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Ligamentum patellae

Injury or disease

The tendinous synovitis on the peak of the kneecap (ligamentum patellae) is also called “jumper’s knee”.

The sinews in a small area on the upper end of the ligamentum patellae are hurt or inflamed in this injury.

The entire power of the quadriceps is concentrated in this area.

Some single tendon fibers that have died or have been torn are often surrounded by inflammatory changed tissue.

Cause

The most common cause is frequent tiny tendon fissures that chronically overtax the tendon in connection with sports that include a lot of jumping, excessive stretching of the joint in “kicking-movements” (football) as well as extensive jogging.

Symptoms

Pain in the lower tip of the kneecap that becomes worse during sporting activities is a typical symptom.

Local swelling and over sensitivity in that area are common in more severe cases.

Weakness of the quadriceps is also often reported.

Examination
Apart from the standard x-ray screening, which is used in order to rule out local calcifications, an MRI shows necrosis of tendon fibers.

Treatment

In minor cases, conservative treatment with anti-inflammatory and pain relieving medication as well as ice is recommended.

Special knee bandages with silicon inlays can alleviate the discomfort.

Sporting activities should be reduced in order to facilitate the tendon’s regeneration.

Cortisone injections into the tendon should be avoided. It weakens the tendon tissue and often leads to more damage or even tendon fissures.

In stubborn cases, surgical treatment becomes necessary.
In the process the dead parts of the tendon are removed endoscopically. At the same time the inflammatory changed tissue surrounding the tendon is ablated or removed.

After treatment

Kneeling on solid ground should be avoided.
Reduce exercise to a level that allows sporting activities without any pain during rehabilitation. If an arthroscopy should be necessary, the leg should be put up frequently after surgery and activities should slowly be increased in the postoperative phase.

You don’t need crutches after surgery.

Restitution

Recovery under conservative therapy progresses very slowly and can take up to 6 months.

Also in surgical treatment the recuperation can take a couple of weeks. Complete recovery is possible in the majority of cases.

Intended effects of the treatment

The aim of the treatment is a complete and painless extension of the knee joint.

The surgery aims to entirely remove the scar tissue, which facilitates normal functioning of the knee and a complete recovery without exception.

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