In a new study by Roald Bahr (Oslo Sports Trauma Research Center) and co-workers, no advantage was demonstrated for surgical treatment compared with eccentric strength training. The authors therefore conclude that eccentric training should be tried for twelve weeks before open tenotomy is considered for the treatment of patellar tendinopathy.
In this study, thirty-five patients with grade-IIIB patellar tendinopathy were randomized to surgical treatment (twenty knees) or eccentric strength training (twenty knees). The eccentric training group performed squats on a 25° decline board as a home exercise program (with three sets of fifteen repetitions being performed twice daily) for a twelve-week intervention period. In the surgical treatment group, the abnormal tissue was removed by means of a wedge-shaped full-thickness excision, followed by a structured rehabilitation program with gradual progression to eccentric training. The patients were evaluated, using a custom made symptom-based questionnaire, after three, six, and twelve months of follow-up. No differences were found after 12 months of follow-up, but both groups had significant improvements (From 30 to 70 on a scale from 0-100). It was concluded that eccentric training should be tried for twelve weeks before open tenotomy is considered for the treatment of patellar tendinopathy.
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