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What is the most appropriate treatment for patellar tendinopathy?

J L Cook¹, K M Khan²

¹ Musculoskeletal Research Centre La Trobe University, Bundoora Victoria 3086, Australia J.Cook@latrobe.edu.au
² Department of Family Practice and School of Human Kinetics University of British Columbia, Canada kkhan@interchange.ubc.ca

Key Words: patella; tendinopathy; conservative treatment

Since the demise of the concept of an inflammatory basis for tendinopathy, treatment has been based on the degenerative concept.¹ However, an alternative theory of a failed healing response may be more fitting,² and treatment that maintains or encourages the healing response in the tendon is required. Currently, treatment remains empirically based, as it is not known what interventions may best stimulate a healing response.

The conservative treatment of patellar tendinopathy recorded in the literature includes combinations of rest,³ exercise, especially eccentric exercise,⁴ modalities including ultrasound, heat, and cryotherapy,⁵ frictions,⁶ biomechanical adjustment,⁷ and pharmaceutical treatment.⁸ Many of these treatments are based on "clinical experience" rather than appropriately analysed data.

The surgical management of patellar tendinopathy includes several different operative procedures and postoperative rehabilitation protocols. The choice of surgical treatment of patellar tendinopathy appears to be based on the surgeon's preference.⁹

Recent literature reviews^{8, 10} document a dearth of controlled trials in . . . [Full text of this article]

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