Arthroscopic resection of the lower patellar pole in patients with chronic patellar tendinosis.
OBJECTIVE
The aim of this prospective study is to evaluate the clinical results of arthroscopic resection of the lower patellar pole in patients with patellar tendinosis.


METHODS
Twenty patients underwent an arthroscopic resection of the lower patellar pole between 2002 and 2004. All of them were evaluated at 6 weeks and 3, 6, 12, and 24 months after surgery using the Tegner activity level, the Lysholm score, the Kujala score, a modified jumper's knee classification according to Blazina, and visual analog scales for pain, function, and satisfaction. Clinical evaluation was performed 2 years after surgery. In addition, magnetic resonance imaging was performed preoperatively and at a 2-year follow-up.


RESULTS
By 6 weeks postoperatively and at every other follow-up visit, significant improvements were seen in the Lysholm score (P = .001), the Kujala score (P = .001) and the visual analog scales. The Tegner score improved significantly by 3 months postsurgery (P = .01). Two years after surgery, the Tegner score improved from 4.4 +/- 2.9 to 7.95 +/- 1.6 (P < .0001); the Lysholm score from 57.1 +/- 17.1 to 97.3 +/- 4.4 (P < .0001); and Kujala score from 53.7 +/- 14.7 to 95.4 +/- 7.8 (P < .0001). The jumper's knee classification showed excellent (stage 0) or good (stage I) results in 18 of 20 patients. At follow-up, all but one magnetic resonance image showed hypodens areals in the proximal aspect of the patellar tendon, and small osteophytes were seen in some cases at the resection area. These findings did not seem to have any influence on the results.


CONCLUSIONS
The arthroscopic resection of the lower patellar pole as a minimal invasive method to treat jumper's knee provides satisfactory clinical results in knee function and pain reduction with fast recovery and return to sport activities.


METHODS
Level IV, therapeutic case series.
Lorbach
Olaf
O
Department of Orthopedic Surgery, University of Homburg/Saar, Homburg/Saar, Germany. olaf.lorbach@gmx.de
Diamantopoulos
Andreas
A
Paessler
Hans H
HH
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010329:Patella / Q000293:injuries / Q000601:surgery*; D017847:Patellar Ligament / Q000293:injuries / Q000601:surgery*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D052256:Tendinopathy / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome