrow aspirate concentrate).
• Exploration of operative interventions including arthroscopic or open debridement and suture anchor repair for significant tears (>50% thickness).

Main Results:

• Nonoperative treatments form the initial approach, with growing evidence supporting therapies like PRP and extracorporeal shock wave treatment.
• Ultrasound-guided percutaneous tendon scraping with injections is an emerging, promising technique.
• Surgical intervention is reserved for tears >50% thickness, offering improved patient-reported outcomes and return to sport.

Conclusions:

• Patellar tendinopathy management requires a stepwise approach, often starting with conservative measures.
• Biologic treatments and minimally invasive procedures show potential for improving outcomes.
• Surgical debridement provides reliable results for severe, non-responsive cases of jumpers' knee.