Jumper's Knee

Blazina, Martin E.; Kerlan, Robert K.; Jobe, Frank W.; Carter, Vincent S.; Carlson, Gunnar

doi:10.1016/s0030-5898(20)32343-9

Cited by 451 publications

(93 citation statements)

References 2 publications

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“…The clinician must distinguish between patellar tendinopathy and other clinical entities such as Sinding-Larsen-Johansson disease or Osgood-Schlatter disease, which typically resolve with skeletal maturity. 14,63 It is our opinion that PRP is not indicated for these diagnoses. However, a PRP injection can be considered in a skeletally mature adolescent patient with chronic, refractory patellar tendinosis.…”

Section: Chronic Tendinopathymentioning

confidence: 99%

Platelet-Rich Plasma

Foster

Puskas

Mandelbaum³

et al. 2009

Am J Sports Med

1,073

381

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Platelet-rich plasma (PRP) has been utilized in surgery for 2 decades; there has been a recent interest in the use of PRP for the treatment of sports-related injuries. PRP contains growth factors and bioactive proteins that influence the healing of tendon, ligament, muscle, and bone. This article examines the basic science of PRP, and it describes the current clinical applications in sports medicine. This study reviews and evaluates the human studies that have been published in the orthopaedic surgery and sports medicine literature. The use of PRP in amateur and professional sports is reviewed, and the regulation of PRP by antidoping agencies is discussed.

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Section: Chronic Tendinopathymentioning

confidence: 99%

Platelet-Rich Plasma

Foster

Puskas

Mandelbaum³

et al. 2009

Am J Sports Med

1,073

381

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“…20,35,47,48 Patellar tendinopathy is characterized by microtears and histologic evidence of failed healing response, more commonly in the patellar tendon close to the lower pole of the patella, but at times in the midportion of the tendon and close to its insertion on the anterior tibial tuberosity. 5,30 The abnormal tissue presents pseudocyst cavities at the bone-tendon junction, disappearance of the tidemark, ossification and metaplasia of the fibrocartilage, and increased thickness of the fibrocartilage. 19,31 The presence of abnormal neovascularity, typically arising from z Hoffa's fat pad, has been described using power Doppler ultrasound (US).…”

mentioning

confidence: 99%

“…1,18,41 The first-line management for patellar tendinopathy is nonoperative 8,9,14,17,38,47 : this aims to provide symptom relief, allowing athletes to return to sports, 5,19 although the success of a program of nonoperative treatment may be related to the severity of the symptoms as defined by the Blazina staging classification. 5,17,18 Nonoperative management modalities are varied, 5,20,32,47 and the regimens include 1 or more of the combination of activity modification or relative rest, nonsteroidal anti-inflammatory drugs, 10 eccentric exercises, 46,57 cryotherapy, 24 corticosteroid injection or iontophoresis, therapeutic US, 52,53 and manual therapy techniques such as deep friction massage. 7,8 Up to 90% of patients, perhaps those with milder symptoms 42 or in the early stages of the condition, 10,17 are successfully managed nonoperatively.…”

mentioning

confidence: 99%

“…8,14,18,32,47,51 However, the minimum duration of nonoperative treatment before surgical intervention is not agreed upon, ranging from 3 months 18 to 6 months, 14 with early surgery not beneficial. 5,47 There is an absence of consensus on the ideal surgical technique, including whether open techniques are preferable to arthroscopic methods. 9,12,16,26,27,32,46 This article reports the results of a medium-to long-term case series of arthroscopic debridement of the adipose tissue of the Hoffa's body on the posterior aspect of the patellar tendon to remove the area of neovascularity, debridement of abnormal patellar tendon, and excision of the lower pole of the patella.…”

mentioning

confidence: 99%

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Arthroscopic Management of Chronic Patellar Tendinopathy

Pascarella¹,

Alam

Pascarella³

et al. 2011

Am J Sports Med

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Arthroscopic surgery for patients with patellar tendinopathy, refractory to nonoperative management, appears to provide significant improvements in symptoms and function, with improvements maintained for at least 3 years. These results suggest that some patients may not be able to achieve their presymptom sporting level; or if they do, they may participate in sports with some degree of residual symptoms. Limited data show that these improvements are maintained for up to 10 years. Early return to sports may also be achieved.

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“…18,24,43,44,59 PT considerably limits sports participation and performance and may be career-ending in professional athletes. 52 Blazina et al 13 classified PT into 4 stages according to pain and functional impairment. This classification starts with pain after (stage 1) or during (stage 2) sports activities through to persistent pain (stage 3) and ends with the patellar tendon rupture (stage 4).…”

mentioning

confidence: 99%

Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

Maffulli

Oliva

Maffulli

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

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Jumper's Knee

Cited by 451 publications

References 2 publications

Platelet-Rich Plasma

Platelet-Rich Plasma

Arthroscopic Management of Chronic Patellar Tendinopathy

Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

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