Diagnosis Patellar Tendon Inflammation

The determination (diagnosis) of patellar tendon inflammation is usually based on the clinical picture obtained by the attending physician through detailed questioning (anamnesis) and clinical physical examination. The medical history indicates a gradual onset of symptoms, especially pain below the kneecap (infrapatellar) with repeated, unusually high strain on the leg extensors, for example, due to a resumption or resumption of sports activities. For example, running and ball sports or athletic disciplines that involve sudden changes of direction or acceleration and deceleration as well as jumps etc.

can also cause patellar tendon inflammation, as can excessive stretching, for example in the gym or through excessive running exercises. If the medical history and physical examination still show an unclear image, the suspicion of patellar tendonitis can be confirmed by an ultrasound examination of the corresponding region (sonography) or by magnetic resonance imaging of the knee (knee MRI). Furthermore, a blood sample is taken to complete the diagnosis.

Here the focus is primarily on so-called inflammation parameters such as the number of inflammatory cells (leukocytes), but the C-reactive protein also represents an important diagnostic marker. The most probable alternative disease that can cause a similar clinical picture is the so-called patellar tendon syndrome, which, however, in contrast to patellar tendon inflammation, is a pure wear-and-tear disease that presents itself without inflammatory events and has the insertion of the patellar tendon at the patella as its main point of pain, whereas patellar tendon inflammation usually affects a larger part of the tendon. Nevertheless, patellar tendon inflammation may also develop on the floor of a patellar tip syndrome.

Patellar tendonitis is usually treated conservatively, but in individual cases, such as particularly severe courses, failure of conservative treatment or a conservatively uncontrollable chronification, it can also be treated surgically. In the rare case of a well-founded suspicion of an infectious cause of patellar tendonitis, conservative therapy is mainly based on the administration of a so-called broad-spectrum antibiotic, i.e. an antibacterial drug with a broad spectrum of action against a particularly large number of pathogens. If this antibiotic is not effective, a more targeted antibiotic therapy must be started against the pathogen to be determined first.

In the much more frequent case of a development of patellar tendon inflammation due to repeated overloading, the most important therapeutic measure is to immediately stop the stressful activities. Depending on the severity of the disease and the speed of healing, this prohibition can last from weeks to months and should be followed by a slow increase in stress. The healing process is usually accompanied by physiotherapy and supported by suitable measures such as anti-inflammatory cold applications and, if necessary, first stretching exercises and then light muscular training.

Above all, in the acute or early phase of the disease, anti-inflammatory medication is prescribed by the treating physician as standard.The main pillar of this treatment is the long-term therapy with drugs of the active substance class of the so-called non-steroidal anti-rheumatic drugs (NSAIDs) such as ibuprofen or diclofenac, which are characterized by an anti-inflammatory mode of action in addition to a pain-inhibiting effect. In severe cases, injection of an anti-inflammatory agent (cortisone/glucocorticoid) into the patellar tendon region may also be considered. In this case, special care must be taken that the tendon itself is not affected.

If the affected knee has increased mobility of the joint, or above all of the kneecap, an orthopedic bandage that gives the joint stability and guidance to the kneecap can sometimes accelerate the healing process and alleviate symptoms. In the same way, the patient can accelerate the healing process by taking care of the patella tendon and cooling it independently, but not excessively. In an emergency, if conservative therapeutic measures have failed or other factors speak against conservative treatment, surgical therapy must be considered.

This involves the removal of severely inflamed tendon tissue by arthroscopy. Kinesiotapes can help to heal an inflammation of the patellar tendon by promoting blood circulation and supporting the muscles. In addition, tapes also lead to pain relief in the tendon.

The tapes are stuck to the skin and lead to elastic tension in the muscles. They are breathable and can be worn for several days, even during sports. They promote both healing and can prevent recurrence.

Surgery for patellar tendon inflammation is considered a last resort if all conservative measures have not led to healing. There are two procedures, firstly knee endoscopy (arthroscopy) and secondly open surgery. In both procedures, the affected parts are removed and the knee joint is rinsed.

In addition, calcium deposits that may have led to the inflammation can be removed and any tendon tears sutured. However, a short resting phase is also required after surgery until the knee is fully resilient again. In addition, an operation carries its own risks.

The patella tendon is a very strained tendon. The expected healing time depends on various factors, including age and fitness level. Before starting the full strain, the inflammation of the patella tendon should be completely cured to prevent chronic inflammation.

In the case of acute inflammation, the leg should first be spared and cooled as much as possible, i.e. lie up and put little weight on the knee. Anti-inflammatory and analgesic medication can also help. If the tendon no longer hurts so much, you can start with small loads.

Knee bandages can be worn for 3 to 6 weeks as a support. These promote blood circulation and thus lead to faster healing. Crutches can also help.

By means of light exercises, if necessary with the help of physiotherapy, the recovery can be accelerated. On the whole, however, it can take up to 6 months until complete healing. Physiotherapy can help to speed up the healing process and prevent muscle loss during the sports break.

The training exercises are mainly aimed at strengthening the thigh muscle. Examples of such exercises are knee bends and wall sitting. The physiotherapeutic method of transverse friction can, for example, help to relieve pain in the knee joint.

The muscle groups are treated with massage. However, adequate stretching of the muscles and ligaments of the upper and lower leg also helps to prevent patellar tendon inflammation. Through training exercises you can also learn to perceive your own body better. Thus, incorrect and overloading can be reduced.