Sclerosing polidocanol injections or arthroscopic shaving to treat patellar tendinopathy/jumper's knee? A randomised controlled study

Abstract

Background Proximal patellar tendinopathy/jumper's knee (PT/JK) is well known to be diffi cult to treat. Recent studies using an ultrasound and colour Dopplerbased treatment approach on the dorsal side of the tendon, sclerosing polidocanol injections and ultrasoundguided arthroscopic shaving, have shown promising clinical results. Objectives To compare the clinical effects after treatment with sclerosing polidocanol injections and arthroscopic shaving. Material and methods 52 patellar tendons (43 men and two women) with ultrasound and colour Dopplerverified diagnosis of PT/JK were randomly assigned to treatment with ultrasound and colour Doppler-guided sclerosing polidocanol injections (group A) or ultrasound and colour Doppler-guided arthroscopic shaving (group B). All patients were involved in patellar tendon loading sports or recreational activities, and had had a long duration of pain symptoms from the proximal patellar tendon. Pain during patellar tendon loading activity, and at rest, before and after treatment (visual analogue scale; VAS), and patient satisfaction with the result of the treatment, was registered. Results After treatment, the patients treated with arthroscopic shaving had a signifi cantly lower VAS score at rest and during activity, and were signifi cantly more satisfied compared with the patients in the sclerosing injection group. Conclusions Both treatment with ultrasound and colour Doppler-guided sclerosing polidocanol injections and arthroscopic shaving showed good clinical results, but patients treated with arthroscopic shaving had less pain and were more satisfied with the treatment result. Because surgical treatment is a one-stage treatment return to sports was faster in this group.