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The patellar tendon connects the kneecap (the patella) to the shin bone. This is part of the ‘extensor mechanism’ of the knee, and together with the kneecap quadriceps tendon and the quadriceps muscle, these structures allow your knee to straighten out, and provide strength for a kicking motion. The patellar tendon, like other tendons, is made of tough string-like bands. These bands are surrounded by a vascular tissue lining that provides nutrition to the tendon.
Patellar tendonitis is the condition that occurs when the tendon becomes inflamed and irritated. This condition is most often seen in athletes who do repetitive jumping, the reason patellar tendonitis is often called “jumper’s knee.” Patellar tendonitis is most often seen in participants of sports including basketball and volleyball, although can also be seen in runners and other types of athletes.
Patellar tendinosis is a chronic condition. Instead of the tendon becoming inflamed and irritated, the condition is more gradual in developing, and characterized by microscopic tears and thickening of the tendon. Patellar tendinosis causes similar symptoms, but the treatment of this condition is different from tendonitis.
Partial patellar tendon tears, a finding sometimes described on an MRI, are usually characteristic of chronic patellar tendinosis. These tears are differentiated from a complete patellar tendon tear where the entire tendon is detached and requires surgical repair.
Patellar tendonitis and tendinosis usually cause pain directly over the patellar tendon. The tendon is usually tender and swollen. Movement of the knee may causes a crunching sensation called crepitus directly over the swollen tendon. The other common symptom of patellar tendon problems is pain with activities, especially jumping or kneeling.
X-ray tests are usually performed to confirm there is no problem with the bones around the knee. Occasionally, a calcium deposit may be seen, particularly in patients with a more chronic patellar tendinosis. An MRI may be helpful to look for symptoms of inflammation or partial tears within the tendon.
Dr. Woodworth typically begins with less invasive treatments before considering other options, such as surgery.
Medications: Pain relievers such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others) may provide short-term relief from pain associated with patellar tendinitis.
Therapy: A variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis.
Surgical and Other Procedures: If conservative treatments haven’t helped, your doctor may suggest other therapies such as:
Corticosteroid Injection: An ultrasound-guided corticosteroid injection into the sheath around the patellar tendon may help relieve pain. But these types of drugs can also weaken tendons and make them more likely to rupture.
Platelet-Rich Plasma Injection: An injection of platelet-rich plasma has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage.
Surgery: If conservative approaches aren’t helping after many months of treatment, in rare cases your doctor might suggest surgical intervention for the patellar tendon. Some of these procedures can be accomplished through small incisions around your knee.
Woodworth Orthopedics and Sports Medicine will help you decide how to best treat your patellar tendonitis. Call Dr. Woodworth today at (702) 545-6194 for an appointment.
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