TOTBİD Dergisi

TOTBİD Dergisi

2012, Cilt 11, Sayı, 4     (Sayfalar: 396-401)

Patellofemoral joint-tendon problems

Rahmi Can Akgün 1

1 Başkent Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Ankara

DOI: 10.5606/totbid.dergisi.2012.57
Görüntüleme: 286
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İndirme : 645

Patellar tendinitis is one of the most frequently seen reasons for patellofemoral pain. It is established that the basic pathophysiology of patellar tendinitis is insertional tendinopathy secondary to excessive and prolonged burden. The most evident sign during the physical examination is palpable sensitivity on the surface of inferior patella. Due to limited surgical treatment modalities and indefinite outcomes of the interventions, non-surgical treatment options are mainly recommended. Physical therapy and rehabilitation techniques account for the majority of these non-surgical treatment options. The aim of surgical treatment is debridement of the granulation tissue in the joint-tendon junction. With this method, the lower part of the patella is drilled and multiple incisions in the tendon are made to induce innervations. Resection of the lower patellar pole is another surgical treatment modality. Quadriceps tendinitis is a type of tendinitis involving proximal patellar surface insertion of quadriceps tendon. It has been found that quadriceps tendon has 20% more collagen than patellar tendon in equal thickness and therefore the view indicating that quadriceps tendon is stronger than patellar tendon has been adopted. Patients usually present with painful proximal patellar surface. Both diseases share the same diagnosis criteria and treatment options. Patellar and quadriceps tendon ruptures are commonly seen in athletes, mostly caused by underlying chronic inflammatory alterations and sudden forceful movements of the extensor mechanism. Painful knee, palpable sensitivity in the upper and lower pole of the patella and catching during flexion are usually interpreted in favor of rupture. The definitive diagnosis is based on the magnetic resonance imaging findings. For partial and asymptomatic ruptures, mobilization and rehabilitation exercises under supervision are recommended. Surgery is the only curative treatment modality for symptomatic and total ruptures. Currently, primary repair with suture anchors are widely accepted.

Anahtar Kelimeler : Patella; quadriceps; rupture; tendinitis