Ultrasound and Doppler-Guided Surgery for the Treatment of Jumper’s Knee in Professional Rugby Players

Abstract

Background: Jumper’s knee is relatively common among rugby players, and treatment of this condition is known to be difficult. Intra-tendinous revision surgery has shown poor results. New research on innervation patterns, and a new US+DP-guided treatment method targeting the regions with vessels and nerves outside the tendon has shown promising results in patients with Jumper’s knee. Material: This study includes 12 patellar tendons from 9 professional rugby players (mean age 26 years) with a long duration (range 12 - 72 months) of pain from the proximal patellar tendon. For 3 tendons there was previously intra-tendinous revision surgery with a poor result. Method: Treatment with Ultrasound (US) and Doppler (DP)-guided arthroscopic shaving + open scraping, followed by immediate weight bearing and gradually increased loading up to full loading after 6 - 8 weeks, was performed. Results: For 9 tendons there was a good clinical result, and all returned to full professional rugby within 4 - 6 months. The mean VISA score increased from 49 to 78 (p < 0.05). Follow-ups (range 10 - 30 months) show remaining good results. For 3 tendons, all have had previous intra-tendinous revision surgery, the clinical results were poor and they couldn’t return to rugby. Conclusions: The short-term results in this relatively small material indicate that US+DP-guided arthroscopic shaving + open scraping is a good treatment method for professional rugby players with chronic painful Jumper’s knee.