Ultrasound Intervention Techniques in Patellar Tendinopathy: A Review

Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 35-38 | Paul German Terán, Estefania Anabel Lozada, Juan Felipe Giraldo. DOI: 10.13107/jrs.2021.v01.i01.019

Author: Paul German Terán [1], Estefania Anabel Lozada [1], Juan Felipe Giraldo [2]

[1] Traumatología y Ortopedia, Centro de Especialidades Ortopédicas, Quito, Ecuador.

[2] Medicina del Deporte, Instituto Colombiano del Dolor INCODOL, Medellín, Antioquia, Colombia.


Address of Correspondence
Dr. Paul German Terán MD,
Traumatología y Ortopedia, Centro de Especialidades Ortopédicas, Quito, Ecuador.
E-mail: paulteranmd@gmail.com


Patellar tendinopathy is a very common, yet very difficult pathology to treat. Its’ frequency in elite athletes, especially in jumping sports, can go as high as 14%. Recently it has been suggested that chronic tendinopathy may be an active process of ongoing tendon degeneration bearing close relation with inflammation-mediated responses, the intensity of pain in patellar tendinopathy appears to have a stronger relation with the number of newly formed blood vessels observed on Doppler ultrasound. This article is a descriptive review of the available information which was obtained during a 1-month period (September 2021) and the following search keywords were used: interventional ultrasonography; patellar ligament; tendinopathy. Based on the information obtained, a total of 787 articles were revied, mainly published in the last 10 years in Pubmed, Medline, and SciELO databases; out of these, a total of 15 articles were used as citations. Even though conservative treatment is preferred as a first-line treatment, if, during a 6-month period it fails, then surgical treatment is proposed; however, recovery time is a crucial issue for elite athletes. Treatment by ultrasound-guided interventionism is presented as an effective alternative and allows athletes to return to their regular activities in less time, with optimal results. In the literature there are not many articles that describe the various techniques of ultrasound-guided interventionism for the treatment of patellar tendinopathy, thus, we have carried out this bibliographic review.

Keywords: Interventional ultrasonography, Patellar ligament, Tendinopathy.


1. Maffulli N, Del Buono A, Oliva F, Testa V, Capasso G, Maffulli G. High-volume image-guided injection for recalcitrant patellar tendinopathy in athletes. Clin J Sport Med 2016;26:12-6.
2. Willberg L, Sunding K, Forssblad M, Fahlström M, Alfredson H. Sclerosing polidocanol injections or arthroscopic shaving to treat patellar tendinopathy/jumper’s knee? A randomised controlled study. Br J Sports Med 2011;45:411-5.
3. Abat F, Diesel WJ, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Effectiveness of the intratissue percutaneous electrolysis (EPI®) technique and isoinertial eccentric exercise in the treatment of patellar tendinopathy at two years follow-up. Muscles Ligaments Tendons J 2014;4:188-93.
4. Moura JL, Abreu FG, Queirós CM, Pisanu G, Clechet J, Vieira TD, et al. Ultrasound-guided electrocoagulation of neovessels for chronic patellar tendinopathy. Arthrosc Tech 2020;9:e803-7.
5. Fogli M, Giordan N, Mazzoni G. Efficacy and safety of hyaluronic acid (500-730kDa) ultrasound-guided injections on painful tendinopathies: A prospective, open label, clinical study. Muscles Ligaments Tendons J 2017;7:388-95.
6. Lee WC, Zhang ZJ, Masci L, Ng GY, Fu SN. Alterations in mechanical properties of the patellar tendon is associated with pain in athletes with patellar tendinopathy. Eur J Appl Physiol 2017;117:1039-45.
7. Rodriguez-Merchan EC. The treatment of patellar tendinopathy. J Orthop Traumatol 2013;14:77-81.
8. Wang JH, Iosifidis MI, Fu FH. Biomechanical basis for tendinopathy. Clin Orthop Relat Res 2006;443:320-32.
9. Hall MM, Rajasekaran S. Ultrasound-guided scraping for chronic patellar tendinopathy: A case presentation. PM R 2016;8:593-6.
10. Masci L, Alfredson H, Neal B, Bee WW. Ultrasound-guided tendon debridement improves pain, function and structure in persistent patellar tendinopathy: Short term follow-up of a case series. BMJ Open Sport Exerc Med 2020;6:e000803.

11. Nielsen TG, Miller LL, Mygind-Klavsen B, Lind M. High-volume image-guided injection in the chronic recalcitrant non-insertional patellar tendinopathy: A retrospective case series. J Exp Orthop 2020;7:80.
12. Crisp T, Khan F, Padhiar N, Morrissey D, King J, Jalan R, et al. High volume ultrasound guided injections at the interface between the patellar tendon and Hoffa’s body are effective in chronic patellar tendinopathy: A pilot study. Disabil Rehabil 2008;30:1625-34.
13. Morton S, Chan O, King J, Perry D, Crisp T, Maffulli N, et al. High volume image-guided Injections for patellar tendinopathy: A combined retrospective and prospective case series. Muscles Ligaments Tendons J 2014;4:214-9.
14. Balius R, Díaz FJ. Ecografía Intervencionista en Traumatología del Deporte. Madrid: Editorial Médica Panamericana; 2015. p. 146.
15. Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 2015;23:1046-52.


How to Cite this article: Terán PG, Lozada EA, Giraldo JF | Ultrasound intervention techniques in patellar tendinopathy: A review. | Journal of Regenerative Science | Dec 2021; 1(1): 35-38.

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