Operative treatment and arthroscopic findings in chronic patellar tendinitis

Patellar tendinitis is a well-described clinical entity that usually responds well to conservative treatment, However, a subset of patients continue with symptoms despite exhaustive nonoperative means. The objective of the study was to review the treatment course and operative results of seven patients (eight knees) with chronic patellar tendinitis treated surgically. Five (70%) of these patients were either professional or collegiate athletes. The average age was 30 years (range, 20 to 45 years). Duration of symptoms averaged 1.4 years (range, 3 months to 4 years) before surgical correction. Operative treatment included knee arthroscopy and open repair consisting of excision of degenerated tissue and stimulation of a healing response of the patellar tendon pathology. Operative findings and pathology reports consistently showed marked fibrotendinous degeneration. Follow-up averaged 3.6 years (range, 4 months to 8.5 years). Outcomes were measured subjectively with SF36 results and objectively with Biodex testing (Biodex, Shirley, NY) and return to previous level of competition. Overall, 86% of patients achieved an excellent result and 14% had a fair result. We recommend operative intervention in a patient with chronic patellar tendinitis who does not improve with well-supervised, comprehensive conservative treatment.