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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 8, pp 1632–1646 | Cite as

Treatment of patellar tendinopathy—a systematic review of randomized controlled trials

  • Maria E. H. Larsson
  • Ingela Käll
  • Katarina Nilsson-Helander
Knee

Abstract

Purpose

Patellar tendinopathy is a common, painful, overuse disorder. Although many different treatment methods have been described, there is no consensus regarding the optimal treatment for this condition. The purpose of this study was to systematically review, summarize, and compare treatments for patellar tendinopathy from published randomized controlled trials.

Methods

Database searches were performed for randomized prospective controlled trials comparing treatment methods for patellar tendinopathy. The thirteen articles considered relevant were scrutinized according to quality assessment guidelines and levels of evidence.

Results

Strong evidence was found for the use of eccentric training to treat patellar tendinopathy. Moderate evidence was found for conservative treatment (heavy slow resistance training) as an alternative to eccentric training. Moderate evidence suggests that low-intensity pulsed ultrasound treatment did not influence treatment outcomes. Limited evidence was found for surgery, sclerosing injections, and shockwave therapy.

Conclusion

Physical training, and particularly eccentric training, appears to be the treatment of choice for patients suffering from patellar tendinopathy. However, type of exercise, frequency, load, and dosage must also be analyzed. Other treatment methods, such as surgical treatment, sclerosing injections, and shockwave therapy, must be investigated further before recommendations can be made regarding their use. Ultrasound can likely be excluded as a treatment for patellar tendinopathy. There is a persistent lack of well-designed studies with sufficiently long-term follow-up and number of patients to draw strong conclusions regarding therapy.

Level of evidence

II.

Keywords

Eccentric training Evidence-based medicine Jumper's knee 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Maria E. H. Larsson
    • 1
    • 2
  • Ingela Käll
    • 1
    • 3
  • Katarina Nilsson-Helander
    • 4
    • 5
  1. 1.Department of Clinical Neuroscience and Rehabilitation/Physiotherapy, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at University of GothenburgGothenburgSweden
  2. 2.Research and Development UnitPrimary Health Care GothenburgGothenburgSweden
  3. 3.Primary Health Care Southern BohuslänGothenburgSweden
  4. 4.Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska AcademyUniversity of Gothenburg, Sahlgrenska University HospitalGothenburgSweden
  5. 5.Department of OrthopaedicsKungsbacka HospitalKungsbackaSweden

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