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Column-editor : A. Louise Fincher

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Mina Samukawa

Edited by Jennifer Medina McKeon

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Sheri A. Hale

Objective:

To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes.

Data Sources:

Information was gathered from a MEDLINE search of literature in English using the key words patellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy, and jumper’s knee.

Study Selection:

All relevant peer-reviewed literature in English was reviewed.

Data Synthesis:

The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle flexibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear.

Conclusions:

The pathoetiology of patellar tendinopathy is a complex process that results from both an inflammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the pathoetiology of patellar tendinopathy and its clinical management.

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Julie K. Wilson, Thomas L. Sevier, Robert Helfst, Eric W. Honing, and Aly Thomann

Objective:

To compare outcomes of 2 rehabilitation protocols on patellar tendinitis subjects.

Design:

Prospective, randomized, blinded, controlled clinical trial.

Setting:

Outpatient rehabilitation clinic.

Subjects:

Randomized into 2 rehabilitation groups—traditional (n = 10) and ASTM AdvantEDGE (n = 10).

Main Outcome Measures:

Clinical data and self-reported questionnaires collected at 0, 6, and 12 weeks.

Results:

On completion of the 6th week, 100% of the ASTM AdvantEDGE group and 60% of the traditional group had resolved. The unresolved subjects were crossed over to the ASTM AdvantEDGE for additional therapy. At the end of the additional therapy, 50% of the crossover subjects had resolved. The ASTM AdvantEDGE group's clinical outcomes and weekly journals indicated a statistically significant (P = .04) improvement in subjective pain and functional-impairment ratings.

Conclusions:

Findings suggest that ASTM AdvantEDGE resulted in improved clinical outcomes in treating patellar tendinitis.

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Lucas C. Bianco, James M. May, Smokey L. Fermin, Robert Oates, and Scott W. Cheatham

completed on this technique to investigate the effects on patients with other conditions and in different populations. References 1. Hamilton B , Purdam C . Patellar tendinosis as an adaptive process: a new hypothesis . Br J Sports Med . 2004 ; 38 ( 6 ): 758 – 761 . PubMed ID: 15562176 doi:10

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Josep C. Benítez-Martínez, Pablo Martínez-Ramírez, Fermín Valera-Garrido, Jose Casaña-Granell, and Francesc Medina-Mirapeix

symptoms in patients with jumper’s knee (patellar tendinosis). Victorian Institute of Sport Tendon Study Group . J Sci Med Sport . 1998 ; 1 : 22 – 28 . PubMed ID: 9732118 doi:10.1016/S1440-2440(98)80005-4 10.1016/S1440-2440(98)80005-4 14. Hernandez-Sanchez S , Hidalgo M , Gomez A . Cross

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Hyunjae Jeon, Melanie L. McGrath, Neal Grandgenett, and Adam B. Rosen

. BMC Musculoskel Dis . 2014 ; 15 : 266 . doi:10.1186/1471-2474-15-266 10.1186/1471-2474-15-266 7. Khan KM , Bonar F , Desmond PM , et al . Patellar tendinosis (jumper’s knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group

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Laura C. Slane, Stijn Bogaerts, Darryl G. Thelen, and Lennart Scheys

, Cook JL , Kiss ZS , Harcourt PR , Wark JD . The VISA score: an index of severity of symptoms in patients with jumper’s knee (patellar tendinosis). Victorian Institute of Sport Tendon Study Group . J Sci Med Sport . 1998 ; 1 ( 1 ): 22 – 28 . PubMed doi:10.1016/S1440-2440(98)80005-4 10

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Pablo Núñez-Martínez and David Hernández-Guillen

KM , Bonar F , Desmond PM , et al . Patellar tendinosis (jumper’s knee): findings at histopathologic examination, US, and MR imaging. Victorian institute of sport tendon study group . Radiology . 1996 ; 200 ( 3 ): 821 – 827 . PubMed ID: 8756939 doi:10.1148/radiology.200.3.8756939 15. Cook