• 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 the treatment of patellar tendinopathy. Hence, a review of treatment of patellar tendinopathy that used a randomised allocation or were prospective in nature was undertaken.

Ten randomised trials were reviewed. These studies investigated the effects on the patellar tendon of anti-inflammatory medication (n = 7), exercise (n = 2), and local massage (n = 1). No randomised surgical papers were identified, hence three prospective studies on the surgical treatment of this condition were included.