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Sports Medicine

, Volume 35, Issue 1, pp 71–87 | Cite as

Patellar Tendinopathy in Athletes

Current Diagnostic and Therapeutic Recommendations
  • Koen H. E. Peers
  • Roeland J. J. Lysens
Injury Clinic

Abstract

Formerly known as ‘jumper’s knee’, patellar tendinopathy gives rise to considerable functional deficit and disability in recreational as well as professional athletes. It can interfere with their performance, often perseveres throughout the sporting career and may be the primary cause to end it. The diagnosis of patellar tendinopathy is primarily a clinical one but new imaging techniques, such as Doppler ultrasonography, may provide additional diagnostic value. Current therapeutic protocols are characterised by wide variability ensuing from anecdotal experience rather than evidence. Moreover, numerous reports in recent years have shattered previous doctrines and dogmatic belief on tendon overuse. Histopathological and biochemical evidence has indicated that the underlying pathology of tendinopathy is not an inflammatory tendinitis but a degenerative tendinosis. Consequently, pain in chronic patellar tendinopathy is not inflammatory in nature, but its exact origin remains unexplained. In pursuit of pathology- and evidence-based management, conservative therapy should be shifted from anti-inflammatory strategies towards a complete rehabilitation with eccentric tendon strengthening as a key element. If conservative management fails, surgery is opted for. However, considering the heterogeneity of surgical procedures and the absence of randomised studies, no conclusive evidence can be drawn from the literature regarding the effectiveness of surgical treatment for patellar tendinopathy. Parallel with the improved knowledge on the pathophysiology and pain mechanisms in patellar tendinopathy, new treatment strategies are expected to emerge in the near future.

Keywords

Patellar Tendon Eccentric Exercise Extracorporeal Shock Wave Therapy Power Doppler Ultrasonography Achilles Tendinopathy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors declare that no funding was used to assist in the preparation of the manuscript and that no conflicts of interest exist relevant to the contents of the manuscript.

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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  1. 1.Department of Physical Medicine and RehabilitationGasthuisberg and Pellenberg University HospitalsPellenberg, LeuvenBelgium

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