Figueroa David, Figueroa Francisco, Calvo Rafael
From the Knee Unit, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
J Am Acad Orthop Surg. 2016 Dec;24(12):e184-e192. doi: 10.5435/JAAOS-D-15-00703.
Patellar tendinopathy is a common cause of pain in athletes' knees. Historically, it has been related to jumping sports, such as volleyball and basketball. Repetitive jumping generates a considerable load of energy in the extensor mechanism, leading to symptoms. The main pathophysiologic phenomenon in patellar tendinopathy is tendinosis, which is a degenerative disorder rather than an inflammatory disorder; therefore, the other popular term for this disease, tendinitis, is not appropriate. The nonsurgical treatment of patellar tendinopathy is focused on eccentric exercises and often has good results. Other experimental options, with variable levels of evidence, are available for recalcitrant cases. Surgical treatment is indicated for cases that are refractory to nonsurgical treatment. Open or arthroscopic surgery can be performed; the two methods are comparable, but arthroscopic surgery results in a faster recovery time.
髌腱病是运动员膝盖疼痛的常见原因。从历史上看,它与排球和篮球等跳跃运动有关。反复跳跃会在伸肌机制中产生相当大的能量负荷,从而导致症状。髌腱病的主要病理生理现象是肌腱病,这是一种退行性疾病而非炎症性疾病;因此,这种疾病的另一个常用术语“肌腱炎”并不恰当。髌腱病的非手术治疗主要集中在离心运动上,通常效果良好。对于顽固病例,还有其他证据水平不一的实验性治疗选择。对于非手术治疗无效的病例,需进行手术治疗。可采用开放手术或关节镜手术;两种方法效果相当,但关节镜手术恢复时间更快。