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Sonosurgery Ultrasound-Guided Arthroscopic Shaving for the Treatment of Patellar Tendinopathy When Conservative Treatment Fails

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Anterior Knee Pain and Patellar Instability
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Abstract

Proximal patellar Tendinopathy, commonly denominated as Jumper´s Knee, is widely considered to be a challenge to treat (Abat et al. in J Exp Orthop. 3:34, 2016). The treatment of patellar tendinopathy focuses on reducing if not eliminating the pain and improving function. At present, there are a several distinct treatments oriented to that end, and a “gold-standard” treatment might be in sight. ( Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options. J Exp Orthop. 2018 Sep 24;5(1):38. https://doi.org/10.1186/s40634-018-0145-5.)

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References

  1. Abat F, Sánchez-Sánchez JL, Martín-Nogueras AM, Calvo-Arenillas JI, Yajeya J, Méndez-Sánchez R, Monllau JC, Gelber PE. Randomized controlled trial comparing the effectiveness of the ultrasound-guided galvanic electrolysis technique (USGET) versus conventional electro-physiotherapeutic treatment on patellar tendinopathy. J Exp Orthop. 2016;3(1):34. https://doi.org/10.1186/s40634-016-0070-4.

  2. Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options. J Exp Orthop. 2018;5(1):38. https://doi.org/10.1186/s40634-018-0145-5.

  3. Jonsson P, Alfredson H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomized study. Br J Sports Med. 2005;39(11):847–50. https://doi.org/10.1136/bjsm.2005.018630.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM. A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Br J Sports Med. 2004;38(4):395–7. https://doi.org/10.1136/bjsm.2003.000053.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Romero-Rodriguez D, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach. J Exp Orthop. 2017;4(1):18. https://doi.org/10.1186/s40634-017-0092-6.

  6. Obara K, Chiba R, Takahashi M, Matsuno T, Takakusaki K. Knee dynamics during take-off and landing in spike jumps performed by volleyball players with patellar tendinopathy. J Phys Ther Sci. 2022;34(2):103–9. https://doi.org/10.1589/jpts.34.103.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Abat F, Valles SL, Gelber PE, Polidori F, Stitik TP, García-Herreros S, Monllau JC, Sanchez-Ibánez JM. Molecular repair mechanisms using the Intratissue Percutaneous Electrolysis technique in patellar tendonitis. Rev Esp Cir Ortop Traumatol. 2014;58(4):201–5. https://doi.org/10.1016/j.recot.2014.01.002.

  8. Vander Doelen T, Jelley W. Non-surgical treatment of patellar tendinopathy: A systematic review of randomized controlled trials. J Sci Med Sport. 2020;23(2):118–124. https://doi.org/10.1016/j.jsams.2019.09.008.

  9. Chen PC, Wu KT, Chou WY, Huang YC, Wang LY, Yang TH, Siu KK, Tu YK. Comparative effectiveness of different nonsurgical treatments for patellar tendinopathy: a systematic review and network meta-analysis. Arthroscopy. 2019;35(11):3117-3131.e2. https://doi.org/10.1016/j.arthro.2019.06.017.

    Article  PubMed  Google Scholar 

  10. Johnson DP. Arthroscopic surgery for patellar tendonitis: A new technique. Arthroscopy. 1998;14:S44.

    Google Scholar 

  11. Lee DW, Kim JG, Kim TM, Kim DH. Refractory patellar tendinopathy treated by arthroscopic decortication of the inferior patellar pole in athletes: mid-term outcomes. Knee. 2018;25(3):499–506. https://doi.org/10.1016/j.knee.2018.02.015.

    Article  PubMed  Google Scholar 

  12. Testa V, Capasso G, Maffulli N, Bifulco G. Ultrasound-guided percutaneous longitudinal tenotomy for the management of patellar tendinopathy. Med Sci Sports Exerc. 1999;31(11):1509–15. https://doi.org/10.1097/00005768-199911000-00003.

    Article  CAS  PubMed  Google Scholar 

  13. Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000;10(1):2–11. https://doi.org/10.1034/j.1600-0838.2000.010001002.x.

  14. Bahr R, Fossan B, Løken S, Engebretsen L. Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper's Knee). A randomized, controlled trial. J Bone Joint Surg Am. 2006;88(8):1689–98. https://doi.org/10.2106/JBJS.E.01181.

  15. Khan KM, Cook JL, Maffulli N, Kannus P. Where is the pain coming from in tendinopathy? It may be biochemical, not only structural, in origin. Br J Sports Med. 2000;34(2):81–3. https://doi.org/10.1136/bjsm.34.2.81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Alfredson H, Ohberg L. Neovascularisation in chronic painful patellar tendinosis–promising results after sclerosing neovessels outside the tendon challenge the need for surgery. Knee Surg Sports Traumatol Arthrosc. 2005;13(2):74–80. https://doi.org/10.1007/s00167-004-0549-x.

    Article  PubMed  Google Scholar 

  17. Forsgren S, Danielson P, Alfredson H. Vascular NK-1 receptor occurrence in normal and chronic painful Achilles and patellar tendons: studies on chemically unfixed as well as fixed specimens. Regul Pept. 2005;126(3):173–81. https://doi.org/10.1016/j.regpep.2004.09.008.

    Article  CAS  PubMed  Google Scholar 

  18. Danielson P, Andersson G, Alfredson H, Forsgren S. Marked sympathetic component in the perivascular innervation of the dorsal paratendinous tissue of the patellar tendon in arthroscopically treated tendinosis patients. Knee Surg Sports Traumatol Arthrosc. 2008;16(6):621–6. https://doi.org/10.1007/s00167-008-0530-1.

    Article  PubMed  Google Scholar 

  19. Hoksrud A, Ohberg L, Alfredson H, Bahr R. Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy: a randomized controlled trial. Am J Sports Med. 2006;34(11):1738–46. https://doi.org/10.1177/0363546506289168.

    Article  PubMed  Google Scholar 

  20. Willberg L, Sunding K, Ohberg L, Forssblad M, Alfredson H. Treatment of Jumper’s knee: promising short-term results in a pilot study using a new arthroscopic approach based on imaging findings. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):676–81. https://doi.org/10.1007/s00167-006-0223-6.

    Article  PubMed  Google Scholar 

  21. Blazina ME, Kerlan RK, Jobe FW, Carter VS, Carlson GJ. Jumper’s knee. Orthop Clin North Am. 1973;4(3):665–78.

    Article  CAS  PubMed  Google Scholar 

  22. Kaux JF, Forthomme B, Goff CL, Crielaard JM, Croisier JL. Current opinions on tendinopathy. J Sports Sci Med. 2011;10(2):238–53.

    PubMed  PubMed Central  Google Scholar 

  23. Masci L, Alfredson H, Neal B, Wynter BW. Ultrasound-guided tendon debridement improves pain, function and structure in persistent patellar tendinopathy: short term follow-up of a case series. BMJ Open Sport Exerc Med. 2020;6(1): e000803. https://doi.org/10.1136/bmjsem-2020-000803.

    Article  PubMed  PubMed Central  Google Scholar 

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Abat, F., Alfredson, H. (2023). Sonosurgery Ultrasound-Guided Arthroscopic Shaving for the Treatment of Patellar Tendinopathy When Conservative Treatment Fails. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, Cham. https://doi.org/10.1007/978-3-031-09767-6_26

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  • DOI: https://doi.org/10.1007/978-3-031-09767-6_26

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