Table 1.
Summary of Injection Treatment Studies for Patellar Tendinopathy
| Authors | Type of Study | Treatment (by group) | Number of Subjects (total/study group) | Results | Authors’ Conclusion | Grade of Recommendation |
|---|---|---|---|---|---|---|
| Fredberg et al23 | RCT | 1. 10 mg/mL lidocaine and 20 mg triamcinolone 2. Placebo: 3.5 mL lidocaine and 0.5 mg 20% intralipid |
24/12 | Treatment groups improved, especially in the short term; 58% of patients were operated on at 2 years | Steroid injections can normalize US pathologic lesions and have dramatic clinical effects but with aggressive rehabilitation; many relapse within 6 months | A |
| Kongsgaard et al42 | RCT | 1. 1 mL of 40 mg/mL methylpredinose in 0.5 mL lidocaine 2. Eccentric training 3. Heavy slow resistance training |
37 (12/12/13) | At 12 weeks, all groups improved significantly, but at 6 months, group 1 declined but groups 2 and 3 were unchanged | Good short-term results with steroids but poor long-term clinical effects; good short- and long-term effects with eccentric training and slow resistance training | A |
| Capasso et al13 | RCT | 1. 62,500 units aprotinin and 2.5 mL lidocaine 2. 50 mg methylpredinisolone acetate and 2.5 mL lidocaine 3. 5 mL 0.9% NaCl |
116 (38/39/39) | At 1 and 12 weeks, significant improvements were seen: aprotinin group was better than the steroid group, and both were better than the placebo group | Aprotinin may have lasting beneficial effect; further evidence needed | A |
| Hoksrud et al34 | RCT | 1. 10 mg/mL polidocanol injections; 2 mL per knee maximum 2. Lidocaine with epinephrine injections |
33/17 | At 12 months, significant improvements in VISA and overall satisfaction in the sclerosis group | Sclerosing injections with polidocanol resulted in a significant improvement in knee function and reduced pain in patients with PT | A |
| Wilberg et al88 | RCT | 1. 10 mg/mL polidocanol injections; 2 mL per knee max 2. US-guided arthroscopic shaving |
45 (52 tendons/26 tendons) | At 6 and 12 months, patients treated with arthroscopic shaving had significantly improved VAS scores for pain at rest and during patellar tendon loading activity and were significantly more satisfied | Both treatments showed good clinical results, but patients treated with arthroscopic shaving had less pain and were more satisfied with the treatment result; because surgical treatment is a 1-stage treatment, return to sports was faster in this group | A |
PT, patellar tendinopathy; RCT, randomized controlled trial; US, ultrasound; VAS, visual analog scale; VISA, Victorian Institute of Sport Assessment.