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Knee

Treating Patellar Tendinopathy

Treatment of patellar tendinopathy case presentation A healthy, 36-year-old triathlete presents with a 1-year history of persistent right anterior knee pain.

A
Andrew Schleihauf
Sports Medicine Physician ยท April 21, 2024 ยท 3 min read

Overview

Treatment of patellar tendinopathy case presentation A healthy, 36-year-old triathlete presents with a 1-year history of persistent right anterior knee pain. He seems to get significantly worse with running and jumping activities and localizes his tenderness over the inferior pole of the patella. A limited diagnostic ultrasound shows increased patellar tendon thickness and vascularity.

Symptoms

Which of the following is the most appropriate first line treatment? Corticosteroid injection into infrapatellar bursa B. PRP over patellar tendon C.

Causes and Risk Factors

Physical therapy including eccentric exercises D. Surgical consult introduction Patellar tendinopathy (also known as patellar tendinosis, jumper's knee, or inferior pole patellar tendinopathy) usually presents with anterior knee pain and tenderness at the inferior pole of the patella, causing significant morbidity among those participating in sports. Most sports medicine providers will encounter patellar tendinopathy (PT) with a fair amount of frequency, particularly in basketball and volleyball.

Treatment Options

A disturbed collagen distribution, changes in vascularity and cellularity, increased thickness of tendon, and incompletely healed tendon microruptures are common changes observed in patients with patellar tendinopathy (PT) [this pathology. The major cause of this injury is overuse during activities that involve jumping, running, and rapid changes of direction, which are very common movements in sports such as basketball and volleyball. In both elite sports, 40โ€“50% of professional athletes are affected.

Recovery

The management of PT can be active or passive. Active strategies involve tendon-loading regimes, and eccentric training is the most widely adopted approach. It has been shown that there is a 50โ€“70% likelihood of improvement at 3โ€“6-month follow-up with this method Passive treatments for PT include different minimally invasive techniques (MITs), such as corticosteroid and platelet-rich plasma (PRP) injections, extracorporeal shockwave therapy (ESWT), low-energy laser therapy, dry needling (DN), and percutaneous needle electrolysis (PNE).

When to See a Doctor

If you are experiencing symptoms that may be related to treatment of patellar tendinopathy, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

KneeTendinopathy
A
Andrew Schleihauf
Sports Medicine Physician
Sports Medicine Review contributor

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