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Patellar Tendinopathy: The Science Behind Treatment

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Anterior Knee Pain and Patellar Instability

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References

  1. Ferretti, A. Epidemiology of jumper’s knee. Sports Med 1986; 3: 289–295.

    CAS  PubMed  Google Scholar 

  2. Almekinders, LC. Tendinitis and other chronic tendinopathies. J Amer Acad Orth Surg 1998; 6: 157–164.

    CAS  Google Scholar 

  3. Khan, K, and N Maffuli. Tendinopathy: An Achilles’ heel for athletes and clinicians. Clin J Sports Med 1998; 8(3): 151–154.

    CAS  Google Scholar 

  4. Khan, KM et al. Patellar tendinosis (jumper’s knee): Findings at histopathologic examination, US and MR imaging. Radiology 1996; 200: 821–827.

    CAS  PubMed  Google Scholar 

  5. Kraushaar, B, and R Nirschl. Tendinosis of the elbow (tennis elbow): Clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone & Joint Surg Amer 1999; 81(2): 259–278.

    CAS  Google Scholar 

  6. Khan, KM et al. Histopathology of common overuse tendon conditions: Update and implications for clinical management. Sports Med 1999; 6: 393–408.

    Google Scholar 

  7. Visentini, PJ et al. The VISA score: An index of the severity of jumper’s knee (patellar tendinosis). J Sci & Med in Sport 1998; 1: 22–28.

    CAS  Google Scholar 

  8. Maffulli, N, KM Khan, and G Puddu. Overuse tendon conditions: Time to change a confusing terminology. Arthroscopy 1998; 14: 840–843.

    CAS  PubMed  Google Scholar 

  9. Cook, J et al. Overuse tendinosis, not tendinitis: Applying the new approach to patellar tendinopathy. Phys & Sports Med 2000; 28(6): 31–46.

    Google Scholar 

  10. Cook, J et al. Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players. Brit J Sports Med 2001; 35: 65–69.

    CAS  Google Scholar 

  11. Purdam, CR et al. Discriminative ability of functional loading tests for adolescent jumper’s knee. Phys Ther in Sport 2003; 4(1): 3–9.

    Google Scholar 

  12. Purdam, CR et al. A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Brit J Sports Med 2004; 38(4): 395–397.

    CAS  Google Scholar 

  13. Young, M et al. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Brit J Sports Med 2005; 39: 102–105.

    CAS  Google Scholar 

  14. Blazina, M et al. Jumper’s knee. Ortho Clin North America 1973; 4: 665–678.

    CAS  Google Scholar 

  15. Yu, J et al. MR imaging of injuries of the extensor mechanism of the knee. Radiographics 1994; 14(3): 541–551.

    CAS  PubMed  Google Scholar 

  16. El-Khoury, GY et al. MR imaging of patellar tendinitis. Radiology 1992; 184: 849–854.

    CAS  PubMed  Google Scholar 

  17. McLoughlin, RF et al. Patellar tendinitis: MR features, with suggested pathogenesis and proposed classification. Radiology 1995; 197: 843–848.

    CAS  PubMed  Google Scholar 

  18. Khan, KM et al. Correlation of US and MR imaging with clinical outcome after open patellar tenotomy: Prospective and retrospective studies. Clin J Sports Med 1999; 9(3): 129–137.

    CAS  Google Scholar 

  19. Sandmeier, R, and P Renstrom. Diagnosis and treatment of chronic tendon disorders in sport. Scand J Med Sci Sports 1997; 7: 96–106.

    CAS  PubMed  Google Scholar 

  20. Shalaby, M, and LC Almekinders. Patellar tendinitis: The significance of magnetic resonance imaging findings. Amer J Sports Med 1999; 27(3): 345–349.

    CAS  Google Scholar 

  21. Pope, CF. Radiologic evaluation of tendon injuries. Clin Sports Med 1992; 11: 579–599.

    CAS  PubMed  Google Scholar 

  22. Erickson, SJ et al. Effect of tendon orientation on MR imaging signal intensity: A manifestation of the “magic angle” phenomenon. Radiology 1991; 181: 389–392.

    CAS  PubMed  Google Scholar 

  23. Erickson, SJ, RW Prost, and ME Timins. The “magic angle” effect: Background physics and clinical relevance. Radiology 1993; 188: 23–25.

    CAS  PubMed  Google Scholar 

  24. Fornage, BD. The hypoechoic normal tendon: A pitfall. J Ultrasound in Med 1987; 6: 19–22.

    CAS  Google Scholar 

  25. Lian, O et al. Relationship between symptoms of jumper’s knee and the ultrasound characteristics of the patellar tendon among high level male volleyball players. Scand J Med & Sci in Sports 1996; 6: 291–296.

    CAS  Google Scholar 

  26. Cook, JL et al. Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: A study of 320 tendons. Clin J Sports Med 1998; 8: 73–77.

    CAS  Google Scholar 

  27. Khan, KM et al. Patellar tendon ultrasonography and jumper’s knee in elite female basketball players: A longitudinal study. Clin J Sports Med 1997; 7: 199–206.

    CAS  Google Scholar 

  28. Cook, JL et al. Asymptomatic hypoechoic regions on patellar tendon US do not foreshadow symptoms of jumper’s knee: A 4 year follow-up of 46 tendons. Scand J Sci & Med in Sports 2000; 11(6): 321–327.

    Google Scholar 

  29. Cook, JL et al. Prospective imaging study of asymptomatic patellar tendinopathy in elite junior basketball players. J Ultrasound in Med 2000; 19: 473–479.

    CAS  Google Scholar 

  30. Testa, V et al. Ultrasound guided percutaneous longitudinal tenotomy for the management of patellar tendinopathy. Med & Sci in Sport and Exercise 1999; 31(11): 1509–1515.

    CAS  Google Scholar 

  31. Józsa, L, and P Kannus. Human Tendons. Champaign, IL: Human Kinetics, 1997, p. 576.

    Google Scholar 

  32. Richards, DP et al. Knee joint dynamics predict patellar tendinitis in elite volleyball players. Amer J Sports Med 1996; 24(5): 676–683.

    CAS  Google Scholar 

  33. Prilutsky, BI, W Herzog, and T Leonard. Transfer of mechanical energy between ankle and knee joints by gastrocnemius and plantaris muscles during cat locomotion. J Biomech 1996; 391–403.

    Google Scholar 

  34. Prapavessis, H, and PJ McNair. Effects of instruction in jumping technique and experience jumping on ground reaction forces. J Orthrop Sports Phys Ther 1999; 29: 352–356.

    CAS  Google Scholar 

  35. Cook, JL et al. Posterior leg tightness and vertical jump are associated with US patellar tendon abnormality in 14-18-year old basketball players: A cross-sectional anthropometric and physical performance study. Brit J Sports Med 2004; 38: 206–209.

    CAS  Google Scholar 

  36. Richards, DP SV Ajemian, SP Wiley, et al. Relation between ankle joint dynamics and patellar tendinopathy in elite volleyball players. 2002; 12: 266–272.

    Google Scholar 

  37. Curwin, S, and WD Stanish. Tendinitis: Its Etiology and Treatment. Lexington: Collamore Press, 1984.

    Google Scholar 

  38. Cannell, LJ et al. A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper’s knee in athletes: Pilot study. Brit J Sports Med 2001; 35: 60–64.

    CAS  Google Scholar 

  39. Jensen, K, and RP Di Fabio. Evaluation of eccentric exercise in treatment of patellar tendinitis. Phys Ther 1989; 69(3): 211–216.

    CAS  PubMed  Google Scholar 

  40. Stasinopoulos, D, and I Stasinopoulos. Comparison of effects of exercise programme, pulsed ultrasound and transverse friction in the treatment of patellar tendinopathy. Clin Rehab 2004; 18: 347–352.

    Article  Google Scholar 

  41. Alfredson, H et al. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Amer J Sports Med 1998; 26(3): 360–366.

    CAS  Google Scholar 

  42. Holmich, P et al. Effectiveness of active physical training as treatment for long-standing adductor related groin pain in athletes: Randomised trial. Lancet 1999; 353: 439–443.

    Article  CAS  PubMed  Google Scholar 

  43. Mafi, N, R Lorentzon, and H Alfredson. Superior shortterm results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 2001; 9: 42–47.

    Article  CAS  PubMed  Google Scholar 

  44. Fyfe, I, and WD Stanish, The use of eccentric training and stretching in the treatment and prevention of tendon injuries. Clin Sports Med 1992; 11(3): 601–624.

    CAS  PubMed  Google Scholar 

  45. El Hawary, R, WD Stanish, and SL Curwin. Rehabilitation of tendon injuries in sport. Sports Med 1997; 24: 347–358.

    PubMed  Google Scholar 

  46. Kannus, P. Tendon pathology: Basic science and clinical applications. Sports Exer & Inj 1997; 3: 62–75.

    Google Scholar 

  47. Lee, E et al. Pulsed magnetic and electromagnetic fields in experimental Achilles tendonitis in the rat: A prospective randomised study. Arch Phys Med & Rehab 1997; 78: 399–404.

    CAS  Google Scholar 

  48. Davidson, C et al. Rat tendon morphological and functional changes resulting from soft tissue mobilization. Med & Sci in Sports & Exer 1997; 29: 313–319.

    CAS  Google Scholar 

  49. Gehlsen, G, L Ganton, and R Helfst. Fibroblast responses to variation in soft tissue mobilisation pressure. Med & Sci in Sport & Exer 1999; 31(4): 531–535.

    CAS  Google Scholar 

  50. Pellecchia, G, H Hamel, and P Behnke. Treatment of infrapatellar tendinitis: A combination of modalities and transverse friction massage versus iontophoresis. J Sport Rehab 1994; 3: 315–345.

    Google Scholar 

  51. Rolf, C et al. An open, randomized study of ketoprofen in patients in surgery for achilles or patellar tendinopathy. J Rheumatol 1997; 24: 1595–1598.

    CAS  PubMed  Google Scholar 

  52. Astrom, M, and N Westlin. No effect of piroxicam on achilles tendinopathy: A randomized study of 70 patients. Acta Orthop Scand 1992; 63: 631–634.

    CAS  PubMed  Google Scholar 

  53. Weiler, JM. Medical modifiers of sports injury: The use of nonsteroiodal anti-inflammatory drugs (NSAIDs) in sports soft tissue injury. Clin in Sports Med 1992; 11(3): 625–644.

    CAS  Google Scholar 

  54. Almekinders, LC. The efficacy of nonsteroidal antiinflammatory drugs in the treatment of ligament injuries. Sports Med 1990; 9: 137–142.

    CAS  PubMed  Google Scholar 

  55. Almekinders, L, and J Temple. Etiology, diagnosis, and treatment of tendonitis: An analysis of the literature. Med & Sci in Sport & Exer 1998; 30(8): 1183–1190.

    CAS  Google Scholar 

  56. Riley, GP et al. Inhibition of tendon cell proliferation and matrix glycosaminoglycan synthesis by nonsteroidal anti-inflammatory drugs in vitro. J Hand Surg (Brit & Eur Vol) 2001; 26B(3): 224–228.

    Google Scholar 

  57. Leadbetter, WB. Tendon Overuse Injuries: Diagnosis and Treatment. In Renstrom, PAFH, ed., Sports Injuries: Basic Principles of Prevention and Care. London: Oxford, 1993, pp. 449–476.

    Google Scholar 

  58. Fredberg, U, and L Bolvig. Jumper’s knee. Scand J Med & Sci in Sports 1999; 9: 66–73.

    CAS  Google Scholar 

  59. Shrier, I, G Matheson, and G Kohl. Achilles tendinitis: Are corticosteroid injections useful or harmful? Clin J Sports Med 1996; 6(4): 245–150.

    CAS  Google Scholar 

  60. Capasso, G et al. Aprotinin, corticosteroids and normosaline in the management of patellar tendinopathy in athletes: A prospective randomized study. Sports Exer & Inj 1997; 3: 111–115.

    Google Scholar 

  61. Paoloni, JA, RC Appleyard, J Nelson et al. Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow: A randomized, double-blinded, placebo-controlled clinical trial. AM J Sports Med 2003; 915–920.

    Google Scholar 

  62. Paoloni, JA Appleyard RC, Nelson J, et al. Topical glyceryl trinitrate treatment of chronic noninsertional achilles tendinopathy: A randomized, double-blind, placebocontrolled trial. J Bone Joint Surg AM 2004; 916–922.

    Google Scholar 

  63. Popp, JE, JS Yu, and CC Kaeding. Recalcitrant patellar tendinitis. Magnetic resonance imaging, histologic evaluation and surgical treatment. Amer J Sports Med 1997; 25(2): 218–222.

    CAS  Google Scholar 

  64. Karlsson, J et al. Partial rupture of the patellar ligament: Results after operative treatment. Amer J Sports Med 1991; 19: 403–408.

    CAS  Google Scholar 

  65. King, J et al. Patellar tendinopathy. Sports Med & Arthrosc Rev 2000; 8: 86–95.

    Google Scholar 

  66. Ferretti, A, E Ippolito, P Mariani, and G Puddu. Jumper’s knee. Amer J Sports Med 1983; 11: 58–62.

    CAS  Google Scholar 

  67. Colosimo, AJ, and FH Bassett. Jumper’s knee: Diagnosis and treatment. Orth Rev 1990; 29: 139–149.

    Google Scholar 

  68. Binfield, PM, and N Maffulli. Surgical management of common tendinopathies in the lower limb. Sports Exer & Inj 1997; 3: 116–122.

    Google Scholar 

  69. Biedert, R, U Vogel, and NF Friedrichs. Chronic patellar tendinitis: A new surgical treatment. Sports Exer & Inj 1997; 3: 150–154.

    Google Scholar 

  70. Raatikainen, T et al. Operative treatment of partial rupture of the patellar ligament. Int J Sports Med 1994; 15: 46–49.

    CAS  PubMed  Google Scholar 

  71. Martens, M et al. Patellar tendonitis: Pathology and results of treatment. Acta Orth Scand 1982; 53:445–450.

    CAS  Google Scholar 

  72. Puddu, G et al. Jumper’s knee and other forms of tendinitis about the knee. In The Hughston Clinic Sports Medicine Book. Baltimore: Williams and Wilkins, 1995, pp. 429–439.

    Google Scholar 

  73. Leadbetter, WB et al. The surgical treatment of tendinitis: Clinical rationale and biologic basis. Clin in Sports Med 1992; 11(4): 679–712.

    CAS  Google Scholar 

  74. Coleman, BD et al. Outcomes of open and arthroscopic patellar tenotomy for chronic patellar tendinopathy: A retrospective study. Amer J Sports Med 2000; 28(2): 1–8.

    Google Scholar 

  75. Coleman, BD et al. Studies of surgical outcome after patellar tendinopathy: Clinical significance of methodological deficiencies and guidelines for future studies. Scand J Med & Sci in Sports 2000; 10(1): 2–11.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Family Practice & School of Human Kinetics, University of British Columbia, Vancouver, Canada

    Karim M. Khan

  2. Musculoskeletal Research Centre, La Trobe University School of Physiotherapy, Melbourne, Australia

    Jill L. Cook & Mark A. Young

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  1. Karim M. Khan
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  2. Jill L. Cook
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  3. Mark A. Young
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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital Arnau de Vilanova, Valencia, Spain

    Vicente Sanchis-Alfonso MD, PhD (Member of the International Patellofemoral Study Group/Member of the ACL Study Group) (Member of the International Patellofemoral Study Group/Member of the ACL Study Group)

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Khan, K.M., Cook, J.L., Young, M.A. (2006). Patellar Tendinopathy: The Science Behind Treatment. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, London. https://doi.org/10.1007/1-84628-143-1_16

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  • DOI: https://doi.org/10.1007/1-84628-143-1_16

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  • Online ISBN: 978-1-84628-143-3

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