From the Research
Orthopedic surgeons, specifically those specializing in sports medicine or pediatric orthopedics, typically manage Sinding-Larsen and Johansson syndrome. This condition is a form of patellar tendinopathy that affects the inferior pole of the patella, commonly seen in adolescents during growth spurts who participate in jumping sports. Management usually involves conservative treatment including rest from aggravating activities, ice application, non-steroidal anti-inflammatory medications, and physical therapy focusing on quadriceps and hamstring stretching and strengthening, as recommended by a recent scoping review 1.
Key Points in Management
- The condition is self-limiting and typically resolves with skeletal maturity, though symptoms may persist for 6-12 months.
- Surgery is rarely needed, and the underlying cause involves repetitive stress at the patellar tendon insertion, creating inflammation and sometimes partial avulsion of the developing bone.
- Ultrasound and MRI are effective diagnostic tools for Sinding-Larsen-Johansson disease, as noted in a study from 2024 1.
- Conservative treatment yields positive outcomes within two to eight months, according to the same study 1.
Diagnostic Considerations
- Differentiating Sinding-Larsen-Johansson syndrome from patellar sleeve avulsion fractures is important, as treatment for the latter is frequently surgical, as discussed in a case report from 2023 2.
- A multimodality approach, including conventional radiography, ultrasound, and magnetic resonance imaging, can aid in diagnosis, as highlighted in a case report from 2023 2.
Treatment Approach
- Conservative management is the preferred initial approach, with a focus on activity limitation, rest, cryotherapy, passive mobilization, muscle restraint, isometric exercise, and NSAIDs, as recommended by a recent review 1.
- The role of arthroscopic treatment is less clear, but it has been used in cases of painful Sinding-Larsen-Johansson syndrome, as described in a case report from 2016 3.