Advertisement

Ultrasound and Doppler-Guided Arthroscopic Shaving for the Treatment of Patellar Tendinopathy/Jumper’s Knee: Biological Background and Description of Method

  • Håkan Alfredson
  • Lotta Willberg
  • Lars Öhberg
  • Sture Forsgren
Chapter

Abstract

Treatment of chronic painful patellar tendinopathy/Jumper’s knee is known to be difficult, and surgical treatment has been shown to give unreliable and, not seldom, poor clinical results.

Keywords

Patellar Tendon Achilles Tendon High Blood Flow Color Doppler Color Doppler Examination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1.  1.
    Alfredson H, Öhberg L, Forsgren S. Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis?-An investigation using ultrasonography and colour doppler, immunohistochemistry, and diagnostic injections. Knee Surg Sports Traumatol Arthrosc. 2003;11:334-338.PubMedCrossRefGoogle Scholar
  2.  2.
    Alfredson H, Öhberg L. Neovascularisation in chronic painful patellar tendinosis promising results after sclerosing neovessels outside the tendon challenges the need for surgery. Knee Surg Sports Traumatol Arthrosc. 2005;13:74-80.PubMedCrossRefGoogle Scholar
  3.  3.
    Alfredson H, Öhberg L. Sclerosing injections to areas of neovascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2005;13:338-344.PubMedCrossRefGoogle Scholar
  4.  4.
    Alfredson H, Öhberg L, Zeisig E, et al. Treatment of midportion Achilles tendinosis: similar clinical results with US and CD-guided surgery outside the tendon and sclerosing polidocanol injections. Knee Surg Sports Traumatol Arthrosc. 2007;15:1504-1509.PubMedCrossRefGoogle Scholar
  5.  5.
    Andersson G, Danielson P, Alfredson H, et al. Nerve-related characteristics of ventral paratendinous tissue in chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc. 2007;15:1272-1279.PubMedCrossRefGoogle Scholar
  6.  6.
    Coleman BD, Khan KM, Maffulli N, et al. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Scand J Med Sci Sports. 2000;10:2-11.PubMedCrossRefGoogle Scholar
  7.  7.
    Coleman BD, Khan KM, Kiss ZS, et al. Open and arthroscopic patellar tenotomy for chronic patellar tendinopathy. A retrospective outcome study. Am J Sports Med. 2000;28:183-190.PubMedGoogle Scholar
  8.  8.
    Cook JL. What’s the appropriate treatment for patellar tendinopathy? Br J Sports Med. 2001;35:291-294.PubMedCrossRefGoogle Scholar
  9.  9.
    Danielson P, Andersson G, Alfredson H, et al. Marked sympathetic component in the perivascular innervation of the dorsal paratendinous tissue of the patellar tendon in arthroscopically treated tendinosis patients. Knee Surg Sports Traumatol Arthrosc. 2008;16:621-626.PubMedCrossRefGoogle Scholar
  10. 10.
    Forsgren S, Danielsson P, Alfredson H. Vascular NK-1R receptor occurrence in normal and chronic painful Achilles and patellar tendons. Studies on chemically unfixed as well as fixed specimens. Regul Pept. 2005;126:173-181.PubMedCrossRefGoogle Scholar
  11. 11.
    Khan KM, Cook JL, Maffuli N, et al. Where is the pain coming from in tendinopathy? It may be biochemical, not only structural, in origin. Br J Sports Med. 2000;34:81-83.PubMedCrossRefGoogle Scholar
  12. 12.
    Lind B, Öhberg L, Alfredson H. Sclerosing polidocanol injections in mid-portion Achilles tendinosis: remaining good clinical results and decreased tendon thickness at 2-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2006;14:1327-1332.PubMedCrossRefGoogle Scholar
  13. 13.
    Öhberg L, Lorentzon R, Alfredson H. Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc. 2001;9:233-238.PubMedCrossRefGoogle Scholar
  14. 14.
    Öhberg L, Alfredson H. Ultrasound guided sclerosis of neovessels in painful chronic Achilles tendinosis: pilot study of a new treatment. Br J Sports Med. 2002;36:173-177.PubMedCrossRefGoogle Scholar
  15. 15.
    Terslev L. Ultrasound and Power Doppler findings in Jumper’s knee-preliminary observations. Eur J Ultrasound. 2001;13:183-189.PubMedCrossRefGoogle Scholar
  16. 16.
    Weinberg EP, Adams MJ, Hollenberg GM. Color doppler sonography of patellar tendinosis. Am J Roentgenol. 1998;171:743-744.Google Scholar
  17. 17.
    Willberg L, Sunding K, Öhberg L, et al. Treatment of Jumper’s knee: promising short-term results in a pilot study using a new arthroscopic approach based on imaging findings. Knee Surg Sports Traumatol Arthrosc. 2007;15:676-681.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  • Håkan Alfredson
    • 1
  • Lotta Willberg
  • Lars Öhberg
  • Sture Forsgren
  1. 1.Sports Medicine Unit, Department of Surgical and Perioperative SciencesUmeå UniversityUmeåSweden

Personalised recommendations