University clinic for orthopedic surgery, traumatology, anesthesiology and intensive care, Skopje, Republic of North Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2020 Sep 1;41(2):71-79. doi: 10.2478/prilozi-2020-0035.
The surgical treatment of chronic patellar tendinopathy could be open or arthroscopic. A general agreement on the best surgical treatment option is still lacking.
The aim of our study was to evaluate the clinical results after a minimally invasive arthroscopic treatment of chronic patellar tendinopathy including a resection of the lower patellar pole.
The study included 14 patients with a mean age of 26 years and chronic patellar tendinopathy refractory to non-operative treatment of more than 6 months. All patients underwent arthroscopic debridement of the adipose tissue of the Hoffa's body posterior to the patellar tendon, debridement of abnormal patellar tendon and resection of the lower patellar pole. Preoperative and postoperative evaluation was undertaken using clinical examination, magnetic resonance imaging (MRI) and the Lysholm and Victorian Institute of Sport Assessment-Patella (VISA-P) scores. Return to sports and postoperative complications were also assessed. The mean follow-up was 12.2 ± 0.9 months.
All 14 patients continued with sport activities, but only 12 of them (85.7%) achieved their presymptom sporting level. The median time to return to preinjury level of activity was 3.9 ± 0.8 months. Patients showed a major improvement in the mean Lysholm score from 51.1 ± 3.8 to 93.4 ± 4.2 (p=0.001) and in the mean VISA-P score from 42.1 ± 3.5 to 86.7 ± 8.4 (p=0.001) There were no postoperative complications.
We found that this arthroscopic technique gives reduced morbidity and satisfactory outcome resulting in significantly faster recovery and return to sports in patients with chronic patellar tendinopathy.
慢性髌腱病的手术治疗可以是开放性的或关节镜下的。对于最佳手术治疗选择，目前仍未达成普遍共识。
本研究旨在评估包括髌下极切除在内的微创关节镜治疗慢性髌腱病的临床疗效。
本研究纳入了 14 例平均年龄为 26 岁且对超过 6 个月的非手术治疗无效的慢性髌腱病患者。所有患者均接受了关节镜下髌腱后脂肪组织清除、髌腱异常组织清除和髌下极切除。术前和术后评估采用临床检查、磁共振成像（MRI）和 Lysholm 评分及维多利亚大学髌腱评估-髌腱（VISA-P）评分。还评估了重返运动情况和术后并发症。平均随访时间为 12.2±0.9 个月。
14 例患者均继续进行运动，但只有 12 例（85.7%）恢复到受伤前的运动水平。恢复到受伤前活动水平的中位数时间为 3.9±0.8 个月。患者的 Lysholm 评分从 51.1±3.8 平均分提高到 93.4±4.2（p=0.001），VISA-P 评分从 42.1±3.5 平均分提高到 86.7±8.4（p=0.001）。无术后并发症。
我们发现，与传统开放性手术相比，这种关节镜技术具有较低的发病率和令人满意的疗效，可显著加快慢性髌腱病患者的康复和重返运动。
