Patellar tendinopathy: late-stage results from surgical treatment

Cenni, Marcos Henrique Frauendorf; Silva, Thiago Daniel Macedo; Nascimento, Bruno Fajardo do; Andrade, Rodrigo Cristiano de; Júnior, Lúcio Flávio Biondi Pinheiro; Nicolai, Oscar Pinheiro

doi:10.1016/j.rboe.2015.08.013

Cited by 1 publication

(1 citation statement)

References 31 publications

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“…7 Lastly, the prior review by Everhart et al, along with multiple studies in this review, advocated for 6 months of conservative management prior to surgery for PT. 3,7,14,20,22,23,31,[36][37][38]54,56,63,64 However, it should be noted that this threshold is derived from a low likelihood of further improvement over longer durations which neglects factors, such as final outcomes and time to RTS/work, which are most important to patients and may be affected by chronicity. 7…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Patellar Tendinopathy Results in Improved Outcomes and High Rates of Return to Sport: A Systematic Review

et al. 2022

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Although the majority of patients with patellar tendinopathy (PT) can be treated nonoperatively, operative management may be indicated for recalcitrant cases. While several surgical techniques have been described, there is limited understanding of postoperative outcomes and expectations regarding return to activity and sport. The purpose of this study was to characterize the clinical outcomes associated with the surgical management of PT with an emphasis on return to sport (RTS) rates. We hypothesized that surgical management would lead to clinically important improvements in patient-reported outcomes (PROs) with high rates of RTS and RTS at the same level. A comprehensive search of the PubMed, Medline, and Embase databases was performed in December 2020. Level of evidence studies I through IV, investigating results of surgical management for PT (PRO, functional outcomes, pain, and/or RTS), were included. The search was performed in accordance with the Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Forty clinical studies reporting on surgery for PT satisfied inclusion criteria, with 1,238 total knees undergoing surgery for PT. A comparison of pre- and postoperative Victorian Institute of Sport Assessment, patellar tendon (VISA-P) scores (mean difference: 41.89, p < 0.00001), Lysholm scores (mean difference: 41.52, p < 0.00001), and visual analogue scale (VAS) pain scores (mean difference: 5, p < 0.00001) demonstrated clinically and statistically significant improvements after surgery. The overall RTS rate following operative management was 89.8% (95% confidence interval [CI]: 86.4–92.8, I 2 = 56.5%) with 76.1% (95% CI: 69.7.5–81.9, I 2 = 76.4%) of athletes returning to the same level of activity. Surgery for PT provides meaningful improvement in patient reported outcomes and pain while allowing athletes to RTS at high rates with levels of participation similar to that of preinjury. Comparative studies of open and/or arthroscopic surgery are still limited but current evidence suggests better rates of RTS for arthroscopic surgery compared with open surgery. This is a systematic review of level-I to -IV studies.

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