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Severe Knee Tendinitis Can Be Alleviated With Surgery

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Dec. 8, 1999 (Atlanta) -- One of the most common injuries in athletes is "jumper's knee" or patellar tendinitis. This injury is especially common in sports such as basketball, volleyball, football, soccer, and track and field, where jumping is frequent. The tendon of the thigh muscle -- the quadriceps -- when overused develops a series of small tears in a condition called patellar tendinitis. Atlanta Hawks guard Jim Jackson has suffered from this condition since he had knee surgery last summer.

Although most sufferers of this condition can be treated conservatively, occasionally the little tears in the tendon enlarge to create an area of dead tissue within the tendon. British and Italian researchers reported on a new surgical procedure in the current issue of Medicine and Science in Sports and Exercise, which they believe should be the first line of surgical treatment.

Those most likely to benefit from surgery are those who have damaged, or torn, the main body of the tendon, according to the investigators. "The ones who had the marked commonly occurring jumper's knee ... were the ones in whom the procedure is not indicated or warranted," study co-author Nicola Maffulli, MD, PhD, associate professor of orthopedic surgery at the University of Aberdeen Medical School in Scotland, tells WebMD.

The doctors used ultrasound to identify the damaged area of the knee and to guide their surgery on 37 patients. "What we also found is that given this procedure, it's not necessary to excise the area of degeneration [or dead tissue]," Maffulli says. "It is sufficient to perform just longitudinal tenotomies [cuts in the tendon]. So it should make the procedure faster and less injurious to the remaining part of the tendon. We think that by performing multiple ... longitudinal tenotomies, we end up stimulating an acute healing response from the remaining part of the tendon."

"It is a minimally invasive procedure that when performed in the right patients and followed by appropriate rehabilitation, has a high chance of returning them to active sports in a reasonable time," Maffulli says. All the patients in the study were treated as outpatients.

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