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|Non-surgical treatment of patellar tendinopathy: a systematic review of randomized controlled trials|
|Vander Doelen T, Jelley W|
|Journal of Science and Medicine in Sport 2019 Sep 13:Epub ahead of print|
STUDY DESIGN: Systematic review of randomized controlled trials. OBJECTIVES: To determine the most effective non-surgical treatment interventions for reducing pain and improving function for patients with patellar tendinopathy. METHODS: Studies considered for this systematic review were from peer-reviewed journals published between January 2012 and September 2017. All included studies used a visual analogue scale (VAS) to evaluate the participant's pain. The majority of the included studies also used the Victorian Institute of Sport Assessment Patellar Tendinopathy (VISA-P questionnaire) to assess participant's symptoms and function. RESULTS: Nine randomized controlled trials fit the inclusion criteria and were analyzed. The results of three studies supported the use of isometric exercise to reduce pain immediately. One study found patellar strapping and sports taping to be effective for reduction in pain during sport and immediately after. Eccentric exercise, dry needling (DN) (2 studies), injections with platelet rich plasma (PRP), autologous blood injection (ABI), and saline were found to have a more sustained effect on reducing pain and improving knee function. CONCLUSION: Isometric exercise, patellar strapping, sports taping, eccentric exercise, injections with PRP, ABI, and saline and DN demonstrated a short-term pain relieving and functional improvement effect in subjects with patellar tendinopathy. Longer term follow up on interventions involving eccentric exercise, DN, and injections with PRP, ABI and saline showed sustained pain reduction and improvement in knee function. LEVEL OF EVIDENCE: Level 1.