Patella tip syndrome
CONSULT TREATMENT PROTOCOL

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GLOSSARY OF DISEASES

NameTissueType of pathologies
Acute and chronic muscle aches and pain Muscle Pain management
Acute and chronic cervical and lumbar pain Muscle Idiopathic cervical and low back pain
Acute and chronic soft tissue wounds Skin Wounds
Adhesive capsulitis Joint Capsulitis
Calcifying tendinitis of the shoulder Tendons Tendinopathy
Cellulite Skin Cellulite
Chronic distal biceps tendinopathy Tendons Tendinopathy
Chronic proximal hamstring tendinopathy Tendons Tendinopathy
Diseases secondary to trigger points and myofascial Pain Muscle Myofascial pain syndrome
Golfer’s elbow Tendons Tendinopathy
Greater trochanteric pain syndrome Tendons Tendinopathy
Insertional Achilles tendinopathy Tendons Tendinopathy
Knee osteoarthritis Joint Osteoarthritis
Medial tibial stress syndrome Tendons Tendinopathy
Mid-body Achilles tendinopathy Tendons Tendinopathy
Osgood-Schlatter disease Bone Disturbance of musculoskeletal development
Patella tip syndrome Tendons Tendinopathy
Plantar fasciopathy Tendons Tendinopathy
Primary and secondary lymphedema Skin Lymphedema
Primary long bicipital tenosynovitis Tendons Tendinitis
Proliferative connective tissue disorders Connective tissue Fibrosis
Spasticity Central nervous system Cerebral palsy and stroke
Stress fractures Bone Fracture
Subacromial pain syndrome Tendons Tendinopathy
Superficial nonunions Bone Fracture
Tennis elbow Tendons Tendinopathy
Trigger points Muscle Myofascial pain syndrome
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MORE INFORMATION

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.

 

CLINICAL EVIDENCE

Furia et al., Knee Surg Sports Traumatol Arthrosc 2013;21:346-350

A single application of low-energy radial extracorporeal shock wave therapy is effective for the management of chronic patellar tendinopathy.

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TREATMENT PROTOCOL

Number of treatment sessions 3 to 5
Interval between two sessions 1 week
Air pressure Evo Blue® 2 to 4 bar
Air pressure Power+ 1.5 to 3 bar
Impulses 2000 on the painful spot
Frequency 8Hz to 12Hz
Applicator 15mm
Skin pressure Light to moderate

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