Patellar Tendinopathy.
BACKGROUND
Patellar tendinopathy is a common condition. There are a wide variety of treatment options available, the majority of which are nonoperative. No consensus exists on the optimal method of treatment.


METHODS
PubMed spanning 1962-2014.


METHODS
Clinical review.


METHODS
Level 4.


RESULTS
The majority of cases resolve with nonoperative therapy: rest, physical therapy with eccentric exercises, cryotherapy, anti-inflammatories, corticosteroid injections, extracorporeal shockwave therapy, glyceryl trinitrate, platelet-rich plasma injections, and ultrasound-guided sclerosis. Refractory cases may require either open or arthroscopic debridement of the patellar tendon. Corticosteroid injections provide short-term pain relief but increase risk of tendon rupture. Anti-inflammatories and injectable agents have shown mixed results. Surgical treatment is effective in many refractory cases unresponsive to nonoperative modalities.


CONCLUSIONS
Physical therapy with an eccentric exercise program is the mainstay of treatment for patellar tendinopathy. Platelet-rich plasma has demonstrated mixed results; evidence-based recommendations on its efficacy cannot be made. In the event that nonoperative treatment fails, surgical intervention has produced good to excellent outcomes in the majority of patients.
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois schwaaron@gmail.com.
Aaron
A
Schwartz
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois.
Jonathan N
JN
Watson
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois.
Mark R
MR
Hutchinson
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017679:Cryotherapy; D003646:Debridement; D005081:Exercise Therapy; D019220:High-Energy Shock Waves / Q000627:therapeutic use; D006801:Humans; D005996:Nitroglycerin / Q000008:administration & dosage; D017847:Patellar Ligament / Q000293:injuries* / Q000503:physiopathology; D053657:Platelet-Rich Plasma; D012597:Sclerosing Solutions / Q000008:administration & dosage; D052256:Tendinopathy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D012597:Sclerosing Solutions; D005996:Nitroglycerin
eccentric therapy; jumper’s knee; patellar tendinopathy