Sclerosing injections and ultrasound-guided arthroscopic shaving for patellar tendinopathy: good clinical results and decreased tendon thickness after surgery-a medium-term follow-up study.

Abstract

PURPOSE:

Treatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections or ultrasound-guided arthroscopic shaving has shown good clinical short-term results. Former studies indicate that the tendon thickness and structure stays unaffected after successful treatment. The aim of this study was to evaluate the sonographic findings and clinical outcome 3-5 years after treatment of patellar tendinopathy with ultrasound-guided sclerosing injections or arthroscopic shaving.

METHODS:

Fifty-seven patellar tendons (43 patients) with chronic patellar tendinopathy were evaluated, with ultrasound, colour Doppler (CD) and visual analogue scale (VAS) for pain and satisfaction with treatment, 3-5 years after treatment. Functional status was evaluated with a single question-"Back in full loading activity?" yes or no.

RESULTS:

At endpoint (mean 46 months), there was a significant decrease in anteroposterior thickness of the proximal patellar tendon in patients treated with ultrasound-guided arthroscopic shaving but not after sclerosing injections. Tendon structure had improved, and CD local blood flow had diminished significantly in both groups. There were good clinical results with a significant decrease in VAS for pain after sclerosing injections (VAS 64 ± 18 → 17 ± 23) with 74 % satisfied patients and also after arthroscopic shaving (VAS 77 ± 16 → 13 ± 23) with 80 % satisfied patients. There were no significant differences in VAS between groups. A significant correlation between low local blood flow and high patient satisfaction was found.

CONCLUSIONS:

Tendon thickness decreased over time after ultrasound-guided arthroscopic shaving, and tendon structure and local blood flow decreased after both treatments. There were good, and similar, clinical results with both methods.

LEVEL OF EVIDENCE:

III.

• Authors: Kerstin Sunding, Lotta Willberg, Suzanne Werner, Håkan Alfredson, Magnus Forssblad, Martin Fahlström
• Journal: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA (Knee Surg Sports Traumatol Arthrosc) Vol. 23 Issue 8 Pg. 2259-2268 (Aug 2015) ISSN: 1433-7347 [Electronic] Germany
• PMID: 24797812 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Sclerosing Solutions
• Polidocanol
• Polyethylene Glycols

Topics

• Adolescent
• Adult
• Arthroscopy
• Athletic Injuries (therapy)
• Chronic Disease
• Female
• Follow-Up Studies
• Humans
• Injections
• Male
• Patellar Ligament (diagnostic imaging, drug effects, surgery)
• Polidocanol
• Polyethylene Glycols (administration & dosage)
• Randomized Controlled Trials as Topic
• Recovery of Function
• Sclerosing Solutions (administration & dosage)
• Tendinopathy (diagnostic imaging, drug therapy, surgery)
• Ultrasonography, Doppler, Color
• Ultrasonography, Interventional
• Young Adult