Patella tip syndrome
CONSULT TREATMENT PROTOCOL

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The patellar tendon connects the lower pole of the patella to the tibia. Patellar tendinopathy (PT), often referred to as jumper’s knee, is a chronic overuse injury of the patellar tendon.

The main clinical symptom is pain at the inferior pole of the patella. Diagnosis is based on the clinical features of the disease. Diagnostic imaging should be considered to rule out other causes of knee pain or to establish the diagnosis of PT when in doubt.

Similar to other tendinopathies, the etiology of PT is not completely understood, but repetitive overload is thought to be an important factor. Histologic examination of biopsy specimens from patients undergoing patellar tendon surgery for chronic symptoms has shown that chronic PT is associated with degenerative changes in the tendon. Accordingly, the disease is better characterized as “tendinopathy” than “tendinitis”, resembling the situation in other overuse tendon problems such as Achilles tendinopathy.

Athletes have a very high prevalence of PT, i.e., up to 40% among elite basketball and volleyball players. The condition can be debilitating and may prevent athletes to return to sport for long periods between 6 months and more than 2 years.

The treatment of PT should start with conservative treatment modalities including rest, physiotherapy, eccentric strengthening, bracing and non-steroidal anti-inflammatory drugs. Patients not responding to conservative treatment for six months should then be subjected to radial shock wave therapy (RSWT). Surgery should be considered for recalcitrant cases of PT. Numerous arthroscopic and open procedures were described, but a consensus agreement about the best option is not available.