title: Sclerosing injections and ultrasound-guided arthroscopic shaving for patellar tendinopathy: good clinical results and decreased tendon thickness after surgery-a medium-term follow-up study.
abstract: OBJECTIVE
  Treatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections or ultrasound-guided arthroscopic shaving has shown good clinical short-term results. Former studies indicate that the tendon thickness and structure stays unaffected after successful treatment. The aim of this study was to evaluate the sonographic findings and clinical outcome 3-5 years after treatment of patellar tendinopathy with ultrasound-guided sclerosing injections or arthroscopic shaving.
  
  
  METHODS
  Fifty-seven patellar tendons (43 patients) with chronic patellar tendinopathy were evaluated, with ultrasound, colour Doppler (CD) and visual analogue scale (VAS) for pain and satisfaction with treatment, 3-5 years after treatment. Functional status was evaluated with a single question-"Back in full loading activity?" yes or no.
  
  
  RESULTS
  At endpoint (mean 46 months), there was a significant decrease in anteroposterior thickness of the proximal patellar tendon in patients treated with ultrasound-guided arthroscopic shaving but not after sclerosing injections. Tendon structure had improved, and CD local blood flow had diminished significantly in both groups. There were good clinical results with a significant decrease in VAS for pain after sclerosing injections (VAS 64 ± 18 → 17 ± 23) with 74 % satisfied patients and also after arthroscopic shaving (VAS 77 ± 16 → 13 ± 23) with 80 % satisfied patients. There were no significant differences in VAS between groups. A significant correlation between low local blood flow and high patient satisfaction was found.
  
  
  CONCLUSIONS
  Tendon thickness decreased over time after ultrasound-guided arthroscopic shaving, and tendon structure and local blood flow decreased after both treatments. There were good, and similar, clinical results with both methods.
  
  
  METHODS
  III.
authors.affiliation: Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden. kerstin.sunding@capio.se.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Sunding
authors.affiliation: Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden.|Sports Medicine Unit, Department of Surgical and Perioperative Science, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Lotta
authors.initials: L
authors.lastname: Willberg
authors.affiliation: Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Werner
authors.affiliation: Sports Medicine Unit, Department of Surgical and Perioperative Science, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Alfredson
authors.affiliation: Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Box 5605, 114 86, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Forssblad
authors.affiliation: Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Fahlström
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols