Evidence-Based Management of Patellar Tendinopathy in Athletes: A Narrative Review

To synthesize the available literature for evidence-based management of patellar tendinopathy (PT) among athletes and to provide a conceptual framework to help guide clinical decision-making when managing in-season and off-season athletes with PT. Physical therapy remains the first line treatment for PT. Several studies have reported no improvement or inferior outcomes in patients treated with corticosteroid injection. Preliminary studies show promising outcomes for athletes treated with tendon scraping and percutaneous ultrasonic tenotomy. Recent studies report high rates of return to sport with arthroscopic and open surgical treatments in refractory cases. Despite PT being a common condition affecting athletes, the optimal management remains undetermined. The location and severity of patellar tendon pathology, individual characteristics of the affected athlete, timeline of the athletic season, recovery time post-intervention, treatment efficacy, associated cost, and potential treatment side effects should be considered when determining management. Multiple effective and safe non-operative treatment options are available to manage this condition with surgery available for refractory cases. The treatment framework described here is based on a comprehensive review of the available evidence.