Patellar Tendinopathy: Clinical Diagnosis, Load Management, and Advice for Challenging Case Presentations

被引:196
作者
Malliaras, Peter [1 ,2 ]
Cook, Jill [1 ,3 ]
Purdam, Craig [3 ,4 ,5 ]
Rio, Ebonie [1 ,3 ]
机构
[1] La Trobe Univ, Musculoskeletal Res Ctr, Hawthorn, Vic 3122, Australia
[2] Univ London, Ctr Sport & Exercise Med, London WC1E 7HU, England
[3] Federat Univ, Australian Ctr Res Injury Sport & Its Prevent, Ballarat, Vic, Australia
[4] Australian Inst Sport, Dept Phys Therapies, Canberra, ACT, Australia
[5] Univ Canberra, Fac Hlth, Dept Physiotherapy, Canberra, ACT 2601, Australia
关键词
anterior knee pain; eccentric exercises; knee; tendinitis; ECCENTRIC DECLINE SQUAT; INFRAPATELLAR FAT PAD; JUMPERS KNEE; TENDON PAIN; THERAPEUTIC EXERCISES; SYNOVIAL PLICAE; RISK-FACTORS; FOLLOW-UP; ACHILLES; ULTRASOUND;
D O I
10.2519/jospt.2015.5987
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should focus on progressively developing load tolerance of the tendon, the musculoskeletal unit, and the kinetic chain, as well as addressing key biomechanical and other risk factors. Rehabilitation can be slow and sometimes frustrating. This review aims to assist clinicians with key concepts related to examination, diagnosis, and management of patellar tendinopathy. Difficult clinical presentations (eg, highly irritable tendon, systemic comorbidities) as well as common pitfalls, such as unrealistic rehabilitation time frames and overreliance on passive treatments, are also discussed.
引用
收藏
页码:887 / 898
页数:12
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