Patellar tendinopathy: some aspects of basic science and clinical management.

Abstract

Tendon injuries account for a substantial proportion of overuse injuries in sports.[1][2][3][4][5][6] Despite the morbidity associated with patellar tendinopathy in athletes, management is far from scientifically based.7 After highlighting some aspects of clinically relevant basic science, we aim to (a) review studies of patellar tendon pathology that explain why the condition can become chronic, (b) summarise the clinical features and describe recent advances in the investigation of this condition, and (c) outline conservative and surgical treatment options. MethodA computerised literature search of the entire MEDLINE database, covering the years 1966 to the present, was conducted for this review.Table 1 lists the keywords used in the search.All relevant articles were retrieved, either locally or by interlibrary loan.The search was not limited to the English literature, and articles in all journals were considered.The authors' personal collections of papers and any relevant personal correspondence were also included.The references selected were reviewed by the authors, and judged on their contribution to the body of knowledge of this topic.The conduct and validity of any clinical studies was carefully considered, and the outcomes of management protocols were carefully scrutinised.Case reports were excluded, unless they mentioned a specific association with the condition which was thought to be relevant to the discussion.Only papers that made a significant contribution to the understanding of this condition were included in the review.This left a total of 315 publications, 52 of which were directly related to patellar tendinopathy, and the remainder to tendon or tendon structure in general.