Abstract
Background: The surgical treatment of chronic patellar tendinopathy could be open or arthroscopic. A general agreement on the best surgical treatment option is still lacking.
Purpose: The aim of our study was to evaluate the clinical results after a minimally invasive arthroscopic treatment of chronic patellar tendinopathy including a resection of the lower patellar pole.
Methods: The study included 14 patients with a mean age of 26 years and chronic patellar tendinopathy refractory to non-operative treatment of more than 6 months. All patients underwent arthroscopic debridement of the adipose tissue of the Hoffa’s body posterior to the patellar tendon, debridement of abnormal patellar tendon and resection of the lower patellar pole. Preoperative and postoperative evaluation was undertaken using clinical examination, magnetic resonance imaging (MRI) and the Lysholm and Victorian Institute of Sport Assessment-Patella (VISA-P) scores. Return to sports and postoperative complications were also assessed. The mean follow-up was 12.2 ± 0.9 months.
Results: All 14 patients continued with sport activities, but only 12 of them (85.7%) achieved their presymptom sporting level. The median time to return to preinjury level of activity was 3.9 ± 0.8 months. Patients showed a major improvement in the mean Lysholm score from 51.1 ± 3.8 to 93.4 ± 4.2 (p=0.001) and in the mean VISA-P score from 42.1 ± 3.5 to 86.7 ± 8.4 (p=0.001) There were no postoperative complications.
Conclusion: We found that this arthroscopic technique gives reduced morbidity and satisfactory outcome resulting in significantly faster recovery and return to sports in patients with chronic patellar tendinopathy.