Importantly, there is a disconnection between pathology on imaging and pain; it is common to have abnormal tendons on imaging in people with pain-free function.1 The
term tendinopathy will be used in this review to mean painful tendons. The term tendon pathology will be used to indicate abnormal imaging or histopathology without reference to pain. Treatment of patellar tendinopathy may involve prolonged rehabilitation and can ultimately be ineffective. Management is limited by a poor understanding of how see more this condition develops, limited knowledge of risk factors and a paucity of time-efficient, effective treatments. Many treatment protocols are derived from evidence about other tendinopathies in the body and applied to the patellar tendon; however, the differences in tendons at a structural and clinical level may invalidate this transfer between tendons. This review discusses the prevalence C59 cost of patellar tendinopathy, associated and risk factors, assessment techniques and treatment approaches that are based on evidence where possible, supplemented by expert opinion. Patellar tendinopathy is an overuse injury that typically has a gradual onset of pain. Athletes with mild to moderate symptoms frequently continue to
train and compete. Determining the prevalence of overuse injuries such as patellar tendinopathy is difficult because overuse injuries are often not recorded when injuries are
defined exclusively by time-loss from competitions and training.2 The time-loss model only records acute injuries and the most severe overuse injuries, making it difficult to gather an accurate estimate of the prevalence of patellar tendinopathy in the athletic population. Studies that have specifically examined the prevalence of patellar tendinopathy showed that the type of sport performed affected the prevalence of tendinopathy.3 The highest prevalence in recreational athletes aminophylline was in volleyball players (14.4%) and the lowest was in soccer players (2.5%);3 the prevalence was substantially higher in elite athletes. Tendon pathology on imaging in asymptomatic elite athletes was reported in 22% of athletes, male athletes had twice the prevalence as female athletes, and basketball players had the highest prevalence of pathology (36%) amongst the sports investigated: basketball, netball, cricket and Australian football.4 It is not only a condition that affects adults; the prevalence of patellar tendinopathy in young basketball players was reported as 7%, but 26% had tendon pathology on imaging without symptoms.4 Patellar tendon rupture, however, is rare. The most extensive analysis of tendon rupture reported that only 6% of tendon ruptures across the body occurred in the patellar tendon.