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.
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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)
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Chemical References |
- Sclerosing Solutions
- Polidocanol
- Polyethylene Glycols
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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
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