Jumper's knee and ultrasonography

Abstract

Twenty-five patients, aged between 15 and 45 years old, who were athletically active, presented with jump er's knee (patellar tendinitis). By use of ultrasono graphic examination, new and precise information was obtained that benefited the diagnosis, choice of treat ment, and monitoring of the evolution of jumper's knee in our patients. In 18 of the 25 patients, only 1 knee was affected; in 7 of the patients, both knees were affected, thus making a total of 32 painful tendons. These 25 patients were compared with a control group of 15 healthy, athletically active subjects between the ages of 25 and 35 years old. In all of the 32 painful tendons, ultrasonographic anomalies were observed: thickening or swelling of the tendon (15 knees) appeared in acute cases; a hetero geneous structure of the tendon (24 knees); and thick ening and irregularities of the tendinous envelope (8 knees). The 15 acute patients all responded to classic con servative treatment including physical therapy and elec trotherapy. Four of the remaining 10 patients were treated successfully with various conservative treat ments, including deep transverse friction massage with ice. The other six patients were treated surgically, with tenolysis and "carding" of the patellar tendon. In one patient, this procedure failed, and 12 months later a second operation was performed, in which the distal pole of the patella was resected and the patellar tendon reinserted into bone. Recovery was uneventful. Now, at least 2 years after treatment, all of the patients consider themselves healed.