Patellar tendinitis, also known as jumper's knee, is an overuse injury of the tendon that straightens the knee.[1] Symptoms include pain in the front of the knee.[1] Typically the pain and tenderness is at the lower part of the kneecap, though the upper part may also be affected.[2] Generally there is no pain when the person is at rest.[2] Complications may include patellar tendon rupture.[2]
Quick Facts Other names, Specialty ...
Patellar tendinitis |
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Other names | quadriceps tendinopathy, patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis |
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Location of the pain in patellar tendinitis |
Specialty | Orthopedics, sports medicine |
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Symptoms | Pain at the front of the knee[1] |
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Complications | Patellar tendon rupture[2] |
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Risk factors | Jumping sports, being overweight[1] |
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Diagnostic method | Based on symptoms and examination[2] |
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Differential diagnosis | Chondromalacia patella, Osgood-Schlatter disease, patellofemoral syndrome, infrapatellar bursitis[1][2] |
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Treatment | Rest, physical therapy[2] |
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Prognosis | Recovery can be slow[2] |
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Frequency | 14% of athletes[1] |
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Risk factors include being involved in athletics and being overweight.[1] It is particularly common in athletes who are involved in jumping sports such as basketball and volleyball.[1][2] Other risk factors include sex, age, occupation, and physical activity level.[3] It is increasingly more likely to be developed with increasing age.[3] The underlying mechanism involves small tears in the tendon connecting the kneecap with the shinbone.[2] Diagnosis is generally based on symptoms and examination.[2] Other conditions that can appear similar include infrapatellar bursitis, chondromalacia patella and patellofemoral syndrome.[1][2]
Treatment often involves resting the knee and physical therapy.[2] Evidence for treatments, including rest, however is poor.[4][5] Recovery can take months and persist over years.[6][7][8][2] It is relatively common with about 14% of athletes currently affected; however research reflects that more than half of athletes with this injury end their careers as a result.[9][8][1] Males are more commonly affected than females.[2] The term "jumper's knee" was coined in 1973.[2]
People report anterior knee pain, often with an aching quality. The symptom onset is insidious. Rarely is a discrete injury described. Usually, the problem is below the kneecap but it may also be above. Jumper's knee can be classified into 1 of 4 stages, as follows:[2]
Stage 1: Pain only after activity, without functional impairment
Stage 2: Pain during and after activity, although the person is still able to perform satisfactorily in his or her sport
Stage 3: Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory level
Stage 4: Complete tendon tear requiring surgical repair
It begins as inflammation in the patellar tendon where it attaches to the patella and may progress by tearing or degenerating the tendon. People present with an ache over the patella tendon. Magnetic resonance imaging can reveal edema (increased T2 signal intensity) in the proximal aspect of the patellar tendon.[citation needed]
Evidence for treatment is poor.[4] In the early stages rest, ice, compression, and elevation may be tried. Tentative evidence supports exercises involving eccentric muscle contractions of the quadriceps on a decline board.[13] Specific exercises and stretches to strengthen the muscles and tendons may be recommended, e.g. cycling or swimming. Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems. Corticosteroid injections and NSAIDs are generally recommended.[2][dubious – discuss]
Surgery
Surgery may be tried if other measures fail.[2] This may involve removal of myxoid degeneration in the tendon. This is reserved for people with severe pain for 6–12 months despite conservative measures. Novel treatment modalities targeting the abnormal blood vessel growth which occurs in the condition are currently being investigated.[citation needed] Knee operations in most cases have no better effects than exercise programs.[citation needed]
It is relatively common with about 14% of athletes currently affected.[1] Males are more commonly affected than females.[2]
Santana JA, Sherman A (January 2019). Jumpers Knee. Treasure Island, FL: StatPearls Publishing. PMID 30422564. Cummings K, Skinner L, Cushman DM: "Patellar tendinopathy in athletes". Curr Phys Med Rehabil Rep 2019;7:227–36
Plinsinga M.L., Meeus M., Brink M., Heugen N., Van Wilgen P. "Evidence of Widespread Mechanical Hyperalgesia but Not Exercise-Induced Analgesia in Athletes with Mild Patellar Tendinopathy Compared with Pain-Free Matched Controls: A Blinded Exploratory Study". Am. J. Phys. Med. Rehabil. 2021;100(10):946-951. doi:10.1097/PHM.0000000000001673
Kettunen JA, Kvist M, Alanen E, et al: Long-term prognosis for Jumper's knee in male athletes: a prospective follow-up study. Am J Sports Med 2002;30:689–92
Koban M (2013). Beating Patellar Tendonitis. CreateSpace Independent Publishing Platform. pp. 20–25. ISBN 978-1-4910-4973-0. Backman LJ, Danielson P (December 2011). "Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study". The American Journal of Sports Medicine. 39 (12): 2626–33. doi:10.1177/0363546511420552. PMID 21917610. S2CID 39755525.