Inflammation of the patellar tendon

Inflammation of the patellar tendon (also known as patellar tip syndrome) refers to the degeneration and inflammation of the tendon beneath the kneecap .

This tendonitis often affects athletes who repeatedly jump, which is why the inflammation of the patellar tendon is also called “jumper’s knee” or “jumper’s knee”. Kneecap tendinitis is typical of sports such as basketball, volleyball, soccer and athletics

Tendinosis of the patellar tendon is a chronic condition. In contrast to acute tendinitis, tendinosis occurs gradually; it is characterized by micro-injuries and thickening of the tendon. Tendinosis produces similar symptoms to patellar tendinitis but requires different treatment.

The partial patellar tendon lesions seen on magnetic resonance imaging are usually typical of chronic tendinosis of the patellar tendon. Complete lesions can also occur, signifying a rupture of the patellar tendon. In this case, the entire tendon has completely detached and needs to be repaired through surgery.


 Anatomy of the patellar tendon

The patellar tendon connects the kneecap to the tibia. The patella-quadriceps tendon-patella tendon-quadriceps complex provides the mechanism for extending the knee and providing the necessary power to perform a soccer action (shooting the ball). The patellar tendon, like other tendons, consists of hard, strip-shaped bundles. These strips are surrounded by a lining of vascular tissue that supplies nutrients to the tendon.

What are the causes of hamstring inflammation?

The most common causes include:

  • Footwear
  • Wrong technique in sports,
  • Anatomical defects (knock knees, bowlegs or dysmetria of the lower extremities),
  • Excessive training load,
  • Too hard walking surface (e.G. Asphalt),
  • Muscular imbalance.

Finding the right footwear is important ; there is a wide range of shoes for every type of foot and specific to the sport; an amateur runner, for example, has to wear heavier shoes than a professional.

In patients suffering from patellar tendon syndrome, the movements generate microtrauma with hypoxia , rise in temperature, etc.
It occurs much more frequently after the age of 30-40, because aging leads to a change in the fibers and a Injury is therefore more easily possible.
Cycling can cause tendinitis in the knee, but it usually affects the tendon of the quadriceps muscle, which is above the kneecap. The culprit is usually a saddle that is too low.

Stages of tendonitis

In the   first stage , the discomfort appears after physical activity, but the patient is able to stop exercising; there are no anatomical-pathological changes, the tendon can be described as normal; there is only alteration of the synovial fluid , which is a reversible condition .

In the second stage , pain occurs at the beginning of exercise, the tendon is swollen and there are cellular infiltrate with inflammation. This condition is reversible when the inflammatory component is removed. From a clinical point of view, the first case is more disadvantageous because no importance is attached to pain and it is attributed to fatigue.

The third stage is permanent and irreversible , a consolidated inflammatory process has established itself in the tendon and the tendon begins to tear . The tendon will never regain its typical elasticity , and it is very likely that it will become chronic . This type of tendinopathy is called tendinosis, it is recurrent and usually becomes chronic.
There is an advanced third stage, in which the pain becomes so severe that continuing to exercise is unthinkable; the tendon is stiff, more sensitive and prone to injury. Cyclists often suffer from tendonitis of the quadriceps tendon, which is the tendon above the kneecap; in this case, the bicycle saddle must be placed higher, as this is usually the cause.

How does the inflammation of the patellar tendon become noticeable? signs and symptoms

The first symptom of jumper’s knee is pain ; they usually occur at the level of the patellar tendon, between the kneecap and the tibia. Initially, the pain can become noticeable at the beginning of sporting activity or immediately after a strenuous workout. Later, the symptoms can affect athletic performance. In an advanced stage of inflammation, it is possible that even everyday movements such as climbing stairs and getting up from a chair cause problems. A swollen tendon and limitation of knee movement are rare.

Diagnosis of knee tendonitis

Usually, the doctor can diagnose tendinitis with a thorough examination; if there is any doubt, an ultrasound scan may be ordered to confirm.
X-rays may be done to rule out broken bones; they can also be useful for children suffering from anterior knee pain due to Osgood-Schlatter disease ( osteochondritis ).

Calcium deposits can form, especially in patients with chronic patellar tendinosis. Magnetic resonance imaging
can be helpful in looking for signs of inflammation or partial lesions within the tendon. In the differential diagnosis, the doctor must rule out bursitis in the knee.

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