title: Should ultrasound-guided needle fenestration be considered as a treatment option for recalcitrant patellar tendinopathy? A retrospective study of 47 cases.
abstract: OBJECTIVE
  To report the retrospective results of ultrasound-guided needle fenestration for the treatment of recalcitrant patellar tendinopathy.
  
  
  METHODS
  Retrospective follow-up study.
  
  
  METHODS
  University outpatient sports medicine clinic.
  
  
  METHODS
  Forty-seven patellar tendons in 32 patients (26 men and 6 women; mean age, 26 years) with recalcitrant patellar tendinopathy. Diagnosis made via history, physical examination, and sonographic examination.
  
  
  METHODS
  Ultrasound-guided needle fenestration after failure of conservative management.
  
  
  METHODS
  Pre-treatment and 4-week clinical follow-up determination of functional activity score. Phone follow-up determination of best achievable level of activity and satisfaction score of the procedure.
  
  
  RESULTS
  Average time to follow-up was 45 months. Seventy-two percent of patients reported excellent or good results when questioned regarding return to activity. Twenty-eight percent of patients were unable to return to their desired activity level. Six patients subsequently underwent surgical treatment. One athlete underwent surgery to repair a patellar tendon rupture that occurred 6 weeks after the procedure. Eighty-one percent of patients reported excellent or good satisfaction scores.
  
  
  CONCLUSIONS
  Ultrasound-guided needle fenestration warrants further investigation for the treatment of recalcitrant patellar tendinopathy.
authors.affiliation: Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA. jhousner@umich.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Housner
authors.forename: Jon A
authors.initials: JA
authors.lastname: Jacobson
authors.forename: Yoav
authors.initials: Y
authors.lastname: Morag
authors.forename: George Guntar A
authors.initials: GG
authors.lastname: Pujalte
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Northway
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Boon
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult