Systematic Review
Results of Surgical Treatment of Chronic Patellar Tendinosis (Jumper's Knee): A Systematic Review of the Literature

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Purpose

To review the literature concerning surgical treatment options for chronic patellar tendinosis (jumper's knee), a common problem among athletes. When conservative treatment fails, surgical treatment is required.

Methods

Systematic review of the literature concerning the results of current surgical treatment options for chronic patellar tendinosis. All articles of studies with an evidence level ≥IV from January 2000 until February 2015 presenting the surgical outcome after arthroscopic as well as open treatment of chronic patellar tendinosis were included. The literature research of the PubMed database was performed using the following key words: “patellar” and “tendinitis,” “tendonitis,” “tendinosis” or “tendinopathy”; “inferior patellar pole”; “jumper's knee”; “surgical treatment” and “open” or ”arthroscopic patellar tenotomy.”

Results

A systematic review of the literature was performed especially to point out the effectiveness of arthroscopic treatment of chronic patellar tendinosis. The results revealed good clinical results for arthroscopic as well as open treatment of chronic patellar tendinosis that is refractory to conservative treatment in athletes. An average success rate of 87% was found for the open treatment group and of 91% for the arthroscopic treatment group. However, after open surgery, the mean time of return to the preinjury level of activity is 8 to 12 months, with a certain number of patients/athletes who cannot return to the preinjury level of activity.

Conclusions

Minimally invasive, arthroscopically assisted or all-arthroscopic procedures may lead to a significantly faster return to sporting activities and may, therefore, be the preferred method of surgical treatment.

Level of Evidence

Level IV, systematic review of Level I-IV studies.

Section snippets

Study Selection

In February 2015, a systematic literature research of the PubMed database was performed using following keywords: “patellar” and “tendinitis,” “tendonitis,” “tendinosis” or “tendinopathy”; “inferior patellar pole”; “jumper's knee”; “surgical treatment” and “open” or “arthroscopic patellar tenotomy.” All articles with an evidence level ≥IV from 2000 until February 2015 presenting the surgical outcome after arthroscopic as well as after open treatment of chronic patellar tendinosis were included.

Results

Eight prospective case series, 8 retrospective case series, and one randomized controlled trial were included within this systematic review. Nine of them presented the results of arthroscopic surgical treatment, and 8 of them showed the outcome for open surgical treatment of chronic patellar tendinosis. Patellar bone resection was done in only 2 of the 8 studies in which open surgical treatment was performed, whereas in 5 of 9 studies presenting the arthroscopic technique, additional bony work

Discussion

A systematic review of the literature was done especially to point out the effectiveness of arthroscopic treatment of chronic patellar tendinosis. The results of the above-mentioned studies reveal good to excellent clinical results for arthroscopic as well as open treatment of chronic patellar tendinosis that is refractory to conservative treatment in athletes. An average success rate of 87% was found for the open treatment group and 91% for the arthroscopic treatment group.

Conclusions

The arthroscopic treatment of chronic patellar tendinosis is a safe and minimally invasive procedure to treat patients with jumper's knee. It provides excellent clinical results in knee function and pain reduction, a high satisfaction rate, and a fast rehabilitation period/recovery and return to sport activities. Therefore, arthroscopic techniques may be a good alternative to current open procedures. With regard to a faster recovery and return to sporting activities, arthroscopic treatment may

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    The authors report that they have no conflicts of interest in the authorship and publication of this article.

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