| 词条 | Patellar tendinitis |
| 释义 |
Not to be confused with Runner's knee which often affects runners; or Sinding-Larsen and Johansson syndrome and Osgood-Schlatter disease.{{Infobox medical condition (new) | name = Patellar tendinitis | synonyms = Patellar tendinopathy, jumper's knee, patellar tendinosis, patellar tendinitis | image = Patellar Tendonitis.jpg | caption = | pronounce = | field = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} Patellar tendinitis, also known as jumper's knee, is a common cause of knee pain among athletes. It is a repetitive strain injury to the tendon connecting the patella, or kneecap, with the shinbone.[1] Jumper's knee commonly occurs in athletes who are involved in jumping sports such as basketball and volleyball, but can affect any athlete. Signs and symptomsPatients report anterior knee pain, often with an aching quality. The symptom onset is insidious. Rarely is a discrete injury described. Usually, the problem is below the kneecap but it may also be above. Depending on the duration of symptoms, jumper's knee can be classified into 1 of 4 stages, as follows: Stage 1 – Pain only after activity, without functional impairmentStage 2 – Pain during and after activity, although the patient is still able to perform satisfactorily in his or her sportStage 3 – Prolonged pain during and after activity, with increasing difficulty in performing at a satisfactory levelStage 4 – Complete tendon tear requiring surgical repairIt begins as inflammation in the patellar tendon where it attaches to the patella and may progress by tearing or degenerating the tendon. Patients present with an ache over the patella tendon. Most patients are between 10 and 16 years old. Magnetic resonance imaging can reveal edema (increased T2 signal intensity) in the proximal aspect of the patellar tendon. CausesIt is an overuse injury from repetitive overloading of the extensor mechanism of the knee. The microtears exceed the body's healing mechanism unless the activity is stopped. Among the risk factors for patellar tendonitis are low ankle dorsiflexion, weak gluteal muscles, and muscle tightness, particularly in the calves, quadriceps muscle, and hamstrings.[2] Studies have shown it may be associated with stiff ankle movement and ankle sprains.[3][4] DiagnosisA physiotherapist performs a physical examination. If the symptoms are severe, further tests may be done, such as magnetic resonance imaging, or ultrasound. TreatmentEarly stages may be treated conservatively using the R.I.C.E method: Rest, Ice, Compression, and Elevation. Exercises involving eccentric muscle contractions of the quadriceps on a decline board are strongly supported by extant literature.[5][6][7][8] A physical therapist may also recommend specific exercises and stretches to strengthen the muscles and tendons, eg. cycling or swimming. Use of a strap for jumper's knee and suspension inlays for shoes may also reduce the problems. Should this fail, autologous blood injection, or platelet-rich plasma injection may be performed and is typically successful though not as successful as high volume saline injection (Crisp et al.).{{citation needed|reason=Crisp et al. not cited|date=July 2015}} Uncommonly it may require surgery to remove myxoid degeneration in the tendon. This is reserved for patients with debilitating pain for 6–12 months despite conservative measures. Novel treatment modalities targeting the abnormal blood vessel growth which occurs in the condition are currently being investigated.{{fact|date=August 2018}} New research shows that knee operations in most cases have no better effects than exercise programs, and that most knee operations thus can be avoided.{{fact|date=August 2018}} See also
References1. ^{{cite web |title=Patellar tendinitis |url=https://www.mayoclinic.org/diseases-conditions/patellar-tendinitis/symptoms-causes/syc-20376113 |website=Mayo Clinic |accessdate=14 December 2018}} 2. ^{{cite book|last=Koban|first=Martin | name-list-format = vanc |title=Beating Patellar Tendonitis|year=2013|isbn=978-1491049730|pages=20–25}} 3. ^{{cite web | first = Adam | last = Marcus | name-list-format = vanc | title = Stiff ankles tied to young athletes' painful knees| url = https://www.reuters.com/article/us-stiff-ankles/stiff-ankles-tied-to-young-athletes-painful-knees-idUSTRE7964V620111007 | work = Reuters | date = 7 October 2011 }} 4. ^{{cite journal | vauthors = Backman LJ, Danielson P | title = Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study | journal = The American Journal of Sports Medicine | volume = 39 | issue = 12 | pages = 2626–33 | date = December 2011 | pmid = 21917610 | doi = 10.1177/0363546511420552 }} 5. ^{{cite journal | vauthors = Cannell LJ, Taunton JE, Clement DB, Smith C, Khan KM | title = A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper's knee in athletes: pilot study | journal = British Journal of Sports Medicine | volume = 35 | issue = 1 | pages = 60–4 | date = February 2001 | pmid = 11157465 | doi = 10.1136/bjsm.35.1.60 }} 6. ^{{cite journal | vauthors = Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM | title = A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy | journal = British Journal of Sports Medicine | volume = 38 | issue = 4 | pages = 395–7 | date = August 2004 | pmid = 15273169 | pmc = 1724885 | doi = 10.1136/bjsm.2003.000053 }} 7. ^{{cite journal | vauthors = Kongsgaard M, Aagaard P, Roikjaer S, Olsen D, Jensen M, Langberg H, Magnusson SP | title = Decline eccentric squats increases patellar tendon loading compared to standard eccentric squats | journal = Clinical Biomechanics | volume = 21 | issue = 7 | pages = 748–54 | date = August 2006 | pmid = 16675081 | doi = 10.1016/j.clinbiomech.2006.03.004 }} 8. ^{{cite journal | vauthors = Visnes H, Bahr R | title = The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes | journal = British Journal of Sports Medicine | volume = 41 | issue = 4 | pages = 217–23 | date = April 2007 | pmid = 17261559 | pmc = 2658948 | doi = 10.1136/bjsm.2006.032417 }} Further reading{{refbegin}}
External links{{Medical resources| DiseasesDB = 9704 | ICD10 = {{ICD10|M|76|5|m|70}} | ICD9 = {{ICD9|726.64}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = sports | eMedicineTopic = 56 | MeshID = }}
3 : Overuse injuries|Soft tissue disorders|Patella |
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