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Review Question - QID 11

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QID 11 (Type "11" in App Search)
A 22-year-old college pole vaulter has chronic anterior pain on her jumping knee. The patient has had over 6 months of physical therapy without improvement. It initially only bothered her during training, but she is now no longer able to compete and has pain with daily activities. Her MRI is shown. What is the recommended treatment?
  • A

Use of a Chopat strap

12%

276/2287

Intra-tendinous injection of corticosteroid

2%

53/2287

Intra-articular corticosteroid injection

2%

50/2287

Arthroscopic patellar chondroplasty

9%

205/2287

Surgical excision of the affected tissue

74%

1688/2287

  • A

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The clinical presentation and imaging studies are consistent with Blazina Stage III patellar tendonitis. This is supported by the chronic inflammation and mucoid degeneration seen within the patellar tendon on the MRI. Therefore, surgical excision of the affected tissue is indicated.

Blazina et al. descibe a classification system wherein persistent pain with or without activities, as well as deterioration of performance is indicitive of Blazina stage III disease. They report surgical treatment is indicated in Stage III disease.

Panni et al review extensor mechanism injuries in athletes. They report debridement can be performed in an open or arthroscopic fashion. Postoperative rehabilitation involves initial immobilization in extension, with weight bearing as tolerated and progressive range-of-motion. They report approximately 80% to 90% of athletes are able to return to play post-operatively.

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