Abstract
Patellar tendinopathy – also known as the jumper’s knee – represents a clinically relevant lesion in orthopedic sports medicine and can be commonly seen in recreational as well as in professional sports performing repetitive jumping and landing activities. Many different treatment modalities have been suggested; however, there is yet no consensus for the optimal treatment regime of patellar tendinopathy. This chapter defines the term “patellar tendinopathy”, describes its pathogenetic mechanisms, summarizes diagnostics including clinical and imaging-based findings as well as conservative and operative treatment options by focusing on evidence-based levels in the treatment of patellar tendinopathy.
Similar content being viewed by others
Abbreviations
- ESWT:
-
Extracorporeal shock wave therapy
- MMP:
-
Matrix metalloproteinase
- PrP:
-
Platelet-rich plasma
- MRI:
-
Magnetic resonance imaging
- BMI:
-
Body mass index
References
Alfredson H (2011) Ultrasound and Doppler-guided mini-surgery to treat midportion Achilles tendinosis: results of a large material and a randomised study comparing two scraping techniques. Br J Sports Med 45:407–410
Alfredson H, Ohberg L (2005) Neovascularisation in chronic painful patellar tendinosis–promising results after sclerosing neovessels outside the tendon challenge the need for surgery. Knee Surg Sports Traumatol Arthrosc 13:74–80
Bahr R, Fossan B, Loken S, Engebretsen L (2006) Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper’s Knee). A randomized, controlled trial. J Bone Joint Surg Am 88:1689–1698
Baksh N, Hannon CP, Murawski CD, Smyth NA, Kennedy JG (2013) Platelet-rich plasma in tendon models: a systematic review of basic science literature. Arthroscopy 29:596–607
Blazina ME, Kerlan RK, Jobe FW, Carter VS, Carlson GJ (1973) Jumper’s knee. Orthop Clin North Am 4:665–678
Cáceres M, Hidalgo R, Sanz A, Martínez J, Riera P, Smith PC (2008) Effect of platelet-rich plasma on cell adhesion, cell migration, and myofibroblastic differentiation in human gingival fibroblasts. J Periodontol 79:714–720
Clarke AW, Alyas F, Morris T, Robertson CJ, Bell J, Connell DA (2011) Skin-derived tenocyte-like cells for the treatment of patellar tendinopathy. Am J Sports Med 39:614–623
Coleman BD, Khan KM, Kiss ZS, Bartlett J, Young DA, Wark JD (2000) Open and arthroscopic patellar tenotomy for chronic patellar tendinopathy. A retrospective outcome study. Victorian Institute of Sport Tendon Study Group. Am J Sports Med 28:183–190
Cook JL, Purdam CR (2009) Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 43:409–416
Cucurulo T, Louis ML, Thaunat M, Franceschi JP (2009) Surgical treatment of patellar tendinopathy in athletes. A retrospective multicentric study. Orthop Traumatol Surg Res 95:S78–S84
Cuéllar EC, Mina NZ (2007) Jumper’s knee. Surgery and arthroscopic treatment with scraping and povidone collagen in high-performance athletes. Acta Ortop Mex 21:234–238
Danielson P, Alfredson H, Forsgren S (2006) Immunohistochemical and histochemical findings favoring the occurrence of autocrine/paracrine as well as nerve-related cholinergic effects in chronic painful patellar tendon tendinosis. Microsc Res Tech 69:808–819
Ferretti A, Conteduca F, Camerucci E, Morelli F (2002) Patellar tendinosis: a follow-up study of surgical treatment. J Bone Joint Surg Am 84-A:2179–2185
Fritschy D, Wallensten R (1993) Surgical treatment of patellar tendinitis. Knee Surg Sports Traumatol Arthrosc 1:131–133
Frohm A, Saartok T, Halvorsen K, Renstrom P (2007) Eccentric treatment for patellar tendinopathy: a prospective randomised short-term pilot study of two rehabilitation protocols. Br J Sports Med 41:e7
James LP, Kelly VG, Beckman EM (2014) Injury risk management plan for volleyball athletes. Sports Med 44(9):1185–95
Jonsson P, Alfredson H (2005) Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomised study. Br J Sports Med 39:847–850
Katler E, Weissmann G (1977) Steroids, aspirin, and inflammation. Inflammation 2:295–307
Khan KM, Cook JL, Kannus P, Maffulli N, Bonar SF (2002) Time to abandon the “tendinitis” myth. BMJ 324:626–627
Larsson ME, Kall I, Nilsson-Helander K (2012) Treatment of patellar tendinopathy – a systematic review of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc 20:1632–1646
Maier D, Bornebusch L, Salzmann GM, Südkamp NP, Ogon P (2013) Mid- and long-term efficacy of the arthroscopic patellar release for treatment of patellar tendinopathy unresponsive to nonoperative management. Arthroscopy 29:1338–1345
Ogon P, Maier D, Jaeger A, Suedkamp NP (2006) Arthroscopic patellar release for the treatment of chronic patellar tendinopathy. Arthroscopy 22(462):e461–e465
Ostlere S (2013) The extensor mechanism of the knee. Radiol Clin North Am 51:393–411
Pascual-Garrido C, Rolon A, Makino A (2012) Treatment of chronic patellar tendinopathy with autologous bone marrow stem cells: a 5-year-followup. Stem Cells Int 2012:953510
Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM (2004) A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Br J Sports Med 38:395–397
Rees JD, Wilson AM, Wolman RL (2006) Current concepts in the management of tendon disorders. Rheumatology (Oxford) 45:508–521
Rodriguez-Merchan EC (2013) The treatment of patellar tendinopathy. J Orthop Traumatol 14:77–81
Saithna A, Gogna R, Baraza N, Modi C, Spencer S (2012) Eccentric exercise protocols for patella tendinopathy: should we really be withdrawing athletes from sport? A systematic review. Open Orthop J 6:553–557
Terslev L, Qvistgaard E, Torp-Pedersen S, Laetgaard J, Danneskiold-Samsoe B, Bliddal H (2001) Ultrasound and power doppler findings in jumper’s knee – preliminary observations. Eur J Ultrasound 13:183–189
Thomas S, Rupiper D, Stacy GS (2014) Imaging of the patellofemoral joint. Clin Sports Med 33:413–436
van Ark M, Zwerver J, van den Akker-Scheek I (2011) Injection treatments for patellar tendinopathy. Br J Sports Med 45:1068–1076
van der Worp H, van Ark M, Roerink S, Pepping GJ, van den Akker-Scheek I, Zwerver J (2011) Risk factors for patellar tendinopathy: a systematic review of the literature. Br J Sports Med 45:446–452
van Leeuwen MT, Zwerver J, van den Akker-Scheek I (2009) Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature. Br J Sports Med 43:163–168
Visnes H, Bahr R (2007) The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical review of exercise programmes. Br J Sports Med 41:217–223
Warden SJ (2007) Animal models for the study of tendinopathy. Br J Sports Med 41:232–240
Warden SJ, Metcalf BR, Kiss ZS, Cook JL, Purdam CR, Bennell KL, Crossley KM (2008) Low-intensity pulsed ultrasound for chronic patellar tendinopathy: a randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford) 47:467–471
Weinberg EP, Adams MJ, Hollenberg GM (1998) Color Doppler sonography of patellar tendinosis. AJR Am J Roentgenol 171:743–744
Willberg L, Sunding K, Forssblad M, Fahlstrom M, Alfredson H (2011) Sclerosing polidocanol injections or arthroscopic shaving to treat patellar tendinopathy/jumper’s knee? A randomised controlled study. Br J Sports Med 45:411–415
Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H (2005) Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med 39:102–105
Zwerver J, Dekker F, Pepping GJ (2010) Patient guided Piezo-electric extracorporeal shockwave therapy as treatment for chronic severe patellar tendinopathy: a pilot study. J Back Musculoskelet Rehabil 23:111–115
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this entry
Cite this entry
Brucker, P.U., Imhoff, A.B. (2014). Patellar Tendinopathy. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_68-1
Download citation
DOI: https://doi.org/10.1007/978-3-642-36801-1_68-1
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Online ISBN: 978-3-642-36801-1
eBook Packages: Springer Reference MedicineReference Module Medicine