Patellofemoral Update

Patellofemoral Update

Disclosures: Breda reports no relevant financial disclosures. Please see the study for all other authors' relevant financial disclosures.
October 29, 2021
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Progressive tendon-loading yields positive outcomes in patients with patellar tendinopathy

Disclosures: Breda reports no relevant financial disclosures. Please see the study for all other authors' relevant financial disclosures.
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Compared with eccentric exercise therapy, progressive tendon-loading exercise resulted in “superior” clinical outcomes after 24 weeks in patients with patellar tendinopathy, according to published results.

In a stratified, investigator-blinded, block-randomized trial, researchers analyzed outcomes of 38 patients who were assigned to progressive tendon-loading exercises (PTLE) for clinically diagnosed and ultrasound-confirmed patellar tendinopathy (PT) and a matched cohort of 38 patients who were assigned to eccentric exercise therapy (EET).

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Return to sport was also higher in the PTLE cohort (43%) compared with the EET cohort (27%). Data were derived from Breda SJ, et al. Br J Sports Med. 2021;doi:10.1136/bjsports-2020-103403.

According to the study, outcome measures were collected at 24 weeks and included the Victorian Institute of Sports Assessment for patellar tendons (VISA-P) questionnaire, return to sport, patient satisfaction and exercise adherence.

After 24 weeks, the researchers found VISA-P score was “significantly better” in the PTLE cohort (28 points) compared with the EET cohort (18 points). Return to sport was also higher in the PTLE cohort (43%) compared with the EET cohort (27%); however, the researchers found no significant differences between the two cohorts in patient satisfaction or exercise adherence.

“EET is pain-provoking and the therapeutic effects on pain and functional outcome are debated when applied during the competitive season,” the researchers wrote in the study. “A recent review proposed an alternative exercise therapy for PT consisting of PTLE within the limits of acceptable pain.”

According to the study, treatment with PTLE was found to be superior to EET in patients with mostly chronic PT, regardless of chronic symptoms and previous conservative treatment in most patients.