Surgical Technique: Jumper's Knee—Arthroscopic Treatment of Chronic Tendinosis of the Patellar Tendon

Abstract

Chronic patellar tendinosis (jumper's knee) is a common problem among athletes. Conservative treatment is successful in most of the cases including, among others, the use of nonsteroidal anti-inflammatory drugs, local cryotherapy, eccentric muscle training, limitation of sports activity, and local infiltration. In approximately 10% of conservatively treated patients, conservative treatment fails and surgery is required. Different open and arthroscopic surgical techniques have been described in the literature. The presented all-arthroscopic surgical technique for the treatment of chronic patellar tendinosis includes debridement of soft tissue at the lower patellar pole and resection of the bony lower patellar pole. It leads to excellent clinical results comparable to described open treatment and provides the benefits of a minimally invasive and safe procedure with a faster recovery and return to sporting activities after surgery. An additional bony resection in case of a prominent lower patellar pole does not lead to a significant extension of the operation time and may avoid a relapse or treatment failure in selective cases. Therefore, arthroscopic treatment such as the presented technique may be the preferred method for surgical treatment of chronic patellar tendinosis.

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“…Anti-inflammatories and injectable agents have shown mixed results [2]. In approximately 10% of conservatively treated patients, conservative treatment fails and surgery is required [3]. Since tendinopathy appears to be a highly active process of ongoing neovascularization, anti-angiogenic therapies could be a new approach for treating tendinopathies [4].…”

Quadriceps tendinopathy: a review, part 2—classification, prognosis, and treatment

“…Several studies have evaluated the surgical treatment of athletes who had tendinopathy and have shown superior outcomes in patients who have failed non-operative treatments for a minimum of 3 months (4,16,25). Various surgical techniques for treatment of patellar tendinopathy have been described in the literature, however, a consensus for the best surgical treatment option still does not exist (32)(33)(34)(35)(36)(37)(38). A retrospective study by Cucurulo et al (19) examined outcomes of 64 athletes who had patellar tendinopathy treated by arthroscopic or conventional open surgery after failing non-operative treatment that averaged 28 months.…”