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Treatment for patellar tendonitis

Orestis Karargyris, Vipul Mandalia
Surgical treatment of recalcitrant patellar tendinopathy includes both the open surgical approach and minimally invasive arthroscopic debridement. A variety of arthroscopic techniques have been described that involve the use of a standard 30° arthroscope and standard anterolateral and anteromedial portals. As a result, visualization of the infrapatellar region can be variable, and it may be necessary to create additional portals. A 70° arthroscope provides the advantage of a wider field of view to the surgeon...
October 2016: Arthroscopy Techniques
Mark F Reinking
: Patellar tendon pain is a significant problem in athletes who participate in jumping and running sports and can interfere with athletic participation. This clinical commentary reviews patellar tendon anatomy and histopathology, the language used to describe patellar tendon pathology, risk factors for patellar tendinopathy and common interventions used to address patellar tendon pain. Evidence is presented to guide clinicians in their decision-making regarding the treatment of athletes with patellar tendon pain...
December 2016: International Journal of Sports Physical Therapy
Michael Saper, Candice Brady, Robert Zondervan, David Shneider
BACKGROUND: We describe the preliminary clinical results of a patellar stabilization technique to treat bidirectional patellar subluxation (BPS). METHODS: Patients: six patients (one male, five females; mean age 30.2years) underwent this procedure with a minimum of 24months follow-up. Patients were assessed for clinical instability, patellar complications, and need for revision surgery. Patient functional outcomes were evaluated using the criteria of Crosby and Insall and the Kujala Anterior Knee Pain Scale at the time of final follow-up...
December 2016: Knee
Raju Vaishya, Ahmad Tariq Azizi, Amit Kumar Agarwal, Vipul Vijay
Osgood-Schlatter disease (OSD) is a condition in which the patellar tendon insertion on the tibial tuberosity becomes inflamed. It is a well-known condition in late childhood characterized by pain and a bony prominence over the tibial tuberosity. The pain is usually exacerbated by physical activities like running, jumping, and climbing stairs. In the acute stage, the margins of the patellar tendon become blurred in radiographs due to the soft tissue swelling. After three to four months, bone fragmentation at the tibial tuberosity is viewed...
September 13, 2016: Curēus
Eric C McCarty, Matthew J Kraeutler, Paula Langner, Shane Cook, Byron Ellis, Jenna M Godfrey
We conducted a study to identify and contrast patterns in the treatment of common injuries that occur in National Football League (NFL) players and National Collegiate Athletic Association (NCAA) Division I football players. Orthopedic team physicians for all 32 NFL and 119 NCAA Division I football teams were asked to complete a survey regarding demographics and preferred treatment of a variety of injuries encountered in football players. Responses were received from 31 (97%) of the 32 NFL and 111 (93%) of the 119 NCAA team physicians...
September 2016: American Journal of Orthopedics
Giuseppe Filardo, Berardo Di Matteo, Elizaveta Kon, Giulia Merli, Maurilio Marcacci
PURPOSE: Platelet-rich plasma (PRP) is currently the most exploited strategy in the clinical practice to provide a regenerative stimulus for tendon healing. The aim of the present study was to systematically review the available evidence on the treatment of the main tendon disorders where PRP is currently applied. METHODS: A systematic review of the literature was performed on the use of PRP as a treatment for tendinopathies focusing on the following sites: Achilles tendon, patellar tendon, rotator cuff tendons, and lateral elbow tendons...
September 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Amaia Ormaza, Jesús Moreta, Javier Mosquera, Oskar Sáez de Ugarte, José Luis Martinez-de Los Mozos
Tear of the quadriceps tendon after revision or primary total knee arthroplasty is a rare complication, but when it occurs, this injury has serious functional consequences. In complete tears, the outcome of direct repair is unpredictable, and several authors recommend that the suture should be reinforced. Several techniques have been described, including the use of autografts, allografts, and synthetic mesh. The goal of this study was to assess the outcomes of a reconstruction technique augmented with synthetic mesh...
September 19, 2016: Orthopedics
Endre Soreide, Lars-Petter Granan, Geir A Hjorthaug, Birgitte Espehaug, Sigbjørn Dimmen, Lars Nordsletten
BACKGROUND: The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to patients undergoing anterior cruciate ligament reconstruction (ACLR) is controversial because it may impair tissue healing and clinical outcomes. PURPOSE: To assess the effect of NSAID administration on patients undergoing ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Included patients were aged >15 years and were registered in the Norwegian Knee Ligament Registry from 2008 until 2013 after the primary ACLR...
December 2016: American Journal of Sports Medicine
Raju Vaishya, Amit Kumar Agarwal, Sachin Ingole, Vipul Vijay
BACKGROUND: The aim of this study was to determine the current practices and preferences of the arthroscopic surgeons of Delhi in the diagnosis, treatment and rehabilitation of patients with anterior cruciate ligament (ACL) injury. METHODS: It was a cross-sectional descriptive study conducted among arthroscopic surgeons of Delhi. A survey was conducted using a questionnaire that was sent either by e-mail or by direct contact to all sixty arthroscopic surgeons of Delhi...
July 2016: Journal of Clinical Orthopaedics and Trauma
Dariusz Witoński, Rafał Kęska, Rafał Cyranowski, Przemysław T Paradowski
INTRODUCTION: Several studies have suggested that anterior cruciate ligament reconstruction (ACLR) without wound drainage has no impact on long-term follow-up. AIM: To investigate a prospective patient series as measured by the patient-administered disease-specific questionnaire Knee injury and Osteoarthritis Outcome Score (KOOS). MATERIAL AND METHODS: The study included 101 consecutive patients (71 men and 30 women) with a mean age of 30 years (SD 10, range: 15-62 years), who had undergone primary single incision arthroscopic bone-patellar tendon-bone autograft (BPTB) ACLR without wound drainage...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Pedro Debieux, Carlos E S Franciozi, Mário Lenza, Marcel Jun Tamaoki, Robert A Magnussen, Flávio Faloppa, João Carlos Belloti
BACKGROUND: Anterior cruciate ligament (ACL) tears are frequently treated with surgical reconstruction with grafts, frequently patella tendon or hamstrings. Interference screws are often used to secure the graft in bone tunnels in the femur and tibia. This review examines whether bioabsorbable interference screws give better results than metal interference screws when used for graft fixation in ACL reconstruction. OBJECTIVES: To assess the effects (benefits and harms) of bioabsorbable versus metallic interference screws for graft fixation in ACL reconstruction...
July 24, 2016: Cochrane Database of Systematic Reviews
Xiaozuo Zheng, Tong Li, Juan Wang, Jiangtao Dong, Shijun Gao
BACKGROUND: The medial collateral ligament (MCL) is the main static stabilizer of the medial knee. The surgical treatment was recommended in cases with serious medial collateral ligament insufficiency combined with multi-ligament injuries and chronic symptomatic medial instability. Several surgical techniques have been described for the MCL reconstruction, while potential problems including donor site morbidity, complicated procedure, and high risk of femoral tunnel collision were reported...
2016: Journal of Orthopaedic Surgery and Research
Zachary Meyer, William M Ricci
Patellar and quadriceps tendon ruptures are relatively common injuries. Rupture of the knee extensor mechanism may occur because of a forceful eccentric contraction of the quadriceps against a resisted flexed knee, though atraumatic cases have also been described. Patients at higher than normal risk for knee extensor mechanism rupture include those with systemic co-morbidities, fluoroquinolone use, and chronic tendinopathy. Early operative treatment and mobilization of acute extensor mechanism ruptures has proven effective, and numerous techniques have been described...
August 2016: Journal of Orthopaedic Trauma
Hongbin Lu, Can Chen, Jin Qu, Huabin Chen, Yong Chen, Cheng Zheng, Zhanwen Wang, Daqi Xu, Jingyong Zhou, Tao Zhang, Ling Qin, Jianzhong Hu
BACKGROUND: Low-intensity pulsed ultrasound stimulation (LIPUS) has been proven to be a beneficial biophysical therapy for tendon-bone (T-B) healing. However, the optimal time to initiate LIPUS treatment has not been determined yet. LIPUS initiated at different stages of the inflammatory phase may profoundly affect T-B healing. PURPOSE: An established rabbit model was used to preliminarily investigate the effect of LIPUS initiation timing on T-B healing. STUDY DESIGN: Controlled laboratory study...
June 29, 2016: American Journal of Sports Medicine
Zi Yin, Jia Guo, Tian-Yi Wu, Xiao Chen, Liang-Liang Xu, Si-En Lin, Yun-Xin Sun, Kai-Ming Chan, Hongwei Ouyang, Gang Li
UNLABELLED: : Tendon injuries are common and present a clinical challenge, as they often respond poorly to treatment and result in long-term functional impairment. Inferior tendon healing responses are mainly attributed to insufficient or failed tenogenesis. The main objective of this study was to establish an efficient approach to induce tenogenesis of bone marrow-derived mesenchymal stem cells (BMSCs), which are the most common seed cells in tendon tissue engineering. First, representative reported tenogenic growth factors were used as media supplementation to induce BMSC differentiation, and the expression of teno-lineage transcription factors and matrix proteins was compared...
August 2016: Stem Cells Translational Medicine
Seung-Hun Lee, Eun-Kyoo Song, Jong-Keun Seon, Seong-Hwan Woo
Quadriceps tendon rupture is an uncommon injury. This disabling condition is the result of direct or indirect trauma. It requires surgical repair to avoid poor outcomes in cases of neglected or chronic rupture. In most acute cases, simple tendon suture or reinsertion is suitable for an extensor mechanism reconstruction of the knee joint. However, chronic lesions often require a tendon graft or flap reconstruction. We report a case of a 15-year-old male who was diagnosed with a chronic quadriceps rupture with a patellar superior pole fracture...
June 2016: Knee Surgery & related Research
Zefeng Zheng, Huihui Le, Weishan Chen, Weiliang Shen, Hongwei Ouyang
Platelet-enriched plasma (PRP) contains high concentration of platelets and abundant growth factors, which is made by centrifuging of blood and separating of blood elements. PRP promotes tendon repair by releasing various cytokines to enhance cell proliferation, tenogenic differentiation, formation and secretion of matrix; meantime, it can reduce pain by inhibiting the expression of pain-associated molecules. A number of clinical studies demonstrated that PRP was effective in treatment of tendinopathy, including patellar tendinopathy, lateral epicondylitis and plantar fasciopathy...
March 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Xiangpeng Kong, Ming Ni, Guoqiang Zhang, Wei Chai, Xiang Li, Yucong Li, Yan Wang
OBJECTIVE: To evaluate the application of tendon-derived stem cells (TDSC) and bone marrow-derived mesenchymal stem cells (BMSC) for patellar tendon injury repair in rat model. METHODS: TDSCs and BMSCs were isolated from patellar tendons or bone marrow of healthy SD rats. The patellar tendon injury model was induced in 60 SD rats, then the animals were divided into 3 groups with 20 in each group: rats in TDSC group received transplantation of TDSC with fibrin glue in defected patellar tendon, rats in BMSC group received BMSC with fibrin glue for transplantation and those in control group received fibrin glue only...
March 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Lucio Ventura-Ríos, Guadalupe Sánchez-Bringas, Carlos Pineda, Cristina Hernández-Díaz, Anthony Reginato, Magaly Alva, Marcelo Audisio, Ana Bertoli, Tomas Cazenave, Marwin Gutiérrez, Claudia Mora, Guillermo Py, Oscar Sedano, Carla Solano, Eugenio de Miguel
The objective of the present study is to evaluate, by ultrasonography (US), the prevalence in the quadriceps, patellar, and Achilles tendon involvement of gout compared to that of patients with osteoarthritis and asymptomatic marathon runners. This is a multicenter, multinational, transverse cross-sectional, and comparative study comprising 80 patients with the diagnosis of gout according to the American College of Rheumatology (ACR) criteria, compared with two control groups: 35 patients with generalized osteoarthritis according to the ACR criteria and 35 subjects who were healthy marathon runners...
August 2016: Clinical Rheumatology
Marcos George de Souza Leao, Abelardo Gautama Moreira Pampolha, Nilton Orlando Junior
OBJECTIVES: To evaluate knee function in patients undergoing reconstruction of the anterior cruciate ligament (ACL) using the central third of the patellar ligament or the medial flexor tendons of the knee, i.e. quadruple ligaments from the semitendinosus and gracilis (ST-G), by means of the Knee Society Score (KSS) and the Lysholm scale. METHODS: This was a randomized prospective longitudinal study on 40 patients who underwent arthroscopic ACL reconstruction between September 2013 and August 2014...
November 2015: Revista Brasileira de Ortopedia
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