Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
1999-12-21
pubmed:abstractText
Thirty-eight athletes with unilateral patellar tendinopathy (17 with a tendinopathy of the main body of the tendon, and 21 with an insertional tendinopathy) underwent ultrasound-guided multiple percutaneous longitudinal tenotomy under local anaesthetic infiltration after failure of conservative management. Thirty-four patients were reviewed at least 24 months after the operation. Sixteen patients were rated excellent, nine good, eight fair, and five poor. Nine of the 13 patients with a fair or poor result had an insertional tendinopathy, and eight of them underwent a formal exploration of the patellar tendon. Before the operation, there were some areas of altered echogenicity at and around the site of involvement. These were still visible 6 wk after surgery in 70% of the patients. At the latest follow-up, in the patients with an excellent or good result, the tendon was generally isoechogenic but slightly thicker (P = 0.06) than the normal contralateral. In the patients with a fair or poor result, the tendon was significantly thicker than the contralateral (P = 0.03), and showed some areas of mixed echogenicity. In the patients in whom the procedure was successful, the thicker operated tendon did not interfere with physical training. Bilateral isokinetic peak torque (Nm), average work (Joules), and average power (Watts) were tested at 90 degrees x s(-1). Immediately before the operation, there was no significant difference in peak torque, but total work and average power were significantly lower in the limb to be operated (0.01 < P < 0.05). By the end of the study, although peak torque was, on average, within 7% of the unoperated limb, total work and average power were still significantly lower than in the unoperated limb (0.01 < P < 0.04). Percutaneous longitudinal internal tenotomy is simple, can be performed on an outpatient basis, requires minimal follow-up care, does not hinder further surgery should it be unsuccessful, and, in our experience, has produced no significant complications. In our hands, it has become the first line operative intervention in the treatment of chronic patellar tendinopathy after failure of conservative management. However, patients should be advised that, if they suffer from an tendinopathy at the attachment of the patellar tendon at the lower pole of the patella, a formal surgical exploration with stripping of the paratenon is preferable.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0195-9131
pubmed:author
pubmed:issnType
Print
pubmed:volume
31
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1509-15
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:10589850-Adolescent, pubmed-meshheading:10589850-Adult, pubmed-meshheading:10589850-Ambulatory Surgical Procedures, pubmed-meshheading:10589850-Anesthesia, Local, pubmed-meshheading:10589850-Athletic Injuries, pubmed-meshheading:10589850-Chronic Disease, pubmed-meshheading:10589850-Ergometry, pubmed-meshheading:10589850-Female, pubmed-meshheading:10589850-Follow-Up Studies, pubmed-meshheading:10589850-Humans, pubmed-meshheading:10589850-Isometric Contraction, pubmed-meshheading:10589850-Male, pubmed-meshheading:10589850-Middle Aged, pubmed-meshheading:10589850-Musculoskeletal Diseases, pubmed-meshheading:10589850-Patellar Ligament, pubmed-meshheading:10589850-Prospective Studies, pubmed-meshheading:10589850-Range of Motion, Articular, pubmed-meshheading:10589850-Surgical Procedures, Minimally Invasive, pubmed-meshheading:10589850-Torque, pubmed-meshheading:10589850-Treatment Outcome, pubmed-meshheading:10589850-Ultrasonography, Interventional, pubmed-meshheading:10589850-Weight-Bearing
pubmed:year
1999
pubmed:articleTitle
Ultrasound-guided percutaneous longitudinal tenotomy for the management of patellar tendinopathy.
pubmed:affiliation
Scuola di Specializzazione in Ortopedia, Istituto di Clinica Ortopedica, II Università di Napoli, Italy.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't