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Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature
  1. M T van Leeuwen,
  2. J Zwerver,
  3. I van den Akker-Scheek
  1. Center for Sports Medicine, University Center for Sport, Exercise and Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  1. J Zwerver, Center for Sports Medicine, UMC Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; j.zwerver{at}


Background and purpose: Extracorporeal shockwave therapy (EWST) has become a popular treatment for patellar tendinopathy. The purpose of this review was to study the effectiveness of ESWT treatment for patellar tendinopathy; to draft guidelines for an effective treatment protocol of ESWT treatment; and to identify topics for further research.

Methods: A computerised search of the Medline and Embase databases was conducted on 1 August 2007, to identify studies dealing with the effectiveness of ESWT for patellar tendinopathy.

Results: Seven articles describing the effectiveness of ESWT on patellar tendinopathy, all published after 2000, were included. These studies included a total of 283 patients (298 tendons), 204 of whom (215 tendons) were assigned to ESWT treatment. The treatment results were positive but most studies had methodological deficiencies, small numbers and/or short follow-up periods. Method of application and shockwave generation, energy level, number and frequency of treatments, use of (local) anaesthesia and method of localisation were variable.

Conclusion: ESWT seems to be a safe and promising treatment for patellar tendinopathy with a positive effect on pain and function. Based on current knowledge it is impossible to recommend a specific treatment protocol. Further basic and clinical research into the working mechanism and effectiveness of ESWT for patellar tendinopathy are necessary.

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  • Competing interests: None.