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{{Short description|Human disease}}
{{distinguish|anterior cruciate ligament injury}}
{{cs1 config|name-list-style=vanc}}
⚫
{{Use dmy dates|date=August 2020}}
{{Infobox medical condition (new)
{{Infobox medical condition (new)
| name = Patellar tendinitis
| name = Patellar tendinitis
| synonyms = Quadriceps tendinopathy, patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis
| synonyms = quadriceps tendinopathy, patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis
| image = Jumpers knee.jpg
| image = Jumpers knee.jpg
| caption = Location of the pain in patellar tendinitis
| caption = Location of the pain in patellar tendinitis
| pronounce =
| pronounce =
| field = [[Orthopedics]], [[sports medicine]]
| field = [[Orthopedics]], [[sports medicine]]
| symptoms = Pain at the front of the knee<ref name=King2019/>
| symptoms = Pain at the front of the knee<ref name=King2019/>
| complications = [[Patellar tendon rupture]]<ref name=Stat2019/>
| complications = [[Patellar tendon rupture]]<ref name=Stat2019/>
| onset =
| onset =
| duration =
| duration =
| types =
| types =
| causes =
| causes =
| risks = Jumping sports, being [[overweight]]<ref name=King2019/>
| risks = Jumping sports, being [[overweight]]<ref name=King2019/>
| diagnosis = Based on symptoms and [[physical examination|examination]]<ref name=Stat2019/>
| diagnosis = Based on symptoms and [[physical examination|examination]]<ref name=Stat2019/>
| differential = [[Chondromalacia patella]], [[Osgood-Schlatter disease]], [[patellofemoral syndrome]], [[infrapatellar bursitis]]<ref name=King2019/><ref name=Stat2019/>
| differential = [[Chondromalacia patella]], [[Osgood-Schlatter disease]], [[patellofemoral syndrome]], [[infrapatellar bursitis]]<ref name=King2019/><ref name=Stat2019/>
| prevention =
| prevention =
| treatment = Rest, [[physical therapy]]<ref name=Stat2019/>
| treatment = Rest, [[physical therapy]]<ref name=Stat2019/>
| medication =
| medication =
| prognosis = Recovery can be slow<ref name=Stat2019/>
| prognosis = Recovery can be slow<ref name=Stat2019/>
| frequency = 14% of athletes<ref name=King2019/>
| frequency = 14% of athletes<ref name=King2019/>
| deaths =
| deaths =
}}
}}
<!-- Definition and symptoms -->
<!-- Definition and symptoms -->
'''Patellar tendinitis''', also known as '''jumper's knee''', is an [[overuse injury]] of the [[tendon]] that straightens the [[knee]].<ref name=King2019/> Symptoms include pain in the front of the knee.<ref name=King2019/> Typically the pain and tenderness is at the lower part of the [[kneecap]], though the upper part may also be affected.<ref name=Stat2019/> Generally there is not pain when the person is at rest.<ref name=Stat2019/> Complications may include [[patellar tendon rupture]].<ref name=Stat2019/>
'''Patellar tendinitis''', also known as '''jumper's knee''', is an [[overuse injury]] of the [[tendon]] that straightens the [[knee]].<ref name=King2019/> Symptoms include pain in the front of the knee.<ref name=King2019/> Typically the pain and tenderness is at the lower part of the [[kneecap]], though the upper part may also be affected.<ref name=Stat2019/> Generally there is no pain when the person is at rest.<ref name=Stat2019/> Complications may include [[patellar tendon rupture]].<ref name=Stat2019/>


<!-- Cause and diagnosis -->
<!-- Cause and diagnosis -->
Risk factors include being involved in athletics and being [[overweight]].<ref name=King2019/> It is particularly common in athletes who are involved in jumping sports such as basketball and volleyball.<ref name=King2019/><ref name=Stat2019/> The underlying mechanism involves small tears in the [[tendon]] connecting the kneecap with the [[tibia|shinbone]].<ref name=Stat2019>{{cite journal |last1=Santana |first1=JA |last2=Sherman |first2=Al |title=Jumpers Knee |date=January 2019 |pmid=30422564}}</ref> Diagnosis is generally based on symptoms and [[physical examination|examination]].<ref name=Stat2019/> Other conditions that can appear similar include [[infrapatellar bursitis]], [[chondromalacia patella]] and [[patellofemoral syndrome]].<ref name=King2019/><ref name=Stat2019/>
Risk factors include being involved in athletics and being [[overweight]].<ref name=King2019/> It is particularly common in athletes who are involved in jumping sports such as basketball and volleyball.<ref name=King2019/><ref name=Stat2019/> Other risk factors include sex, age, occupation, and physical activity level.<ref name=":0">{{Cite journal |last1=Charles |first1=Ravon |last2=Fang |first2=Lei |last3=Zhu |first3=Ranran |last4=Wang |first4=Jinxiang |date=2023 |title=The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis |journal=Frontiers in Immunology |volume=14 |pages=1193835 |doi=10.3389/fimmu.2023.1193835 |doi-access=free |issn=1664-3224 |pmc=10468604 |pmid=37662911}}</ref> It is increasingly more likely to be developed with increasing age.<ref name=":0"/> The underlying mechanism involves small tears in the [[tendon]] connecting the kneecap with the [[tibia|shinbone]].<ref name=Stat2019>{{cite book |last1=Santana |first1=JA |last2=Sherman |first2=Al |date=January 2019 |title=Jumpers Knee |location=Treasure Island, FL |publisher=StatPearls Publishing |pmid=30422564}}</ref> Diagnosis is generally based on symptoms and [[physical examination|examination]].<ref name=Stat2019/> Other conditions that can appear similar include [[infrapatellar bursitis]], [[chondromalacia patella]] and [[patellofemoral syndrome]].<ref name=King2019/><ref name=Stat2019/>


<!-- Treatment and epidemiology -->
<!-- Treatment and epidemiology -->
Treatment often involves resting the knee and [[physical therapy]].<ref name=Stat2019/> Evidence for treatments, including rest, however is poor.<ref name=Med2019>{{cite journal |last1=Mendonça |first1=LM |last2=Leite |first2=HR |last3=Zwerver |first3=J |last4=Henschke |first4=N |last5=Branco |first5=G |last6=Oliveira |first6=VC |title=How strong is the evidence that conservative treatment reduces pain and improves function in individuals with patellar tendinopathy? A systematic review of randomised controlled trials including GRADE recommendations. |journal=British Journal of Sports Medicine |pages=bjsports–2018–099747 |date=6 June 2019 |doi=10.1136/bjsports-2018-099747 |pmid=31171514}}</ref><ref>{{Cite journal|last=Saithna|first=Adnan|last2=Gogna|first2=Rajiv|last3=Baraza|first3=Njalalle|last4=Modi|first4=Chetan|last5=Spencer|first5=Simon|date=2012-11-30|title=Eccentric Exercise Protocols for Patella Tendinopathy: Should we Really be Withdrawing Athletes from Sport? A Systematic Review|url=https://openorthopaedicsjournal.com/VOLUME/6/PAGE/553/|journal=The Open Orthopaedics Journal|volume=6|issue=1|pages=553–557|doi=10.2174/1874325001206010553|issn=1874-3250|pmc=3522085|pmid=23248727}}</ref> Recovery can take a year.<ref name=Stat2019/> It is relatively common with about 14% of athletes currently affected.<ref name=King2019>{{cite journal |last1=King |first1=D |last2=Yakubek |first2=G |last3=Chughtai |first3=M |last4=Khlopas |first4=A |last5=Saluan |first5=P |last6=Mont |first6=MA |last7=Genin |first7=J |title=Quadriceps tendinopathy: a review-part 1: epidemiology and diagnosis. |journal=Annals of Translational Medicine |date=February 2019 |volume=7 |issue=4 |pages=71 |doi=10.21037/atm.2019.01.58 |pmid=30963066|pmc=6409230 }}</ref> Males are more commonly affected than females.<ref name=Stat2019/> The term "jumper's knee" was coined in 1973.<ref name=Stat2019/>
Treatment often involves resting the knee and [[physical therapy]].<ref name=Stat2019/> Evidence for treatments, including rest, however is poor.<ref name=Med2019>{{cite journal |last1=Mendonça |first1=LM |last2=Leite |first2=HR |last3=Zwerver |first3=J |last4=Henschke |first4=N |last5=Branco |first5=G |last6=Oliveira |first6=VC |title=How strong is the evidence that conservative treatment reduces pain and improves function in individuals with patellar tendinopathy? A systematic review of randomised controlled trials including GRADE recommendations. |journal=British Journal of Sports Medicine |volume=54 |issue=2 |pages=bjsports–2018–099747 |date=6 June 2019 |doi=10.1136/bjsports-2018-099747 |pmid=31171514|s2cid=174810797 |url=https://research.rug.nl/en/publications/41d95116-5162-4cac-8611-0878619f5fae }}</ref><ref>{{Cite journal|last1=Saithna|first1=Adnan|last2=Gogna|first2=Rajiv|last3=Baraza|first3=Njalalle|last4=Modi|first4=Chetan|last5=Spencer|first5=Simon|date=2012-11-30|title=Eccentric Exercise Protocols for Patella Tendinopathy: Should we Really be Withdrawing Athletes from Sport? A Systematic Review|journal=The Open Orthopaedics Journal|volume=6|issue=1|pages=553–557|doi= 10.2174/1874325001206010553 |doi-access=free|issn=1874-3250|pmc=3522085|pmid=23248727}}</ref> Recovery can take months and persist over years.<ref>Nuhmani S, Muaidi QI: Patellar tendinopathy: a review of literature. J ''Clin Diagn Res'' 2018;12. {{doi|10.7860/JCDR/2018/35797.11605}}.</ref><ref>Cummings K, Skinner L, Cushman DM: "Patellar tendinopathy in athletes". ''Curr Phys Med Rehabil Rep'' 2019;7:227–36</ref><ref name="ReferenceA">Plinsinga M.L., Meeus M., Brink M., Heugen N., Van Wilgen P. "Evidence of Widespread Mechanical Hyperalgesia but Not Exercise-Induced Analgesia in Athletes with Mild Patellar Tendinopathy Compared with Pain-Free Matched Controls: A Blinded Exploratory Study". ''Am. J. Phys. Med. Rehabil.'' 2021;100(10):946-951. doi:10.1097/PHM.0000000000001673</ref><ref name=Stat2019/> It is relatively common with about 14% of athletes currently affected; however research reflects that more than half of athletes with this injury end their careers as a result.<ref>Kettunen JA, Kvist M, Alanen E, et al: Long-term prognosis for Jumper's knee in male athletes: a prospective follow-up study. Am J Sports Med 2002;30:689–92</ref><ref name="ReferenceA"/><ref name=King2019>{{cite journal |last1=King |first1=D |last2=Yakubek |first2=G |last3=Chughtai |first3=M |last4=Khlopas |first4=A |last5=Saluan |first5=P |last6=Mont |first6=MA |last7=Genin |first7=J |title=Quadriceps tendinopathy: a review-part 1: epidemiology and diagnosis. |journal=Annals of Translational Medicine |date=February 2019 |volume=7 |issue=4 |pages=71 |doi=10.21037/atm.2019.01.58 |pmid=30963066|pmc=6409230 |doi-access=free }}</ref> Males are more commonly affected than females.<ref name=Stat2019/> The term "jumper's knee" was coined in 1973.<ref name=Stat2019/>


==Signs and symptoms==
==Signs and symptoms==
People report anterior knee pain, often with an aching quality. The symptom onset is insidious. Rarely is a discrete injury described. Usually, the problem is below the kneecap but it may also be above. Jumper's knee can be classified into 1 of 4 stages, as follows:<ref name=Stat2019/>
People report anterior knee pain, often with an aching quality. The symptom onset is insidious. Rarely is a discrete injury described. Usually, the problem is below the kneecap but it may also be above. Jumper's knee can be classified into 1 of 4 stages, as follows:<ref name=Stat2019/>


'''Stage 1''' – ''Pain only after activity, without functional impairment''
'''Stage 1''': Pain only after activity, without functional impairment


'''Stage 2''' – ''Pain during and after activity, although the person is still able to perform satisfactorily in his or her sport''
'''Stage 2''': Pain during and after activity, although the person is still able to perform satisfactorily in his or her sport


'''Stage 3''' – ''Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory level''
'''Stage 3''': Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory level


'''Stage 4''' – ''Complete tendon tear requiring surgical repair''
'''Stage 4''': Complete tendon tear requiring surgical repair


It begins as inflammation in the [[patellar tendon]] where it attaches to the [[patella]] and may progress by tearing or degenerating the [[tendon]]. People present with an ache over the patella tendon. Most people are between 10 and 16 years old. Magnetic resonance imaging can reveal [[edema]] (increased T2 signal intensity) in the proximal aspect of the patellar tendon.
It begins as inflammation in the [[patellar tendon]] where it attaches to the [[patella]] and may progress by tearing or degenerating the [[tendon]]. People present with an ache over the patella tendon. Magnetic resonance imaging can reveal [[edema]] (increased T2 signal intensity) in the proximal aspect of the patellar tendon.{{Citation needed|date=August 2020}}


==Causes==
==Causes==
Patellar tendinitis is an overuse injury from repetitive overloading or repetitive stress of the patellar tendon of the knee leading to microtears and inflammation that do not have time to heal before the next use. Patellar tendonitis is common in athletes who participate in activities that include a lot of jumping, changing directions, or running. Risk factors for patellar tendonitis are low ankle [[dorsiflexion]] (stiff ankles) and ankle sprains,<ref>{{cite web |last=Marcus |first=Adam |date=7 October 2011 |title=Stiff ankles tied to young athletes' painful knees |url=https://www.reuters.com/article/us-stiff-ankles/stiff-ankles-tied-to-young-athletes-painful-knees-idUSTRE7964V620111007 |work=Reuters}}</ref><ref>{{cite journal |vauthors=Backman LJ, Danielson P |date=December 2011 |title=Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study |journal=The American Journal of Sports Medicine |volume=39 |issue=12 |pages=2626–33 |doi=10.1177/0363546511420552 |pmid=21917610 |s2cid=39755525}}</ref> weak [[gluteal muscles]], and muscle tightness, particularly in the [[Calf (anatomy)|calves]], [[quadriceps muscle]], and [[hamstrings]].<ref>{{cite book|last=Koban|first=Martin |title=Beating Patellar Tendonitis|year=2013|isbn=978-1-4910-4973-0|pages=20–25|publisher=CreateSpace Independent Publishing Platform }}</ref>
It is an overuse injury from repetitive overloading of the extensor mechanism of the [[knee]]. The microtears exceed the body's healing mechanism unless the activity is stopped.


⚫
==Diagnosis==
Among the risk factors for patellar tendonitis are low ankle [[dorsiflexion]], weak [[gluteal muscles]], and muscle tightness, particularly in the [[Calf (anatomy)|calves]], [[quadriceps muscle]], and [[hamstrings]].<ref>{{cite book|last=Koban|first=Martin | name-list-format = vanc |title=Beating Patellar Tendonitis|year=2013|isbn=978-1491049730|pages=20–25}}</ref>
⚫
Diagnosis is generally based on symptoms and a [[physical examination]].<ref name=Stat2019/> [[Ultrasound]] or [[magnetic resonance imaging]] may help clarify how severe the problem is.<ref name=Stat2019/>


Having a clinical diagnosis is the preferred way to diagnose patellar tendonitis, due to ultrasonographic abnormality.<ref name=":0" />
It may be associated with stiff ankle movement and ankle sprains.<ref>{{cite web | first = Adam | last = Marcus | name-list-format = vanc | title = Stiff ankles tied to young athletes' painful knees| url = https://www.reuters.com/article/us-stiff-ankles/stiff-ankles-tied-to-young-athletes-painful-knees-idUSTRE7964V620111007 | work = Reuters | date = 7 October 2011 }}</ref><ref>{{cite journal | vauthors = Backman LJ, Danielson P | title = Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study | journal = The American Journal of Sports Medicine | volume = 39 | issue = 12 | pages = 2626–33 | date = December 2011 | pmid = 21917610 | doi = 10.1177/0363546511420552 }}</ref>

⚫
==Diagnosis==
⚫
Diagnosis is generally based on symptoms and a [[physical examination]].<ref name=Stat2019/> [[Ultrasound]] or [[magnetic resonance imaging]] may help clarify how severe the problem is.<ref name=Stat2019/>


==Treatment==
==Treatment==
Evidence for treatment is poor.<ref name=Med2019/> In the early [[rest, ice, compression, and elevation]] may be tried. Tentative evidence supports exercises involving [[Muscle contraction#Eccentric contraction|eccentric muscle contractions]] of the [[quadriceps]] on a decline board.<ref name=pmid17261559>{{cite journal | vauthors = Visnes H, Bahr R | title = The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes | journal = British Journal of Sports Medicine | volume = 41 | issue = 4 | pages = 217–23 | date = April 2007 | pmid = 17261559 | pmc = 2658948 | doi = 10.1136/bjsm.2006.032417 }}</ref> Specific exercises and stretches to strengthen the muscles and tendons may be recommended, eg. cycling or swimming. Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems. [[Corticosteroid]] injections and [[NSAIDs]] are not generally recommended.<ref name=Stat2019/>
Evidence for treatment is poor.<ref name=Med2019/> In the early stages [[rest, ice, compression, and elevation]] may be tried. Tentative evidence supports exercises involving [[Muscle contraction#Eccentric contraction|eccentric muscle contractions]] of the [[quadriceps]] on a decline board.<ref name=pmid17261559>{{cite journal | vauthors = Visnes H, Bahr R | title = The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes | journal = British Journal of Sports Medicine | volume = 41 | issue = 4 | pages = 217–23 | date = April 2007 | pmid = 17261559 | pmc = 2658948 | doi = 10.1136/bjsm.2006.032417 }}</ref><ref>{{Cite journal |last1=Challoumas |first1=Dimitris |last2=Pedret |first2=Carles |last3=Biddle |first3=Mairiosa |last4=Ng |first4=Nigel Yong Boon |last5=Kirwan |first5=Paul |last6=Cooper |first6=Blair |last7=Nicholas |first7=Patrick |last8=Wilson |first8=Scott |last9=Clifford |first9=Chris |last10=Millar |first10=Neal L. |date=2021 |title=Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies |journal=BMJ Open Sport & Exercise Medicine |volume=7 |issue=4 |pages=e001110 |doi=10.1136/bmjsem-2021-001110 |issn=2055-7647 |pmc=8634001 |pmid=34900334}}</ref> Specific exercises and stretches to strengthen the muscles and tendons may be recommended, e.g. cycling or swimming. Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems.{{Citation needed|date=October 2024}} [[NSAIDs]] are generally recommended.<ref name=Stat2019/>{{dubious|date=May 2023}} Without proper rest and rehabilitation, patellar tendonitis can worsen, causing persistent pain.{{Citation needed|date=October 2024|reason=hard to find secondary sources to support this! Mayo has one, John Hopkins. There are systematic reviews and clinical guidelines on Management of patellar tendinopathy}}


===Procedures===
===Procedures===
[[Dry needling]], sclerosing injections, [[platelet-rich plasma]], [[extracorporeal shock wave treatment]] (ESWT), and [[heat therapy]] have been tried.<ref name=Stat2019/><ref>{{Cite journal |last1=Nuhmani |first1=Shibili |last2=Ahsan |first2=Mohammad |last3=Bari |first3=Mohd Arshad |last4=Malhotra |first4=Deepak |last5=Al Muslem |first5=Wafa Hashem |last6=Alsaadi |first6=Saad Mohammed |last7=Muaidi |first7=Qassim Ibrahim |date=2022-04-03 |title=Patellar Tendinopathy-Does Injection Therapy Have a Role? A Systematic Review of Randomised Control Trials |journal=Journal of Clinical Medicine |volume=11 |issue=7 |pages=2006 |doi=10.3390/jcm11072006 |doi-access=free |issn=2077-0383 |pmc=8999520 |pmid=35407614}}</ref> According to a systematic review comparing extracorporeal shock wave treatment to conservative treatment, it was found with low certainty that ESWT has a large treatment effect to reduce short term pain.<ref name=":0" />
[[Dry needling]], sclerosing injections, [[platelet-rich plasma]], [[extracorporeal shock wave treatment]], and [[heat therapy]] have been tried.<ref name=Stat2019/>


===Surgery===
===Surgery===
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It is relatively common with about 14% of athletes currently affected.<ref name=King2019/> Males are more commonly affected than females.<ref name=Stat2019/>
It is relatively common with about 14% of athletes currently affected.<ref name=King2019/> Males are more commonly affected than females.<ref name=Stat2019/>


== References ==
==References==
{{reflist}}
{{reflist}}


== External links ==
{{Medical resources
{{Medical resources
| DiseasesDB = 9704
| DiseasesDB = 9704
| ICD10 = {{ICD10|M|76|5|m|70}}
| ICD10 = {{ICD10|M|76|5|m|70}}
| ICD9 = {{ICD9|726.64}}
| ICD9 = {{ICD9|726.64}}
| ICDO =
| ICDO =
| OMIM =
| OMIM =
| MedlinePlus =
| MedlinePlus =
| eMedicineSubj = sports
| eMedicineSubj = sports
| eMedicineTopic = 56
| eMedicineTopic = 56
| MeshID =
| MeshID =
}}
}}
{{Soft tissue disorders}}
{{Soft tissue disorders}}
{{Authority control}}

⚫
{{use dmy dates|date=January 2012}}


[[Category:Overuse injuries]]
[[Category:Overuse injuries]]
[[Category:Soft tissue disorders]]
[[Category:Patella]]
[[Category:Patella]]
[[Category:RTT]]
[[Category:Soft tissue disorders]]
[[Category:Wikipedia medicine articles ready to translate]]

Latest revision as of 02:40, 23 October 2024

Not to be confused with anterior cruciate ligament injury.

Patellar tendinitis
Other namesquadriceps tendinopathy, patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis
Location of the pain in patellar tendinitis
SpecialtyOrthopedics, sports medicine
SymptomsPain at the front of the knee[1]
ComplicationsPatellar tendon rupture[2]
Risk factorsJumping sports, being overweight[1]
Diagnostic methodBased on symptoms and examination[2]
Differential diagnosisChondromalacia patella, Osgood-Schlatter disease, patellofemoral syndrome, infrapatellar bursitis[1][2]
TreatmentRest, physical therapy[2]
PrognosisRecovery can be slow[2]
Frequency14% of athletes[1]

Patellar tendinitis, also known as jumper's knee, is an overuse injury of the tendon that straightens the knee.[1] Symptoms include pain in the front of the knee.[1] Typically the pain and tenderness is at the lower part of the kneecap, though the upper part may also be affected.[2] Generally there is no pain when the person is at rest.[2] Complications may include patellar tendon rupture.[2]

Risk factors include being involved in athletics and being overweight.[1] It is particularly common in athletes who are involved in jumping sports such as basketball and volleyball.[1][2] Other risk factors include sex, age, occupation, and physical activity level.[3] It is increasingly more likely to be developed with increasing age.[3] The underlying mechanism involves small tears in the tendon connecting the kneecap with the shinbone.[2] Diagnosis is generally based on symptoms and examination.[2] Other conditions that can appear similar include infrapatellar bursitis, chondromalacia patella and patellofemoral syndrome.[1][2]

Treatment often involves resting the knee and physical therapy.[2] Evidence for treatments, including rest, however is poor.[4][5] Recovery can take months and persist over years.[6][7][8][2] It is relatively common with about 14% of athletes currently affected; however research reflects that more than half of athletes with this injury end their careers as a result.[9][8][1] Males are more commonly affected than females.[2] The term "jumper's knee" was coined in 1973.[2]

Signs and symptoms

[edit]

People report anterior knee pain, often with an aching quality. The symptom onset is insidious. Rarely is a discrete injury described. Usually, the problem is below the kneecap but it may also be above. Jumper's knee can be classified into 1 of 4 stages, as follows:[2]

Stage 1: Pain only after activity, without functional impairment

Stage 2: Pain during and after activity, although the person is still able to perform satisfactorily in his or her sport

Stage 3: Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory level

Stage 4: Complete tendon tear requiring surgical repair

It begins as inflammation in the patellar tendon where it attaches to the patella and may progress by tearing or degenerating the tendon. People present with an ache over the patella tendon. Magnetic resonance imaging can reveal edema (increased T2 signal intensity) in the proximal aspect of the patellar tendon.[citation needed]

Causes

[edit]

Patellar tendinitis is an overuse injury from repetitive overloading or repetitive stress of the patellar tendon of the knee leading to microtears and inflammation that do not have time to heal before the next use. Patellar tendonitis is common in athletes who participate in activities that include a lot of jumping, changing directions, or running. Risk factors for patellar tendonitis are low ankle dorsiflexion (stiff ankles) and ankle sprains,[10][11] weak gluteal muscles, and muscle tightness, particularly in the calves, quadriceps muscle, and hamstrings.[12]

Diagnosis

[edit]

Diagnosis is generally based on symptoms and a physical examination.[2] Ultrasound or magnetic resonance imaging may help clarify how severe the problem is.[2]

Having a clinical diagnosis is the preferred way to diagnose patellar tendonitis, due to ultrasonographic abnormality.[3]

Treatment

[edit]

Evidence for treatment is poor.[4] In the early stages rest, ice, compression, and elevation may be tried. Tentative evidence supports exercises involving eccentric muscle contractions of the quadriceps on a decline board.[13][14] Specific exercises and stretches to strengthen the muscles and tendons may be recommended, e.g. cycling or swimming. Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems.[citation needed] NSAIDs are generally recommended.[2][dubious – discuss] Without proper rest and rehabilitation, patellar tendonitis can worsen, causing persistent pain.[citation needed]

Procedures

[edit]

Dry needling, sclerosing injections, platelet-rich plasma, extracorporeal shock wave treatment (ESWT), and heat therapy have been tried.[2][15] According to a systematic review comparing extracorporeal shock wave treatment to conservative treatment, it was found with low certainty that ESWT has a large treatment effect to reduce short term pain.[3]

Surgery

[edit]

Surgery may be tried if other measures fail.[2] This may involve removal of myxoid degeneration in the tendon. This is reserved for people with severe pain for 6–12 months despite conservative measures. Novel treatment modalities targeting the abnormal blood vessel growth which occurs in the condition are currently being investigated.[citation needed] Knee operations in most cases have no better effects than exercise programs.[citation needed]

Epidemiology

[edit]

It is relatively common with about 14% of athletes currently affected.[1] Males are more commonly affected than females.[2]

References

[edit]
  1. ^ a b c d e f g h i j k King D, Yakubek G, Chughtai M, Khlopas A, Saluan P, Mont MA, Genin J (February 2019). "Quadriceps tendinopathy: a review-part 1: epidemiology and diagnosis". Annals of Translational Medicine. 7 (4): 71. doi:10.21037/atm.2019.01.58. PMC 6409230. PMID 30963066.
  2. ^ a b c d e f g h i j k l m n o p q r s t u v w Santana JA, Sherman A (January 2019). Jumpers Knee. Treasure Island, FL: StatPearls Publishing. PMID 30422564.
  3. ^ a b c d Charles R, Fang L, Zhu R, Wang J (2023). "The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis". Frontiers in Immunology. 14: 1193835. doi:10.3389/fimmu.2023.1193835. ISSN 1664-3224. PMC 10468604. PMID 37662911.
  4. ^ a b Mendonça LM, Leite HR, Zwerver J, Henschke N, Branco G, Oliveira VC (6 June 2019). "How strong is the evidence that conservative treatment reduces pain and improves function in individuals with patellar tendinopathy? A systematic review of randomised controlled trials including GRADE recommendations". British Journal of Sports Medicine. 54 (2): bjsports–2018–099747. doi:10.1136/bjsports-2018-099747. PMID 31171514. S2CID 174810797.
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  8. ^ a b Plinsinga M.L., Meeus M., Brink M., Heugen N., Van Wilgen P. "Evidence of Widespread Mechanical Hyperalgesia but Not Exercise-Induced Analgesia in Athletes with Mild Patellar Tendinopathy Compared with Pain-Free Matched Controls: A Blinded Exploratory Study". Am. J. Phys. Med. Rehabil. 2021;100(10):946-951. doi:10.1097/PHM.0000000000001673
  9. ^ Kettunen JA, Kvist M, Alanen E, et al: Long-term prognosis for Jumper's knee in male athletes: a prospective follow-up study. Am J Sports Med 2002;30:689–92
  10. ^ Marcus A (7 October 2011). "Stiff ankles tied to young athletes' painful knees". Reuters.
  11. ^ Backman LJ, Danielson P (December 2011). "Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study". The American Journal of Sports Medicine. 39 (12): 2626–33. doi:10.1177/0363546511420552. PMID 21917610. S2CID 39755525.
  12. ^ Koban M (2013). Beating Patellar Tendonitis. CreateSpace Independent Publishing Platform. pp. 20–25. ISBN 978-1-4910-4973-0.
  13. ^ Visnes H, Bahr R (April 2007). "The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes". British Journal of Sports Medicine. 41 (4): 217–23. doi:10.1136/bjsm.2006.032417. PMC 2658948. PMID 17261559.
  14. ^ Challoumas D, Pedret C, Biddle M, Ng NY, Kirwan P, Cooper B, Nicholas P, Wilson S, Clifford C, Millar NL (2021). "Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies". BMJ Open Sport & Exercise Medicine. 7 (4): e001110. doi:10.1136/bmjsem-2021-001110. ISSN 2055-7647. PMC 8634001. PMID 34900334.
  15. ^ Nuhmani S, Ahsan M, Bari MA, Malhotra D, Al Muslem WH, Alsaadi SM, Muaidi QI (3 April 2022). "Patellar Tendinopathy-Does Injection Therapy Have a Role? A Systematic Review of Randomised Control Trials". Journal of Clinical Medicine. 11 (7): 2006. doi:10.3390/jcm11072006. ISSN 2077-0383. PMC 8999520. PMID 35407614.
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