Surgery for Jumper’s Knee: Exploring Treatment Options

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Jumper’s knee, also known as patellar tendinopathy, is a prevalent injury among athletes engaged in sports requiring frequent jumping, landing, and explosive movements. It results in pain and inflammation at the connection point of the patellar tendon to the shinbone below the kneecap, despite not being a true “knee” injury.

Understanding Jumper’s Knee

Jumper’s knee is an overuse injury, characterized by small tears and inflammation in the patellar tendon due to repeated stress and overload. Athletes in jumping sports such as basketball, volleyball, or track and field are particularly susceptible. Risk factors include tight quadriceps muscles, muscle imbalances, intense training schedules, hard playing surfaces, and improper landing mechanics.

The patellar tendon moves every time the knee bends or straightens. Over time, overuse of the knee can cause tiny tears to form within the patellar tendon, which causes jumper’s knee. For example, a basketball player who jumps up and down on a parquet floor every day may experience mini-traumas to the patellar tendon that eventually cause painful knee symptoms.

Typically, jumper’s knee is caused by one or both of these factors:

  • Repeated overuse of the patellar tendon through athletic activity.
  • Not allowing enough time for the patellar tendon to recover between workouts.

Continuing to exert the patellar tendon after experiencing the initial signs of jumper’s knee (mild inflammation and swelling) can cause the acute injury to become a chronic condition. With this in mind, athletes who find that the initial symptoms of jumper’s knee are not easing with a few days rest should seek out medical evaluation to determine the best ways to prevent further injury.

Conservative Treatment Approaches

Most cases of jumper’s knee are initially treated without surgery, utilizing conservative methods like rest, physical therapy, patellar tendon strapping, anti-inflammatory medication, platelet-rich plasma or stem cell injections, and extracorporeal shockwave therapy. Eccentric strengthening exercises for quadriceps muscles are especially beneficial, promoting tendon remodeling over 3-6 months.

Common first-response treatments for jumper’s knee may include:

  • Pain medications. In the event that an athlete is experiencing pain symptoms associated with jumper’s knee, taking nonsteroidal anti-inflammatory medications (NSAIDs) may help to alleviate discomfort. Common NSAIDs include ibuprofen (Advil or Motrin) or naproxen (Aleve).
  • R.I.C.E. The R.I.C.E. method (rest, ice, compression, and elevation) may be used to reduce the pain and swelling surrounding the injured area.

While these treatments are commonly applied after an initial injury, they may also be practiced following a diagnosis to help mitigate symptoms and pain throughout the healing process.

In addition to pausing athletic activity until the symptoms of jumper’s knee begin to fade, an athlete may need to undergo other treatments to ensure the health of his or her patellar tendon. Following a medical evaluation, a doctor will be able to recommend a course of treatment. Common treatments for jumper’s knee include:

  • Exercise training. A physician or physical therapist may recommend exercise training and bracing to strengthen the patellar tendon and reduce the symptoms of jumper’s knee. This process commonly involves having an athlete engage in a series of knee strengthening exercises.
  • Bracing. A physician may recommend stabilizing the patella with either a brace or athletic tape to keep it in place during exercise training.
  • Injection therapies. In more advanced cases of patellar tendinopathy, it is common for physicians to recommend injection therapies. In these treatments, an athlete is given an injection (typically of either polidocanol or corticosteroids) to reduce inflammation and accelerate the healing of the patellar tendon.
  • Platelet-rich plasma therapy. This practice, also known as PRP, involves injecting the site of the injury with the patient’s own platelet-rich plasma in an effort to accelerate healing.
  • Dry needling. In dry needling, a needle without a syringe is inserted into the affected area and moved, with the guidance of an arthroscopic camera, in an effort to break up or destroy degenerative structures within the knee that may be contributing to injury.
  • Hyperthermia thermotherapy. This process involves using both a heating source and a cooling source to raise the temperature of internally damaged tissues (in this case the patellar tendon) while allowing the surface level tissues to stay cool.
  • Extracorporeal shockwave treatment. This procedure, also known as ECSW, involves sending electric impulses into the muscle tissue surrounding the patella to deliver force to damaged tissues. The force from the electric waves can help to do away with damaged or torn soft tissues.

A physician will likely try several non-surgical treatments for runner’s knee before pursuing a surgical option.

When is Surgery Considered?

If symptoms persist after six months of conservative treatment, surgery may be considered. Two main surgical procedures for jumper’s knee are open tenotomy/debridement and arthroscopic shaving/debridement. Recovery involves crutches for 1-2 weeks, sport-specific rehab after 2 months, and a return to full sports in 4-6 months. Complications are rare, and close follow-up care with a physical therapist optimizes recovery.

Up to 20% of patients may experience ongoing symptoms post-surgery, necessitating further procedures if debridement proves insufficient. It’s crucial to address underlying causes like overtraining during rehab to prevent recurrent injuries.

Surgery vs Other Treatments

Comparisons between surgery and alternative treatments like physical therapy indicate that open surgery provides little added benefit over eccentric exercises alone. Arthroscopic shaving may offer better pain reduction compared to sclerosing injections after one year. However, outcomes vary among individuals, and experts generally recommend exhausting conservative therapy options before considering surgery.

Connect with Dr. Herrick J. Siegel at Siegel Orthopaedics

For expert guidance on surgery for Jumper’s Knee and personalized treatment options, contact Dr. Herrick J. Siegel at Siegel Orthopaedics. Serving patients in Birmingham, Alabama, and surrounding areas, Dr. Siegel is dedicated to providing comprehensive orthopedic care, helping you regain mobility and achieve optimal recovery. Take the first step toward a healthier, active lifestyle by reaching out to Dr. Herrick J. Siegel today.