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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Author information

Authors and Affiliations

  1. Department of Clinical Neuroscience and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Maria E. H. Larsson & Ingela Käll

  2. Research and Development Unit, Primary Health Care Gothenburg, Kungsgatan 12, 6th floor, SE 411 18, Gothenburg, Sweden

    Maria E. H. Larsson

  3. Primary Health Care Southern Bohuslän, Gothenburg, Sweden

    Ingela Käll

  4. Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden

    Katarina Nilsson-Helander

  5. Department of Orthopaedics, Kungsbacka Hospital, Kungsbacka, Sweden

    Katarina Nilsson-Helander

Authors
  1. Maria E. H. Larsson
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  2. Ingela Käll
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  3. Katarina Nilsson-Helander
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Correspondence to Maria E. H. Larsson.

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Larsson, M.E.H., Käll, I. & Nilsson-Helander, K. Treatment of patellar tendinopathy—a systematic review of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc 20, 1632–1646 (2012). https://doi.org/10.1007/s00167-011-1825-1

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  • DOI: https://doi.org/10.1007/s00167-011-1825-1

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