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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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I just moved from college sports to the professional world of basketball. Now I'm sidelined because of a chronic knee tendinopathy. I'm searching the web for any kind of treatment that might speed up my recovery. What do you know that might help me?

You might find the results of a recent European study of interest. They reported that recreational and professional athletes who continue to suffer pain and loss of knee function from patellar tendinopathy can benefit from surgery. Significant pain relief and return to full sports participation is possible. Sixty-four patients with patellar tendinopathy who did not get relief from their symptoms with conservative (nonoperative) care were included in the study. Alignment or overuse problems of the knee structures is a common problem among athletes. Strain, irritation, and/or injury of the patellar tendon often produce pain, weakness, and swelling of the knee joint. Nonoperative care is the first-line of treatment for this problem. The best approach (one that works for everyone every time) remains uncertain. Instead, the patient tries activity modification, rest, antiinflammatory medications, exercises, cold therapy, steroid injections, deep friction massage, or some combination of these approaches. When conservative care fails to improve things, the athlete may be directed to a surgical solution. Unfortunately, the best way to treat this problem surgically remains as much a mystery as the best nonoperative approach. The first decision regarding surgical treatment is whether the procedure should be done arthroscopically or with an open incision. That's where this study comes in. The 64 athletes were treated arthroscopically by one surgeon. One-third of the group was involved in professional sports (soccer, basketball, and volleyball). Those athletes involved in recreational sports were also engaged in jogging and tennis. The technique used was debridement (shaving away) of abnormal tissue and removal of the lower pole (portion) of the patella. In particular, the surgeon removed an area of fat called the Hoffa fat pad. This layer of adipose (fat) tissue is located behind the patellar tendon. That's the area where there is the most loss of blood flow. Shaving this tissue away helps stimulate a more natural healing process. Despite concerns that arthroscopic surgery for patellar tendinopathy might not be the ideal choice, the majority of these patients had excellent mid-term and long-term results. Before and after testing showed significant improvements that lasted at least three years. Some of the patients were followed for up to 10 years with the same continued good results. Best of all, half of the professional players were able to return to full sports play within three months of the surgery and there were no complications for anyone enrolled in the study. You may not be a good candidate for this type of treatment. Ask your sports physician or team surgeon for an evaluation of your situation and the best recommendation for you.


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