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Patellar tendinitis

patellar tendinitis, patellar tendinitis symptoms
Patellar tendinitis patellar tendinopathy, also known as jumper's knee, is a relatively common cause of pain in the inferior patellar region in athletes It is common with frequent jumping and studies have shown it may be associated with stiff ankle movement and ankle sprains12

Contents

  • 1 Signs and symptoms
  • 2 Causes
  • 3 Treatment
  • 4 See also
  • 5 References
  • 6 Further reading
  • 7 External links

Signs and symptomsedit

Jumper's knee patellar tendinopathy, patellar tendinosis, patellar tendinitis commonly occurs in athletes who are involved in jumping sports such as basketball and volleyball Patients report anterior knee pain, often with an aching quality The symptom onset is insidious Rarely is a discrete injury described Usually, involvement is infrapatellar at or near the infrapatellar pole, but it may also be suprapatellar

Depending on the duration of symptoms, jumper's knee can be classified into 1 of 4 stages, as follows:

Stage 1 – Pain only after activity, without functional impairment

Stage 2 – Pain during and after activity, although the patient is still able to perform satisfactorily in his or her sport

Stage 3 – Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory level

Stage 4 – Complete tendon tear requiring surgical repair

It begins as inflammation in the patellar tendon where it attaches to the patella and may progress by tearing or degenerating the tendon3 Patients present with an ache over the patella tendon Most patients are between 10 and 16 years old Magnetic resonance imaging can reveal edema increased T2 signal intensity in the proximal aspect of the patellar tendon

Causesedit

It is an overuse injury from repetitive overloading of the extensor mechanism of the knee The microtears exceed the body's healing mechanism unless the activity is stopped

Among the risk factors for patellar tendonitis are low ankle dorsiflexion, weak gluteal muscles, and muscle tightness, particularly in the calves, quadriceps muscle, and hamstrings4

The injury occurs to athletes in many sports

Treatmentedit

Early stages may be treated conservatively using the RICE methods

  1. Rest
  2. Ice
  3. Compression
  4. Elevation

Exercises involving eccentric muscle contractions of the quadriceps on a decline board are strongly supported by extant literature5678 A physical therapist may also recommend specific exercises and stretches to strengthen the muscles and tendons, eg cycling or swimming Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems

Should this fail, autologous blood injection, or platelet-rich plasma injection may be performed and is typically successful though not as successful as high volume saline injection Crisp et alcitation needed Uncommonly it may require surgery to remove myxoid degeneration in the tendon This is reserved for patients with debilitating pain for 6–12 months despite conservative measures Novel treatment modalities targeting the abnormal blood vessel growth which occurs in the condition are currently being investigated

New research shows that knee operations in most cases have no better effects than exercise programs, and that most knee operations thus can be avoided

See alsoedit

  • Patellar tendon rupture
  • Tendinitis
  • Tendinosis
  • Repetitive strain injury

Referencesedit

  1. ^ http://wwwnlmnihgov/medlineplus/news/fullstory_117344html
  2. ^ Backman, Ludvig J; Danielson, Patrik 2011 "Low Range of Ankle Dorsiflexion Predisposes for Patellar Tendinopathy in Junior Elite Basketball Players: A 1-Year Prospective Study" Am J Sports Med 39: 2626–2633 doi:101177/0363546511420552 
  3. ^ "Patellar tendinitis Jumper’s knee" Park Rehab 2013-01-14 Retrieved 2016-05-01 
  4. ^ Koban, Martin 2013 Beating Patellar Tendonitis pp 20–25 ISBN 978-1491049730 
  5. ^ annell LJ, Taunton JE, Clement DB, Smith C, Khan KM 2001 "A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper's knee in athletes: pilot study" Br J Sports Med 35 1: 60–4 PMC 1724276  PMID 11157465 doi:101136/bjsm35160 
  6. ^ Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM 2004 "A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy" Br J Sports Med 38 4: 395–7 PMC 1724885  PMID 15273169 doi:101136/bjsm2003000053 
  7. ^ Kongsgaard M, Aagaard P, Roikjaer S, Olsen D, Jensen M, Langberg H, Magnusson SP 2006 "Decline eccentric squats increases patellar tendon loading compared to standard eccentric squats" Clin Biomech 21 7: 748–54 doi:101016/jclinbiomech200603004 
  8. ^ Håvard Visnes; Roald Bahr 2007 "The evolution of eccentric training as treatment for patellar tendinopathy jumper's knee: a critical review of exercise programmes" Br J Sports Med 41 4: 317–23 PMC 2658948  PMID 17261559 doi:101136/bjsm2006032417 

Further readingedit

  • Kaplan, Helms, Dussault, Anderson, and Major Musculoskeletal MRI 2001
  • Khan KM, Bonar F, Desmond PM, et al 1996 "Patellar tendinosis jumper's knee: findings at histopathologic examination, US, and MR imaging Victorian Institute of Sport Tendon Study Group" Radiology 200 3: 821–7 PMID 8756939 doi:101148/radiology20038756939 
  • Kettunen JA, Kvist M, Alanen E, Kujala UM 2002 "Long-term prognosis for jumper's knee in male athletes A prospective follow-up study" Am J Sports Med 30 5: 689–92 PMID 12239003 
  • Tom Crisp; Faisal Khan; Nat Padhiar; et al 2008 "High volume ultrasound guided injections at the interface between the patellar tendon and Hoffa's body are effective in chronic patellar tendinopathy: A pilot study" Disability and rehabilitation 30 20–22: 1625–34 PMID 18608403 doi:101080/09638280701830936 
  • BMJ: A highly questionable practice without supporting evidence of even moderate quality, 2016 url=http://wwwbmjcom/content/354/bmji3934
  • politikendk: Tusindvis af årlige knæoperationer har ingen effekt, 2016 en: Thousands of yearly knee operations have no effecturl=http://politikendk/forbrugogliv/sundhedogmotion/art5630044/Tusindvis-af-%C3%A5rlige-kn%C3%A6operationer-har-ingen-effekt in Danish
  • politikendk: Enige eksperter: Ondt i knæet skal trænes væk en: experts agreeing: hurting knees shall be cured by training url=http://politikendk/forbrugogliv/sundhedogmotion/art5514651/Enige-eksperter-Ondt-i-kn%C3%A6et-skal-tr%C3%A6nes-v%C3%A6k in Danish

External linksedit

  • Jumpers Knee & Acrobatics
  • Ultrasound images demonstrating patella tendinosis and an autologous blood injection

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Patellar tendinitis


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    29.10.2014


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