PAPER 088: THE TREATMENT OF RECALCITRANT PATELLAR TENDONITIS WITH PATELLAR TENDON DEBRIDEMENT – INDICATIONS, TECHNIQUE, AND CLINICAL OUTCOMES

Abstract

Purpose: Patellar tendonitis (i.e. jumper’s knee) commonly affects young adult athletes who use their knee extensor mechanism in a repetitive and/or intense manner, such as in basketball and volleyball. There is a small but significant percentage of patients with persistent symptoms despite at least a six-month course of conservative management. For these patients, we perform knee arthroscopy and open patellar tendon debridement. This study presents the indications, technique, and clinical results of open patellar debridement.

Method: We investigated the clinical outcomes of 38 consecutive cases of open patellar tendon debridements (3 were bilateral) in 35 patients without previous open ipsilateral knee surgery over 7 years.

Results: Two patients (2 knees) were lost to follow-up (94% follow-up rate). The average age at surgery was 29 (SD 10, range 14–51). There were 21 males and 12 females. At an average follow-up of 43 months (SD 21, range 15–92 months), the Lysholm score showed 27 knees with good or excellent results, 4 fair, and 2 poor. The average post-operative IKDC score was 79 (SD 14, range 41–100). When compared to the pre-operative value, the post-operative Tegner Activity Scores showed no change (average change 0, SD 2, p=0.20), and Visual Analog Pain Scores decreased by an average of 6 points (SD 3, p< 0.001). Twenty-seven patients were completely or mostly satisfied with the surgical outcome, 4 were somewhat satisfied, and 2 were dissatisfied. Twenty-seven patients (82%) said that they would have the surgery performed again for the same problem.

Conclusion: Patellar tendon debridement significantly reduces knee pain in patellar tendonitis patients without significantly affecting their activity level; the great majority of patients are satisfied with the results of the procedure.