Patellar tendinitis: Difference between revisions
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{{Infobox medical condition (new) |
{{Infobox medical condition (new) |
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| name = Patellar tendinitis |
| name = Patellar tendinitis |
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| synonyms = |
| synonyms = Quadriceps tendinopathy, patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis |
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| image = Jumpers knee.jpg |
| image = Jumpers knee.jpg |
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| caption = Location of the pain in patellar tendinitis |
| caption = Location of the pain in patellar tendinitis |
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| risks = |
| risks = |
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| diagnosis = |
| diagnosis = |
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| differential = [[ |
| differential = [[Chondromalacia patella]], [[patellofemoral syndrome]]<ref name=King2019/> |
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| prevention = |
| prevention = |
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| treatment = |
| treatment = |
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<!-- Definition and symptoms --> |
<!-- Definition and symptoms --> |
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'''Patellar tendinitis''', also known as '''jumper's knee''', is an [[overuse injury]] of the [[ligament]]s that straighten the [[knee]].<ref name=King2019/> Symptoms include pain in the front of the knee.<ref name=King2019/> |
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<!-- Cause and diagnosis --> |
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| ⚫ | Risk factors include being involved in athletics and being [[overweight]].<ref name=King2019/> It is a [[repetitive strain injury]] to the [[tendon]] connecting the [[patella]], or kneecap, with the [[tibia|shinbone]].<ref name="mayo">{{cite web |title=Patellar tendinitis |url=https://www.mayoclinic.org/diseases-conditions/patellar-tendinitis/symptoms-causes/syc-20376113 |website=Mayo Clinic |accessdate=14 December 2018}}</ref> Jumper's knee commonly occurs in athletes who are involved in jumping sports such as basketball and volleyball, but can affect any athlete. Other conditions that can appear similar include [[chondromalacia patella]] and [[patellofemoral syndrome]].<ref name=King2019/> |
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<!-- Treatment and epidemiology --> |
<!-- Treatment and epidemiology --> |
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Evidence for treatment 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 |date=6 June 2019 |doi=10.1136/bjsports-2018-099747 |pmid=31171514}}</ref> |
Evidence for treatment 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 |date=6 June 2019 |doi=10.1136/bjsports-2018-099747 |pmid=31171514}}</ref> It is relatively common with about 14% of atheletes 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}}</ref> |
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==Signs and symptoms== |
==Signs and symptoms== |
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Revision as of 23:10, 10 July 2019
| Patellar tendinitis | |
|---|---|
| Other names | Quadriceps tendinopathy, patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis |
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| Location of the pain in patellar tendinitis | |
| Specialty | Orthopedics |
| Differential diagnosis | Chondromalacia patella, patellofemoral syndrome[1] |
Patellar tendinitis, also known as jumper's knee, is an overuse injury of the ligaments that straighten the knee.[1] Symptoms include pain in the front of the knee.[1]
Risk factors include being involved in athletics and being overweight.[1] It is a repetitive strain injury to the tendon connecting the patella, or kneecap, with the shinbone.[2] Jumper's knee commonly occurs in athletes who are involved in jumping sports such as basketball and volleyball, but can affect any athlete. Other conditions that can appear similar include chondromalacia patella and patellofemoral syndrome.[1]
Evidence for treatment is poor.[3] It is relatively common with about 14% of atheletes currently affected.[1]
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. Depending on the duration of symptoms, jumper's knee can be classified into 1 of 4 stages, as follows:
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. 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.
Causes
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.
Among the risk factors for patellar tendonitis are low ankle dorsiflexion, weak gluteal muscles, and muscle tightness, particularly in the calves, quadriceps muscle, and hamstrings.[4]
Studies have shown it may be associated with stiff ankle movement and ankle sprains.[5][6]
Diagnosis
A physiotherapist performs a physical examination. If the symptoms are severe, further tests may be done, such as magnetic resonance imaging, or ultrasound.
Treatment
Evidence for treatment is poor.[3] In the early rest, ice, compression, and elevation may be tried. Tentative evidence supports exercises involving eccentric muscle contractions of the quadriceps on a decline board.[7] A physical therapist may also recommend specific exercises and stretches to strengthen the muscles and tendons, eg. cycling or swimming. Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems.
Uncommonly it may require surgery to remove 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] New research shows that knee operations in most cases have no better effects than exercise programs, and that most knee operations thus can be avoided.[citation needed]
See also
References
- ^ a b c d e f 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. PMID 30963066.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ "Patellar tendinitis". Mayo Clinic. Retrieved 14 December 2018.
- ^ 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. doi:10.1136/bjsports-2018-099747. PMID 31171514.
- ^ Koban, Martin (2013). Beating Patellar Tendonitis. pp. 20–25. ISBN 978-1491049730.
{{cite book}}: Unknown parameter|name-list-format=ignored (|name-list-style=suggested) (help) - ^ Marcus, Adam (7 October 2011). "Stiff ankles tied to young athletes' painful knees". Reuters.
{{cite web}}: Unknown parameter|name-list-format=ignored (|name-list-style=suggested) (help) - ^ 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.
- ^ 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.
External links