What is patellar tendinitis surgery?

Patellar Tendinitis Surgery

Patellar tendinitis surgery is an effective treatment option that should be reserved for patients who have failed conservative therapy for 3-6 months. 1

Overview of Patellar Tendinitis

Patellar tendinopathy (also called jumper's knee) causes activity-related anterior knee pain and affects both athletes and non-athletes. It commonly results from repetitive loading of the patellar tendon, particularly in jumping athletes. 1

• Pain is typically located at the inferior pole of the patella and is exacerbated by activities such as navigating stairs and prolonged sitting 1
• Physical examination reveals pain at the inferior pole of the patella with the leg fully extended during resisted leg extension 1
• A decline squat test places increased load on the patellar tendon and often reproduces the patient's pain 1

Surgical Indications

Surgery becomes an option when:

• Conservative treatment has failed after 3-6 months 1
• Patient continues to experience significant pain affecting quality of life 1
• Patient is unable to return to desired activity level despite appropriate non-surgical management 1

Surgical Techniques

Several surgical approaches exist for treating patellar tendinopathy:

• Open surgery: Involves exploration of the affected patellar tendon, stripping of the paratenon, excision of pathological areas, and multiple longitudinal tenotomies 2
• Arthroscopic surgery: Less invasive approach that allows for debridement of the patellar tendon 3

The specific surgical procedure typically includes:

• Excision of abnormal tendon tissue 1
• Performance of longitudinal tenotomies to release areas of scarring and fibrosis 1
• Decompression of the patellar tendon 2

Surgical Outcomes

Recent evidence demonstrates favorable outcomes following surgical intervention:

• High success rates with 89.8% of patients returning to sport following surgery 4
• 76.1% of athletes return to the same level of activity as before injury 4
• Significant improvements in patient-reported outcomes and pain scores after surgery 4
• Most successful patients are completely free of pain and resume full sporting activity 2

Recovery Timeline

• Average time from surgery to resuming full sporting activity is approximately 7 months (range: 6 weeks to 12 months) 2
• Recovery requires appropriate rehabilitation protocols following surgery 3

Potential Complications

Surgical treatment may involve certain risks:

• Early complications may include wound hematoma and superficial infection 2
• Late complications often relate to the incision, including anterior knee pain on kneeling and skin dysesthesia 2
• Some patients may experience persistent symptoms requiring revision surgery 5

Important Considerations

• Surgical outcomes correlate with study methodology, with more rigorous studies sometimes showing less favorable results 6
• Arthroscopic approaches may offer better return-to-sport rates compared to open procedures 4
• Patients who do not respond to initial surgery may not recover without additional intervention 2

Non-Surgical Management Before Considering Surgery

Before proceeding to surgery, patients should undergo comprehensive conservative treatment:

• Relative rest and reduced activity to prevent further damage 1
• Eccentric strengthening exercises to reduce symptoms and promote tendon healing 1
• Deep transverse friction massage for pain reduction 1
• Cryotherapy for acute pain relief 1
• Short-term use of NSAIDs for pain management (though they don't affect long-term outcomes) 1