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髌腱病

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Updated Sep 2026
Illustration: knee

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您正在感受到的症状

髌腱病，常被称为“跳跃者膝”，是指髌骨正下方肌腱处的疼痛和肿胀。它通常逐渐发生，而非由单次损伤引起。起初，您可能会在活动后（如打无板篮球或跑步后）注意到疼痛。随着时间的推移，疼痛可能开始出现在活动过程中，最终可能限制您在球场或场上的表现。

疼痛部位通常位于髌骨下极，即肌腱附着于骨骼的位置。按压该部位会有压痛。跳跃、跑步及其他对肌腱施加负荷的活动会加重疼痛。在阻力下伸直膝关节（如从低矮的椅子上站起或爬楼梯）也可能引起疼痛。有些人会感到膝盖短暂地“打软”或“失稳”，这是因为疼痛导致大腿肌肉瞬间“关闭”或失能。

在慢性病例中，即使处于休息状态，疼痛也可能持续存在。长时间坐着，如在办公桌前或长途驾驶时，可能会使疼痛持续。疼痛和肿胀往往在数月或数年内缓慢加重，而非一夜之间出现。

此类肌腱问题在从事跳跃类运动的人群中很常见，在更广泛的人群中也有发现。大腿肌肉紧张、较硬的运动场地以及频繁的训练课程都会增加肌腱的负荷。超重也与该病症有关。

如果您已经疼痛了很长时间，您可能会注意到它正在影响您的运动或日常作息。在花园里下蹲、跪姿、从地面起身或下车等动作都可能变得不舒服。有些人发现疼痛在醒来后或久坐不动后加剧，但一旦开始活动，疼痛会稍有缓解。

该病情的进展程度通常以阶段来描述：活动后疼痛、活动中和活动后疼痛，或限制您在活动本身中所能做之事的疼痛。

实际发生了什么

您的髌腱是一根强韧的索带，将髌骨（膝盖骨）的下端与胫骨（小腿骨）连接起来。可以将其想象为由许多细纤维组成的绳索，这些纤维排列整齐，以便协同发力。每次跳跃、落地或蹬地时，这根绳索都会承受张力。上楼梯时，它承受的负荷约为体重的3倍。

问题始于绳索锚定在髌骨处的位置，即其最深层的纤维。当膝关节在负重状态下弯曲时，该部位承受最大的力，且其血液供应较差。由于血流减少，组织难以自我修复。反复的重负荷会导致微小的损伤无法完全愈合。随着时间推移，纤维分解并变得无序，受影响的腱部可能会增厚。

这种损伤不同于撕裂或炎症性肌腱病变。它是组织本身的缓慢退变，有时被称为肌腱变性（tendinosis）。其中没有炎症细胞，因此它不像典型的肿胀后消退的损伤那样表现。新的微小血管可能生长到受损区域，这些血管被认为与您感受到的疼痛有关。髌骨下端的压痛点，以及在抗阻伸膝时的疼痛，均源于这块磨损且增厚的腱组织。

该疾病按阶段描述，与您仍能完成的活动相匹配。第一阶段，疼痛仅在活动后出现。第二阶段，疼痛在活动过程中以及活动后均会出现。第三阶段，疼痛限制了您在运动或训练时实际能完成的活动。大多数病例无需手术即可管理，但在经过适当时长的非手术治疗后，若疼痛和肿胀持续存在，则考虑手术。

还有一点值得了解：相同的改变可能出现在肌腱中而不引起任何疼痛，因此扫描图像并不总是与您的膝关节感觉相符。

我们如何处理该问题

第一步是调整您对肌腱的负荷量。减少或调整引发疼痛的跳跃、跑步和训练，有助于组织恢复稳定。随后，物理治疗会以稳定、渐进的方式强化膝关节和股部肌肉。贴扎或在髌骨下方佩戴护带也可能对部分患者有帮助，且症状较轻的男性患者似乎使用护带效果更好。请给予这种方案数月的合理时间，再对其效果进行评判。

抗炎药物可在短期内缓解疼痛。我们不针对此病症使用皮质类固醇注射，因为这会增加肌腱断裂的风险。当标准治疗无效时，有时会考虑其他注射治疗。冲击波疗法利用声波刺激愈合，在其他治疗失败时可提供帮助。富血小板血浆（PRP）注射——一种取自您自身血液、可能促进愈合的物质——是顽固病例的一个选择，通常与康复计划结合使用。一些针对肌腱内新生血管的注射已改善了膝关节功能并减轻了疼痛，部分患者在注射后恢复了完全的肌腱负荷活动。

当经过适当时长的非手术治疗后疼痛和肿胀仍持续存在时，手术便成为选项。手术会清除肌腱的受损部分，并促进其在髌骨附着处的愈合。在某些情况下，如果肌腱有显著撕裂，还可以进行重建。对于经其他治疗仍未缓解的疼痛，关节镜手术（微创手术）是一个选项。我们会与您讨论手术是否适合您，并由您与我们共同做出决定。

预期情况

大多数患有此病症的人无需手术即可改善。治疗的主要手段是非手术护理：改变活动方式，然后进行渐进性强化锻炼。这需要时间，值得在数月内充分尝试。部分肌腱通过这种方法可完全恢复，尽管在部分患者中，即使康复良好，疼痛仍可能持续数年，且并非肌腱的所有部分在扫描中都能恢复正常。

如果疼痛未能缓解，则考虑手术。对于达到手术指征的患者，手术能显著改善疼痛和日常功能，大多数运动员能够重返运动。关节镜手术后的改善效果至少可维持3年。然而，并非所有人都能恢复到原有水平：仅约半数接受肌腱清理术的患者在术后仍能维持此前的竞技水平。无论如何，大多数接受手术的患者均获得了症状缓解。

有几个诚实的注意事项值得了解。在部分患者中，该病症会反复出现，这在精英足球运动员中尤为常见。某些膝关节形态（如髌骨位置高于正常）与当前手术无法改善的病例相关，这些情况可能需要不同的手术方法。如果肌腱有显著撕裂，在清理受损组织的同时进行重建，可降低并发症风险。

此外，还有一些事项应避免。皮质类固醇注射不用于此病症，因为其会增加肌腱断裂的风险。合成代谢类固醇对该肌腱及其上方的股四头肌腱具有相同的风险。

积极的一面是，治疗后重返赛场的运动员，其职业生涯长度不受影响，且其运动表现不会因曾患此病症而受损。一项短期可能有帮助的事项：等长运动（即保持肌肉紧张而不移动关节的运动）可立即减轻肌腱疼痛，且缓解效果至少持续45分钟。

何时就医

如果您在训练或比赛后膝盖下方（髌骨下）的疼痛反复出现，或者疼痛不仅在活动后出现，在活动过程中也出现，请咨询您的全科医生。如果疼痛导致您无法像以前那样进行比赛或训练，或者即使在休息或长时间坐着时也会感到酸痛，或者尽管经过休息和物理治疗，疼痛仍持续数月，请要求专科医生评估。如果膝盖伸直时按压该部位疼痛，而弯曲时不痛，请尽早就医，因为这种模式提示肌腱本身存在问题。如果您的膝盖突然失去支撑且无法对抗重力伸直，这可能意味着肌腱已撕裂，因此需紧急评估。

Reviewed by AI synthesis (v2) — pending human review · 9 September 2026.

Want the clinical detail? Read the clinician version.

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Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Epidemiology

  • Patellar or quadriceps tendinopathy occurs in active individuals who engage in activities involving forceful, eccentric contraction of the knee extensor mechanism, particularly jumping sports [1].
  • Harder playing surfaces and increased frequency of practices have been associated with increased rates of tendinopathy [1].
  • Patellar tendinopathy occurs most frequently in adolescents and young adults [1].
  • Quadriceps tendinopathy occurs in middle-aged and older adults [1].

Pathoanatomy

  • Patellar tendinopathy tends to occur at the deep fibers of the patellar attachment of the tendon [1].
  • The area of patellar tendinopathy has a tenuous blood supply [1].
  • Affected tissue in patellar tendinopathy may demonstrate fibrinoid necrosis, angiofibroblastic change, or mucoid degeneration and disorganized collagen structure [1].
  • Metaplasia of adjacent fibrocartilage may be present in patellar tendinopathy [1].
  • The medial portion of the patellar tendon often demonstrates thickening compared with the rest of the tendon [1].
  • The pathoanatomy of quadriceps tendinopathy is similar to that of patellar tendinopathy [1].

Evaluation

  • Patients with patellar or quadriceps tendinopathy describe an insidious onset of pain and swelling of the affected tendon [1].
  • Symptoms initially develop after activity, gradually start to bother the individual both during and after activity, and eventually limit athletic performance during the activity [1].
  • Patients may report buckling of the knee, which represents reflex quadriceps inhibition due to pain [1].
  • Physical examination reveals tenderness and soft-tissue swelling, usually in the area where the tendon attaches to the patellar bone [1].
  • Patients often have discomfort with resisted extension of the knee [1].
  • Plain radiographs of the knee may demonstrate degenerative spurring where the affected tendon attaches to bone [1].
  • MRI usually shows thickening in the affected portion of the tendon and may demonstrate intrasubstance signal abnormalities [1].
  • Thickening is much more diagnostic than signal changes when identifying abnormal tendon on MRI [1].

Classification

  • The three stages of tendinopathy according to Blazina are: Stage 1 (pain after activity), Stage 2 (pain during and after activity), and Stage 3 (pain that limits function during an activity) [1].

Treatment

  • Nonsurgical intervention is the mainstay of treatment [1].
  • Initial treatment consists of activity modification [1].
  • Progressive flexibility and eccentric strengthening exercises follow initial treatment [1].
  • Taping to aid proprioception and patellar tracking or using an infrapatellar strap can be helpful [1].
  • NSAIDs can be beneficial [1].
  • Corticosteroid injection is contraindicated because of the increased risk of tendon rupture [1].
  • No recommendation can be made currently regarding prolotherapy injections using a local irritant to elicit an inflammatory healing response [1].
  • No recommendation can be made currently regarding platelet-rich plasma injection [1].
  • Surgery is reserved for patients who continue to have pain and swelling of the tendon after a nonsurgical treatment regimen has been attempted [1].
  • Surgical procedures are performed according to the surgeon’s preference [1].
  • Surgical options include various methods of débriding diseased tissue and stimulating a vigorous healing response [1].
  • A surgical method involves simple longitudinal excision of the diseased portion of tendon, followed by abrasion of the bone to provide a bleeding surface for tendon healing, and finishing with the application of side-to-side sutures or suture anchors as needed [1].
  • Variations of the surgical procedure include drilling of the bone to stimulate a healing response or multiple tendon perforations (“pie crusting”) to stimulate healing of the tendon tissue [1].
  • All surgical procedures can be performed using a standard anterior midline incision to expose the diseased tendon and its attachment to the patella [1].

Anatomy & Pathophysiology

Epidemiology & Risk Factors

  • Harder playing surfaces and increased frequency of practices are associated with increased rates of tendinopathy [1].
  • Patellar tendinopathy occurs most frequently in adolescents and young adults, whereas quadriceps tendinopathy occurs in middle-aged and older adults [1].
  • Patellar tendinitis affects up to 20% of jumping athletes [4].
  • Males are more commonly affected by patellar tendinitis than females [4].
  • Risk factors for patellar tendinitis include poor quadriceps and hamstring flexibility [4].
  • Patellar tendinopathy is most common in athletes who participate in jumping sports such as basketball and volleyball [13].

Pathoanatomy

  • The area of patellar attachment has a tenuous blood supply [1].
  • Affected tissue in patellar tendinopathy may demonstrate fibrinoid necrosis, angiofibroblastic change, mucoid degeneration, and disorganized collagen structure [1].
  • Histologic evaluation of patellar tendinitis tissue reveals degeneration rather than inflammation [4].
  • Patellar tendinopathy is characterized by disorganized collagen structure visualized on MRI by thickening of the tendon and signal intensity changes [6].
  • The patellar tendon receives its blood supply from the infrapatellar fat pad and from the retinaculum through the medial and lateral inferior geniculate arteries [14].
  • The patellar tendon routinely sees forces of 3 times body weight when ascending stairs [14].
  • It takes over 17 times body weight to rupture a normal patellar tendon [14].
  • Under normal conditions, tensile overload of the extensor mechanism usually leads to fracture of the patella, which is considered the weakest link in the extensor mechanism [36].
  • Between 50% and 75% of tendon fibers had to be transected to result in a rupture under forces greater than those seen under physiologic conditions in a rabbit model [36].
  • Patellar tendon ruptures secondary to indirect trauma have been considered the end stage of long-standing chronic tendon degeneration secondary to repetitive microtrauma [36].
  • Biopsy specimens of spontaneously ruptured tendons reveal pathologic findings that are degenerative in nature, including hypoxic tendinopathy, mucoid degeneration, tendolipomatosis, and calcifying tendinopathy [36].
  • Ruptures may occur in the absence of pathologic tendon degeneration [36].
  • The frequent prevalence of prodromal symptoms associated with tendon failure supports the finding of tendon degeneration prior to rupture [36].
  • In a series of 13 athletes with chronic jumper's knee that resulted in tendon rupture, younger patients had more severe symptoms than older patients [36].
  • More advanced degeneration is required to weaken younger healthier tendons [36].
  • Prodromal symptoms were present in 46% of professional football players prior to patellar tendon rupture [36].
  • Underlying chronic degeneration is often present in patellar tendon ruptures and is characterized by angiofibroblastic tendinosis, mucoid degeneration, and pseudocyst formation at the attachment of tendon to bone [2].
  • The quadriceps tendon has been described as having two to four distinct layers [2].

Clinical Presentation

  • Patients often present with an insidious onset of anterior knee pain at the inferior border of the patella [4].
  • In chronic cases, pain may be present at rest with prolonged sitting [4].
  • Palpation is painful at the insertion of the patella tendon to the inferior pole of the patella [4].
  • A Bassett sign is tenderness to palpation at the distal pole of patella in full extension, but no tenderness to palpation at the distal pole of patella in full flexion [4].
  • Patellar tendinosis is associated with pain and tenderness near the inferior border of the patella, which is worse in extension than in flexion [13].
  • Patients with quadriceps tendinosis may note painful clicking and localized pain at the superior border of the patella [13].

Imaging

  • Plain radiographs are often normal but may show inferior traction spurs or enthesophyte in chronic cases [4].
  • Ultrasonography will show thickening of the tendon and hypoechoic areas [4].
  • MRI may be useful to identify partial tears and chronic tears and may be used for surgical planning [4].
  • MRI can show increased signal intensity on both T1 and T2 images and loss of the posterior border of the fat pad in chronic cases [4].

Classification

  • Phase I of the Blazina classification is pain after activity only [4].
  • Phase II of the Blazina classification is pain during and after activity [4].
  • Phase III of the Blazina classification is persistent pain with and without activity along with deterioration of performance [4].

Classification

  • The Blazina classification describes three stages of patellar or quadriceps tendinopathy [1].
  • Stage 1 of the Blazina classification is characterized by pain after activity [1].
  • Stage 2 of the Blazina classification is characterized by pain during and after activity [1].
  • Stage 3 of the Blazina classification is characterized by pain that limits function during an activity [1].
  • Phase I of the Blazina classification is defined as pain after activity only [4].
  • Phase II of the Blazina classification is defined as pain during and after activity [4].
  • Phase III of the Blazina classification is defined as persistent pain with and without activity along with deterioration of performance [4].

Clinical Presentation

Epidemiology and Risk Factors

  • Poor quadriceps and hamstring flexibility are risk factors for patellar tendinopathy [4].

Pathoanatomy

  • The area of patellar tendon attachment has a tenuous blood supply [1].

History and Symptoms

  • In chronic cases of patellar tendinitis, pain may be present at rest with prolonged sitting [4].

Physical Examination

  • A Bassett sign is defined as tenderness to palpation at the distal pole of the patella in full extension, but no tenderness to palpation at the distal pole of the patella in full flexion [4].

Imaging

  • Plain radiographs are often normal but may show inferior traction spurs or enthesophyte in chronic cases of patellar tendinitis [4].
  • Ultrasonography shows thickening of the tendon and hypoechoic areas [4].

Classification

  • The Blazina classification Stage 1 is characterized by pain after activity [1].
  • The Blazina classification Stage 2 is characterized by pain during and after activity [1].
  • The Blazina classification Stage 3 is characterized by pain that limits function during an activity [1].

Investigations

Radiography

  • Weight-bearing AP and lateral radiographs are the standard for initial evaluation of knee pathology [11].
  • A weight-bearing knee flexed at 45-degree angle, imaged posterior to anterior, is included in standard radiographic evaluation [11].
  • The sunrise view (Merchant view) is included in standard radiographic evaluation [11].
  • Extension and flexion lateral views are included in standard radiographic evaluation [11].
  • A standing full-length AP radiograph from hip joint to ankle joint is used to evaluate limb alignment and knee deformity [11].
  • Patella alta on radiographs is a diagnostic feature of patellar tendon rupture [7].
  • In a sleeve fracture of the patella, the small osseous portion of the displaced fragment is visible on lateral radiograph, but the cartilaginous portion is not seen [7].

Magnetic Resonance Imaging (MRI)

  • MRI is not indicated if the joint space is significantly narrowed on radiograph [11].
  • MRI is used when osteonecrosis is suspected [11].
  • MRI has been found to underestimate the size of articular cartilage defects in approximately 75% of cases [33].
  • The reliability of clinical findings and magnetic resonance imaging for the diagnosis of chondromalacia patellae has been evaluated [12].
  • Quantitative MRI analysis has been used to assess the association of patellofemoral joint morphology with chondromalacia patella [12].
  • T2 mapping has been investigated for its role in MRI for patellofemoral chondromalacia [12].
  • MRI findings have been documented in cases of symptomatic bilateral dorsal patellar defects presenting with cartilage involvement and bone marrow edema [12].
  • The accuracy and reproducibility of identifying cruciate and collateral ligament insertions using MRI have been evaluated [34].
  • Current concepts on MRI evaluation of postoperative knee ligaments have been reviewed [34].
  • MRI features of the anterolateral ligament of the knee have been described [8].
  • The MRI appearance of the anterolateral ligament and its association with the Segond fracture have been described [8].
  • Visibility of anterolateral ligament tears in anterior cruciate ligament-deficient knees with standard 1.5-Tesla magnetic resonance imaging has been assessed [8].

Computed Tomography (CT)

  • Three-dimensional CT with remodeling is used for preoperative planning for reconstruction associated with dysplasia, post-trauma planning, and complex total knee arthroplasty planning [11].
  • CT and MRI measurements of tibial tubercle–trochlear groove distances are not equivalent in patients with patellar instability [5].

Ultrasound

  • Dynamic sonography has been used for the diagnosis of medial plica syndrome of the knee [30].
  • Sonographic examination of knee ligaments has been described [34].

Treatment

Non-Operative Management

  • Nonsurgical intervention is the mainstay of treatment for patellar tendinopathy [1].
  • Progressive flexibility and eccentric strengthening exercises follow initial activity modification [1].
  • Taping to aid proprioception and patellar tracking can be helpful in nonsurgical management [1].
  • Using an infrapatellar strap can be helpful in nonsurgical management [1].
  • NSAIDs can be beneficial for patellar tendinopathy [1].
  • Corticosteroid injection is contraindicated for patellar tendinopathy because of the increased risk of tendon rupture [1].
  • No recommendation can currently be made regarding prolotherapy injections using a local irritant to elicit an inflammatory healing response [1].
  • No recommendation can currently be made regarding platelet-rich plasma injection [1].
  • Treatment for patellar tendinitis includes ice, rest, and activity modification [4].
  • Physical therapy focusing on quadriceps and hamstring stretching is part of the treatment for patellar tendinitis [4].
  • Ultrasonography treatment may be helpful for patellar tendinitis [4].
  • Taping may be helpful for patellar tendinitis [4].
  • Chopat straps may be helpful for patellar tendinitis [4].
  • Treatment with platelet-rich plasma showed a significantly better outcome when used correctly [4].
  • Treatment with shock waves has shown positive effects for patellar tendinopathy [4].
  • Treatment with sclerotherapy has shown positive effects for patellar tendinopathy [4].
  • Treatment with corticosteroid injections showed positive short-term effects only [4].
  • Treatment with oral NSAIDs showed positive short-term effects only [4].
  • There was no evidence to support Kinesio taping for patellar tendinopathy [4].
  • There was no evidence to support acupuncture for patellar tendinopathy [4].
  • There was no evidence to support fascial therapy for patellar tendinopathy [4].
  • There was no evidence to support cryotherapy for patellar tendinopathy [4].
  • Cortisone injections are contraindicated due to risk of patellar tendon rupture [4].
  • A systematic review and meta-analysis of 2530 patients found that eccentric exercise therapies obtained the best results at short-term [38].
  • A systematic review and meta-analysis of 2530 patients found that multiple injections of PRP obtained the best results at long-term follow-up [38].
  • One randomized controlled study reported results comparable to surgery for eccentric training in patellar tendinopathy [38].
  • Another randomized controlled study reported no effect of a 12-week eccentric training program for patellar tendinopathy [38].
  • A randomized controlled trial comparing ultrasound-guided injection of autologous skin-derived tendon-like cells and injection of autologous plasma alone found faster response and greater improvements in pain and function with cell therapy [38].
  • Satisfactory results were obtained in 74% of 83 knees treated with extracorporeal shockwave therapy for patellar tendinopathy [38].
  • Athletes treated with extracorporeal shockwave therapy for patellar tendinopathy returned to participation in their sport in an average of 6 weeks [38].
  • Two studies comparing extracorporeal shockwave therapy with PRP injection found that PRP had significantly better results at 6 and 12 months [38].
  • Mesenchymal stem cells may have therapeutic utility in the future for patellar tendinopathy [38].
  • Suggested alternatives to open patellar tenotomy include eccentric exercise, sclerosing injections targeting the area of neovessels and nerves on the dorsal side of the patellar tendon, injections of PRP, arthroscopic shaving of the same area, and extracorporeal shockwave therapy [38].
  • Treatment for patellar tendinosis includes nonsteroidal anti-inflammatory drugs (NSAIDs) [13].
  • Treatment for patellar tendinosis includes physical therapy involving strengthening including eccentric exercise and ultrasonography [13].
  • Treatment for patellar tendinosis includes orthoses such as a patella tendon strap [13].

Operative Management

  • Surgical procedures for patellar tendinopathy are performed according to the surgeon’s preference [1].
  • Simple longitudinal excision of the diseased portion of tendon is a surgical option for patellar tendinopathy [1].
  • Abrasion of the bone to provide a bleeding surface for tendon healing is a surgical option for patellar tendinopathy [1].
  • Application of side-to-side sutures or suture anchors as needed is a surgical option for patellar tendinopathy [1].
  • Drilling of the bone to stimulate a healing response is a variation of the surgical procedure for patellar tendinopathy [1].
  • Multiple tendon perforations (“pie crusting”) to stimulate healing of the tendon tissue is a variation of the surgical procedure for patellar tendinopathy [1].
  • All surgical procedures for patellar tendinopathy can be performed using a standard anterior midline incision to expose the diseased tendon and its attachment to the patella [1].
  • Surgical treatment for patellar tendinitis is usually reserved for cases refractory to conservative management and for partial tears [4].
  • Surgical treatment for patellar tendinitis involves excision of the diseased tendon and suture repair [4].
  • Surgery involving excision of necrotic tendon fibers is rarely indicated for patellar tendinosis [13].
  • Operative treatment is occasionally necessary for quadriceps tendinosis [13].
  • The inferior pole of the patella can be curetted or drilled to incite a healing response during tenotomy and repair for chronic patellar tendinosis [38].
  • The defect in the tendon is sutured with side-to-side interrupted 2-0 Vicryl sutures during tenotomy and repair for chronic patellar tendinosis [38].
  • The peritenon is closed with interrupted absorbable sutures during tenotomy and repair for chronic patellar tendinosis [38].
  • A knee immobilizer is applied after tenotomy and repair for chronic patellar tendinosis [38].
  • The knee immobilizer is worn for 3 to 4 weeks after tenotomy and repair for chronic patellar tendinosis [38].
  • Crutches are used for partial weight bearing after tenotomy and repair for chronic patellar tendinosis [38].
  • Stage 1 of rehabilitation after tenotomy and repair for chronic patellar tendinosis should emphasize range of motion and isometric strengthening [38].
  • Closed-chain kinetics are started in stage 2 of rehabilitation after tenotomy and repair for chronic patellar tendinosis when swelling and tenderness have resolved [38].
  • Stage 3 of rehabilitation after tenotomy and repair for chronic patellar tendinosis should consist of activity-specific exercises, avoiding eccentric overload [38].
  • Return to full activities after tenotomy and repair for chronic patellar tendinosis can be allowed when 85% to 90% of strength and full range of motion are achieved [38].
  • Postoperative rehabilitation for patellar tendinitis surgery includes immobilization in extension [4].
  • Postoperative rehabilitation for patellar tendinitis surgery includes progressive range of motion and strengthening [4].
  • Return to activities is achieved by 80% to 90% of athletes after patellar tendinitis surgery [4].
  • Activity-related aching may persist for 4 to 6 months after patellar tendinitis surgery [4].

Complications

  • Repair of chronic patellar tendon rupture can be complicated by proximal retraction of the patella [2].
  • Repair of chronic patellar tendon rupture can be complicated by insufficient tissue for repair [2].
  • Proximal retraction in chronic patellar tendon rupture repair can be addressed by surgical dissection and mobilization of the quadriceps tendon [2].
  • Tendon augmentation for chronic patellar tendon rupture can be performed with a hamstring autograft passed through tibial and patellar drill holes [2].
  • Tendon augmentation for chronic patellar tendon rupture can be performed with a central quadriceps tendon–patellar bone autograft [2].
  • Tendon augmentation for chronic patellar tendon rupture can be performed with a contralateral bone–patellar tendon–bone autograft [2].
  • Tendon augmentation for chronic patellar tendon rupture can be performed with an allograft [2].
  • Augmentation for chronic patellar tendon rupture can be considered using wire, nonabsorbable tape, or heavy suture [2].
  • Chronic quadriceps tendon ruptures can be complicated by proximal migration of the tendon stump [2].
  • Proximal migration of the tendon stump in chronic quadriceps tendon rupture requires débridement and mobilization of the tendon [2].
  • Following débridement and mobilization for chronic quadriceps tendon rupture, the tendon can be augmented with autograft or allograft tissue and secured to bone [2].
  • Corticosteroid injection is not recommended for patellar or quadriceps tendinopathy because it increases the risk of tendon rupture [6].

References

[1] Aaos Comprehensive Orthopaedic Review 3. Extensor Mechanism Injuries > IV Patellar or Quadriceps Tendinopathy.

[2] Aaos Comprehensive Orthopaedic Review 3. Extensor Mechanism Injuries > III Rupture of the Patellar Tendon or Quadriceps Tendon.

[4] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Soft-­Tissue Injuries About the Knee > Patellar Tendon > Patellar Tendinitis.

[5] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > SELECTED BIBLIOGRAPHY.

[6] Aaos Comprehensive Orthopaedic Review 3. Extensor Mechanism Injuries > Patellar or Quadriceps Tendinopathy.

[7] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 3Sports Medicine > 2. Rupture of the Patellar Tendon.

[8] Campbell S Operative Orthopaedics 4 Volume Set. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE-PATELLAR TENDON-BONE GRAFT > KNEE LIGAMENTS > ANTEROLATERAL LIGAMENT.

[11] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > SECTION 11 KNEE ARTHRITIS ASSESSMENT.

[12] Campbell S Operative Orthopaedics 4 Volume Set. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE-PATELLAR TENDON-BONE GRAFT > DISORDERS OF THE PATELLA.

[13] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > 2. Trauma.

[14] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Soft-­Tissue Injuries About the Knee > Patellar Tendon > Patellar Tendon Rupture.

[30] Campbell S Operative Orthopaedics 4 Volume Set. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE-PATELLAR TENDON-BONE GRAFT > SYNOVIAL PLICA.

[33] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > OSTEOCHONDRAL LESIONS > 1. Osteochondritis dissecans (OCD).

[34] Campbell S Operative Orthopaedics 4 Volume Set. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE-PATELLAR TENDON-BONE GRAFT > GENERAL.

[36] Rockwood And Green S Fractures In Adults. 59: Patellar Fractures and Dislocations and Extensor Mechanism Injuries > Pathoanatomy and Applied Anatomy Related to Extensor Mechanism Injuries.

[38] Campbell S Operative Orthopaedics 4 Volume Set. ULNAR COLLATERAL LIGAMENT REPAIR WITH AN INTERNAL BRACE > CHRONIC PATELLAR TENDINOSIS.

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