Best Practices in Patellar Tendinopathy Management: An Evidence to Practice Review

Authors

Christopher J. Burcal, University of Nebraska at Omaha
Adam B. Rosen, University of Nebraska at Omaha
Tony Taylor, University of Nebraska at Omaha
Mike Nicola, University of Nebraska at Omaha

Keywords

Therapeutic devices, therapeutic exercise, rehabilitation

Abstract

Patellar tendinopathy (PT) is a degenerative condition that is common in sporting populations due to the loads placed on the tendon during dynamic activity. PT often occurs in overtraining situations; however, it may also occur in conjunction with and/or worsen through poor biomechanics, persistent inflammation, and altered movement patterns. Although sports medicine practitioners have evidence to support the prevalence of this injury, we do not have a strong base of evidence surrounding the contributing factors and pathophysiology that lead the pain and disability reported in patients with PT. The purpose of this evidence to practice review was to summarize a systematic review on interventions to treat PT. The authors aimed to include any randomized controlled trial that treated patients with PT and used the Victorian Institute of Sport Assessment Patellar Tendon Questionnaire (VISA-P) as an outcome measure. Seven different PT interventions were described and summarized by the authors in this review. On the conservative end of the treatment spectrum, eccentric loading programs and extracorporeal shockwave therapy were found to be effective at reducing pain. More invasive approaches often utilized after failed conservative treatment, such as platelet-rich plasma injections and arthroscopic tenotomy, were also deemed effective. Therapeutic ultrasound and sclerotherapy were found to be ineffective treatments, and corticosteroid injections are contraindicated in patients with PT. The review highlights that both conservative and invasive treatment approaches can reduce pain in patients with PT. However, there is still no consensus on the optimal treatment protocols for patients with PT due to the variability in in protocols. Thus, we recommend utilizing an individualized approach and appropriate clinical judgement to guide treatments derived from a thorough patient history and physical/biomechanical examination to identify interventions with the highest likelihood of resolving symptoms.

Recommended Citation

Burcal, Christopher J.; Rosen, Adam B.; Taylor, Tony; and Nicola, Mike (2019) "Best Practices in Patellar Tendinopathy Management: An Evidence to Practice Review," Clinical Practice in Athletic Training: Vol. 2: Iss. 1, Article 2.
Available at: https://scholars.indianastate.edu/clinat/vol2/iss1/2