title: Surgery for unilateral and bilateral patellar tendinopathy: a seven year comparative study.
abstract: OBJECTIVE
  Open surgery for patellar tendinopathy allows patients with unilateral and bilateral tendinopathy to return to high levels of physical activity.
  
  
  METHODS
  Two groups of 23 athletes each underwent open surgical exploration for management of patellar tendinopathy. One group suffered from unilateral patellar tendinopathy (unilateral group), and the other group had bilateral (bilateral group) patellar tendinopathy. Maximum voluntary isometric contraction and anthropometric measures were assessed pre-operatively and at an average follow-up of seven years. The Victorian Institute of Sport Assessment (VISA)-P scoring system was also administered; functional outcomes were classified from excellent to poor according to a modification of Kelly's criteria.
  
  
  RESULTS
  At the final follow-up, in both groups, VISA-P scores were significantly improved compared with preoperative values, with no intergroup differences. Clinical results were excellent or good in 21 patients in the unilateral and 19 in the bilateral group. Twenty of 23 patients in the unilateral group and 17 of 23 in the bilateral group were still active in sports (p = 0.2). In the unilateral group, at the last follow-up, thigh volume and strength were significantly improved compared with baseline, with significant difference between operated and nonoperated limbs. In the bilateral group, there were no significant differences in thigh volume and strength between the dominant and nondominant limbs both before and after the index procedure.
  
  
  CONCLUSIONS
  This procedure is not technically demanding and provides a high rate of good and excellent outcomes in the long term.
authors.affiliation: Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy, n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Francesco
authors.initials: F
authors.lastname: Oliva
authors.forename: Gayle
authors.initials: G
authors.lastname: Maffulli
authors.forename: John B
authors.initials: JB
authors.lastname: King
authors.forename: Angelo
authors.initials: A
authors.lastname: Del Buono
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010329:Patella / Q000502:physiology / Q000601:surgery*; D017847:Patellar Ligament / Q000293:injuries* / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D052256:Tendinopathy / Q000503:physiopathology / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult