Patellar Tendinopathy

Sports Medicine and Arthroscopy Review

Volumn 8, Issue 1, 2000, Pages 86-95

  King, John B ^a   Cook, Jill L ^b   Khan, Karim M ^c   Maffulli, Nicola ^d  

^a ROYAL LONDON HOSPITAL   (United Kingdom)

^b LA TROBE UNIVERSITY   (Australia)

^c UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^d UNIVERSITY OF ABERDEEN   (United Kingdom)

Author keywords

Imaging; Knee; Pain; Surgery; Tendinosis

Indexed keywords

EID: 0002933960     PISSN: 10628592     EISSN: None     Source Type: Journal    
DOI: 10.1097/00132585-200008010-00008     Document Type: Article

References (122)

1. Jozsa L, Kannus P. Human Tendons. Champaign, Illinois: Human Kinetics, 1997: 576.
2. Gelberman R, Goldberg V, An K-N, et al. Tendon. In: Woo SL-Y, Buckwalter JA, eds. Injury and Repair of the Musculoskeletal Soft Tissues. Park Ridge IL: American Association of Orthopaedic Surgeons; 1988:5-40.
3. Henke P. The painful tendon: a pathophysiological approach. Aus Fam Phys 1987;16:772-776.
4. Hess GP, Cappiello WK, Poole RM, et al. Prevention and treatment of overuse tendon injuries. Sports Med 1989;8(6):371-384.
5. Jarvinen M. Epidemiology of tendon injuries in sports. Clin Sports Med 1992;11(3):493-504.
6. Kannus P. Tendons-a source of major concern in competitive and recreational athletes [editorial]. Scand J Med Sci Sports 1997;7 (2):53-54.
7. Khan KM, Maffulli N. Tendinopathy: an Achilles' heel for athletes and clinicians [lead editorial]. Clin J Sport Med 1998;8(3): 151-154.
8. Ferretti A, Ippolito E, Mariani P, et al. Jumper's knee. Am J Sports Med 1983;11:58-62.
9. McLoughlin RF, Raber EL, Vellet AD, et al. Patellar tendinitis: MR features, with suggested pathogenesis and proposed classification. Radiology 1995;197:843-848.
10. Scapinelli R. Blood supply of the human patella. J Bone Joint Surg [Br] 1967;49:563.
11. Scapinelli R. Studies on the vasculature of the human knee joint. Acta Anatomica 1968;70:305-331.
12. Astrom M, Westlin N. Blood flow in the normal Achilles tendon assessed by laser doppler flowmetry. J Orthop Res 1994;12(2): 246-252.
13. Oakes BW. Tendons. In: Bloomfield J, Fricker PA, Fitch KD, eds. Textbook of Science and Medicine in Sport. Melbourne: Blackwell Scientific Publications, 1992:209-217.
14. Khan KM, Maffulli N, Coleman BD, Cook JL, Taunton JE. Patellar tendinopathy: some aspects of basic science and clinical management. Br J Sports Med 1998;32(4):346-355.
15. Elliott DH. Structure and function of mammalian tendon. Biol Rev 1965;40:392.
16. O'Brien M. Functional anatomy and physiology of tendons. Clin Sports Med 1992;11:505-520.
17. Zernicke RF, Garhammer J, Jobe FW. Human patellar-tendon rupture: a kinetic analysis. J Bone Joint Surg [Am] 1977;59:179-183.
18. Stanish WD, Curwin KS. Tendinitis. Its Etiology and Treatment. Toronto: Collamore Press; 1984.
19. Stanish WD, Rubinovich RM, Curwin S. Eccentric exercise in chronic tendinitis. Clin Orthop 1986;208:65-68.
20. McClay IS, Robinson JR, Andriacchi TP, et al. A profile of ground reaction forces in professional basketball. J Appl Biomater 1994;10:222-236.
21. Torstensen ET, Bray RC, Wiley JP. Patellar tendinitis: a review of current concepts and treatment. Clin J Sport Med 1994;4(2): 77-82.
22. Karlsson J, Kalebo P, Goksor L-A, et al. Partial rupture of the patellar ligament. Am J Sports Med 1992;20:390-395.
23. Karlsson J, Lundin O, Lossing IW, et al. Partial rupture of the patellar ligament. Results after operative treatment. Am J Sports Med 1991;19:403-108.
24. Raatikainen T, Karpakka J, Puranen J, et al. Operative treatment of partial rupture of the patellar ligament. A study of 138 cases. Int J Sports Med 1994;15:46-49.
25. Colosimo AJ, Bassett FH. Jumper's knee: diagnosis and treatment. Orthop Rev 1990;29:139-149.
26. Yu JS, Popp JE, Kaeding CC, et al. Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis. Am J Roentgenol 1995;165:115-118.
27. King JB, Perry DJ, Mourad K, et al. Lesions of the patellar ligament. J Bone Joint Surg [Br] 1990;72:46-48.
28. Fritschy D, Wallensten R. Surgical treatment of patellar tendinitis. Knee Surg Sports Traumatol Arthrosc 1993;1:131-133.
29. Roels J, Martens M, Mulier JC, et al. Patellar tendinitis (jumper's knee). Am J Sports Med 1978;6:362-368.
30. Martens M, Wouters P, Burssens A, et al. Patellar tendonitis: pathology and results of treatment. Acta Orthop Scand 1982;53: 445-450.
31. Nichols CE. Patellar tendon injuries. Clin Sports Med 1992;11 (4):807-813.
32. Khan KM, Bonar F, Desmond PM, et al. Patellar tendinosis (jumper's knee): findings at histopathologic examination, US and MR imaging. Radiology 1996;200:821-827.
33. Clancy WGJ. Tendon trauma and overuse injuries. In: Leadbetter WB, Buckwalter JA, Gordon SL, eds. Sports-Induced Inflammation: Clinical and Basic Science Concepts. Park Ridge, IL: American Academy of Orthopaedic Surgeons; 1990:609-618.
34. Blazina ME, Kerlan RK, Jobe FW, et al. Jumper's knee. Orthop Clin North Am 1973;4:665-678.
35. Fritschy D, de Gautard R. Jumper's knee and ultrasonography. Am J Sports Med 1988;16:637-640.
36. Myllymski T, Bondestam S, Suramo I, et al. Ultrasonography of jumper's knee. Acta Radiol 1990;31(2):147-149.
37. Davies SG, Baudouin CJ, King JB, et al. Ultrasound, computed tomography and magnetic resonance imaging in patellar tendinitis. Clin Radiol 1991;43:52-56.
38. Kujala UM, Aalto T, Osterman K, et al. The effect of playing volleyball on the knee extensor mechanism. Am J Sports Med 1989;17:766-770.
39. Kannus P, Jozsa L. Histopathologic changes preceding spontaneous rupture of a tendon. J Bone Joint Surg [Am] 1991;73:1507-1525.
40. Waterston SW, Maffulli N, Ewen SWB. Subcutaneous rupture of the Achilles tendon: basic science and some aspects of clinical practice. Br J Sports Med 1997;31:289-298.
41. Kolliker A. Handbuch der Gewebelehre des Menschen. Leipzig: W Engelman; 1855:198-199.
42. Rudolph G. Histochemische Untersuchungen zum Stoffwechsel des bradytrophen Gewebes. Verh Dtsch Ges Path 1964;48:325-329.
43. O'Brien M. Structure and metabolism of tendons. Scand J Med Sci Sports 1997;7:55-61.
44. Peacock EE. A study of the circulation of normal tendons and healing grafts. Ann Surg 1959;149:415.
45. Gerber G, Gerber G, Altman KI. Studies on the metabolism of tissue proteins: I. Turnover of collagen labeled with proline-U-C14 in young rats. J Biol Chem 1960;235:2653-2656.
46. Peacock EEJ, van Winkle WJ. Surgery and biology of wound repair. Philadelphia: WB Saunders; 1970:334-336.
47. Williams IF. Cellular and biochemical composition of healing tendon. In: Jenkins DHR, ed. Ligament Injuries and Their Treatments. Rockville, MD: Aspens Systems Corporation; 1985:43-57.
48. Mourad K, King J, Guggiana P. Computed tomography and ultrasound imaging of jumper's knee - patellar tendinitis. Clin Radiol 1988;39:162-165.
49. Johnson DP. Magnetic resonance imaging of patellar tendonitis. J Bone Joint Surg [Br] 1996;78B:452-457.
50. Maffulli N, Binfield PM, Leach WJ, King JB. Surgical management of tendinopathy of the main body of the patellar tendon in athletes. Clin J Sport Med 1999;9(2):58-62.
51. Leadbetter WB. Cell-matrix response in tendon injury. Clin Sports Med 1992;11(3):533-578.
52. Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy 1998;14(8):840-843.
53. Puddu G, Cipolla M, et al. Tendinitis. In: Fox JM, Del Pizzo W, eds. The Patellofemoral Joint. New York: McGraw-Hill; 1993:.
54. Maffulli N, Dymond NP, Regine R. Surgical repair of ruptured Achilles tendon in sportsmen and sedentary patients: a longitudinal ultrasound assessment. Int J Sports Med 1990;11:78-84.
55. Ferretti A. Epidemiology of jumper's knee. Sports Med 1986;3: 289-295.
56. Pezzullo DJ, Irrgang JJ, Whitney SL. Patellar tendonitis: jumpers knee. J Sports Rehabil 1992;1:56-68.
57. Lian O, Holen KJ, Engebrestson L, et al. Relationship between symptoms of jumper's knee and the ultrasound characteristics of the patellar tendon among high level male volleyball players. Scand J Med Sci Sports 1996;6:291-296.
58. Lian O, Engebretsen L, Ovrebo RV, et al. Characteristics of the leg extensors in male volleyball players with jumper's knee. Am J Sports Med 1996;24:380-385.
59. Cook JL, Khan K, Harcourt PR, et al. A cross-sectional study of 100 cases of jumper's knee managed conservatively and surgically. Br J Sports Med 1997;31(4):332-336.
60. McConnell J. The management of chondromalacia patellae: a long term solution. Aus J Physiol 1986;32(4):215-223.
61. Brukner P, Khan K. Clinical Sports Medicine. Sydney: McGraw-Hill; 1993.
62. Nirschl RP. Elbow tendinosis/tennis elbow. Clin Sports Med 1992;11(4):851-870.
63. Visentini PJ, Khan KM, Cook JL, et al. The VISA score: an index of the severity of jumper's knee. J Sci Med Sport 1998;1:24-30.
64. Beltran J, Noto AM, Herman LJ, et al. Tendons: high-field-strength surface coil MR imaging. Radiology 1987;162:735-740.
65. Fornage BD, Rifkin MD. Ultrasound examination of tendons. Radiol Clin North Am 1988;26:87-107.
66. Richardson ML, Selby B, Montana MA, et al. Ultrasonography of the knee. Radiol Clin North Am 1988;26:63-75.
67. Tietz CC. Ultrasonography in the knee: clinical aspects. Radiol Clin North Am 1988;26:55-62.
68. Maffulli N, Regine R, Carrillo F, et al. Ultrasonographic scan in knee pain in athletes. Br J Sports Med 1992;26(2):93-96.
69. Maffulli N, Regine R, Angelillo M, et al. Ultrasound diagnosis of Achilles tendon pathology in runners. Br J Sports Med 1987;21: 158-162.
70. Sandmeier R, Renstrom P. Diagnosis and treatment of chronic tendon disorders in sport. Scand J Med Sci Sports 1997;7:96-106.
71. Borre A, Berra G, Ravera R, et al. Ultrasonography study of the patellar tendon following bone-tendon-bone anterior cruciate ligament reconstruction arthroscopy [in Italian]. Radiol Med Torino 1995;89:604-607.
72. Adriani E, Mariani PP, Maresca G, et al. Healing of the patellar tendon after harvesting of its mid-third for anterior cruciate ligament reconstruction and evolution of the unclosed donor site defect. Knee Surg Sports Traumatol Arthrosc 1995;3:138-143.
73. Wiley JP, Bray RC, Wiseman DA, et al. Serial ultrasonographic imaging evaluation of the patellar tendon after harvesting its central one third for anterior cruciate ligament reconstruction. J Ultrasound Med 1997;16(4):251-255.
74. Cook JL, Khan KM, Harcourt PR, et al. Patellar tendon sonography in asymptomatic active sportspeople reveals hypoechoic regions: a study of 320 tendons. Clin J Sport Med 1998;8(2):73-77.
75. Kalebo P, Sward L, Karlsson J, et al. Accuracy of ultrasonography in the detection of partial patellar ligament ruptures (jumper's knee). Skeletal Radiol 1991;20:285-289.
76. Khan KM, Cook JL, Kiss ZS, et al. Patellar tendon ultrasonography and jumper's knee in elite female basketball players: a longitudinal study. Clin J Sport Med 1997;7:199-206.
77. Maffulli N, Testa V, Capasso G, et al. Results of percutaneous longitudinal tenotomy in Achilles tendinopathy in middle- and long-distance runners. Am J Sports Med 1997;25:835-840.
78. Khan K, Visentini PJ, Kiss ZS, et al. Correlation of ultrasound and magnetic resonance imaging with clinical outcome after patellar tenotomy: prospective and retrospective studies. Clin J Sport Med 1999;9:129-137.
79. Kiss ZS, Kellaway D, Cook J, et al. Postoperative patellar tendon healing - an ultrasound study. Australia Radiol 1998;42:28-32.
80. Testa V, Capasso G, Maffulli N, Bifulco G. Ultrasound-guided percutaneous longitudinal tenotomy for the management of patellar tendinopathy. Med Sci Sports Exerc 1999;31(11):1509-1515.
81. El-Khoury GY, Wira RL, Berbaum KS, et al. MR imaging of patellar tendinitis. Radiology 1992;184:849-854.
82. Movin T, Kristoffersen-Wiberg M, Shalabi A, et al. Intratendinous alterations as imaged by ultrasound and contrast medium enhanced magnetic resonance in chronic achillodynia. Foot Ankle Int 1998;19(5):311-317.
83. Miniaci A, Dowdy PA, Willits KR, et al. Magnetic resonance imaging evaluation of the rotator cuff tendons in the asymptomatic shoulder. Am J Sports Med 1995;23:142-145.
84. Pope CF. Radiologic evaluation of tendon injuries. Clin Sports Med 1992;11:579-599.
85. Erickson SJ, Cox IH, Hyde JS, et al. Effect of tendon orientation on MR imaging signal intensity: a manifestation of the 'magic angle' phenomenon. Radiology 1991;181:389-392.
86. Erickson SJ, Prost RW, Timins ME. The 'magic angle' effect: background physics and clinical relevance. Radiology 1993;188: 23-25.
87. Ferretti A, Papandrea P, Conteduca F. Knee injuries in volleyball. Sports Med 1990;10(2):132-138.
88. Richards DP, Ajeman SV, Wiley JP, et al: Knee joint dynamics predict patellar tendinitis in elite volleyball players. Am J Sports Med 1996;24(5):676-683.
89. Prilutskii BI, Zatsiorskii VM, Petrova LN: Tendon action of two-joint muscles during human locomotion: transfer of mechanical energy between links in shock-absorbing and push-off phases [in Russian]. Biofizika 1993;38(4):719-725.
90. Prapavessis H, McNair PJ: Effect of instruction in jumping technique and experience jumping on ground reaction forces. J Orthop Sports Phys Ther 1999;29(6):352-356.
91. Zuluaga M, Briggs C, Carlisle J, et al., eds. Sports Physiotherapy. Applied Science and Practice. Melbourne: Churchill Livingstone, 1995.
92. Lee E, Maffulli N, Li CK, et al. Pulsed magnetic and electromagnetic fields in experimental Achilles tendonitis in the rat: a prospective randomised study. Arch Phys Med Rehabil 1997;78: 399-404.
93. Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exer 1999;31(4):531-535.
94. Pellechia G, Hamel H, Behnke P. Treatment of infrapatellar tendinitis: a combination of modalities and transverse friction massage versus iontophoresis. J Sport Rehab 1994;3:1315-1345.
95. Testa V, Ruggiu M, Capasso G. Fibrolisi diacutanea: una tecnica diagnostica e terapeutica nelle patologie croniche del tendine di Achille nell'atleta. Medicina Sport 1996;49:89-94.
96. Curwin S, Stanish WD. Tendinitis: Its Etiology and Treatment. Lexington: Collamore Press; 1984.
97. Fyfe I, Stanish WD. The use of eccentric training and stretching in the treatment and prevention of tendon injuries. Clin Sports Medz 1992;11(3):601-624.
98. El Hawary R, Stanish WD, Curwin SL. Rehabilitation of tendon injuries in sport. Sports Med 1997;24:347-358.
99. Curwin S. The etiology and treatment of tendinitis. In: Harries M, Williams C, Stanish WD, et al., eds. Oxford Textbook of Sports Medicine. Oxford: Oxford University Press; 1994:.
100. Cannell LJ. The effects of an eccentric-type exercise versus a concentric-type exercise in the management of chronic patellar tendonitis. [Masters Thesis]. University of British Columbia, 1982.
101. Galloway MT, Jokl P, Dayton OW. Achilles tendon overuse injuries. Clin Sports Med 1992;11:771-782.
102. Rolf C, Movin T, Engstrom B, et al. An open, randomized study of ketoprofen in patients in surgery for Achilles or patellar tendinopathy. J Rheumatol 1997;24:1595-1598.
103. Astrom M, Westlin N. No effect of piroxicam on Achilles tendinopathy. A randomized study of 70 patients. Acta Orthop Scand 1992;63:631-634.
104. Weiler JM. Medical modifiers of sports injury: the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in sports soft tissue injury. Clin Sports Med 1992;11(3):625-644.
105. Almekinders LC. The efficacy of nonsteroidal anti-inflammatory drugs in the treatment of ligament injuries. Sports Med 1990;9: 137-142.
106. Dingle JT. The effect of NSAIDs on human cartilage glycosaminoglycan synthesis. Eur J Rheumatol Inflamm 1996;16:47-52.
107. Leadbetter WB. Tendon overuse injuries: diagnosis and treatment. In: Renstrom PAFH, ed. Sports Injuries. Basic Principles of Prevention and Care. London: Oxford, 1993:449-476.
108. Shrier I, Matheson GO, Kohl HW. Achilles tendonitis: are corticosteroid injections useful or harmful. Clin J Sport Med 1996;6: 245-250.
109. Fredberg U. Local corticosteroid injection in sport: a review of literature and guidelines for treatment. Scand J Med Sci Sport 1997;7:131-139.
110. Lee J. Intratendinous injections: an experimental study in cadavers. [Masters of Science Thesis]. London Hospital Medical College, 1998.
111. Capasso G, Testa V, Maffulli N, et al. Aprotinin, corticosteroids and normosaline in the management of patellar tendinopathy in athletes: a prospective randomized study. Sports Exerc Injury 1997;3:111-115.
112. Dayer JM. Chronic inflammatory joint diseases: natural inhibitors of IL-1 and TNF-alpha. J Rheumatol 1991;18(Suppl):71-75.
113. Schiavone-Panni A, Tartarone M, Maffulli N. Patellar tendinopathy in athletes. Outcome of nonoperative and operative management. Am J Sports Med 2000;28:392-397.
114. Orava S, Osterback L, Hurme M. Surgical treatment of patellar tendon pain in athletes. Br J Sports Med 1986;20(4):167-169.
115. Popp JE, Yu JS, Kaeding CC. Recalcitrant patellar tendinitis. Magnetic resonance imaging, histologic evaluation and surgical treatment. Am J Sports Med 1997;25(2):218-222.
116. Saillant G, Rolland E, GarÁon P, et al. Surgical treatment of patellar tendinitis. A series of 80 cases. J Trauma Sport 1991;8: 114-120.
117. Binfield PM, Maffulli N. Surgical management of common tendinopathies. Sports Exerc Injury 1997;3:116-122.
118. Biedert R, Vogel U, Friedrichs NF. Chronic patellar tendinitis: a new surgical treatment. Sports Exerc Injury 1997;3:150-154.
119. Leadbetter WB, Mooar PA, Lane GJ, et al. The surgical treatment of tendinitis: clinical rationale and biologic basis. Clin Sports Med 1992;11(4):679-712.
120. Testa V, Capasso G, Maffulli N, et al. Ultrasound guided percutaneous longitudinal tenotomy for the management of patellar tendinopathy. Med Sci Sports Exer 1999;31(11):1509-1515
121. Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Scand J Med Sci Sports 2000;10(1):2-11.
122. Coleman BD, Khan KM, Kiss ZS, Bartlett J, Young DA, Wark JD. Open and arthroscopic patellar tenotomy for chronic patellar tendinopathy. A retrospective outcome study. Victorian Institute of Sport Tendon Study Group. Am J Sports Med 2000;28(2):183-190.