CNY Orthopedic Sports Medicine, PC: Treatment: Patellar Tendonitis
Injuries and Conditions: Knee: Patellar Tendonitis: Treatment Options
The pain and discomfort associated with patellar tendonitis can vary widely from patient to patient and depends upon the severity of the condition. Some patients may experience minor soreness while others may experience very severe and debilitating pain. In each case, treatment is essentially the same, although the length of time required for recovery will vary according to the severity of the tendonitis.
  • Tendonitis does not require surgery; treatment is typically limited to the use of R.I.C.E. (Rest, Ice, Compression, Elevation) and occasional physical therapy.
  • Patients who seek treatment and follow therapy instructions can expect a full recovery, sometimes in less than three weeks.
  • Patients in which the bursae are also inflamed may require an aspiration of one or more of the involved bursae, a process in which some of the fluid is drained from the sac.
  • Identifying the activities that irritate the tendon, followed by modifying or eliminating these injury producing activities is the most critical step in treating the patient.

  • Treatment options:
    Conservative Treatment of Patellar TendonitisACL Patellar Tendon Graft

    Non-Surgical Treatment: Conservative Treatment of Patellar Tendonitis
  • After the activity or behavior that has caused the tendonitis is identified, modification or elimination of the injurious activity is required.
  • A period of rest is required to allow the tendon to heal and irritation to subside. This may vary from one to two days or as long as several weeks.
  • If the patient has a tendency for over-pronation of the feet, orthotics, or corrective inserts for shoes, may be recommended.
  • For severe injuries, a knee immobilizer and crutches may be recommended for use during initial treatment.
  • Ice packs around the knee are used to help reduce pain and swelling, usually for 20-30 minutes 4-6 times daily until the swelling subsides.
  • The use of a compression sleeve helps reduce and prevent further swelling.
  • Anti-inflammatory medication is sometimes administered to treat the pain associated with the inflammation.
  • More severe cases, where the bursae are very swollen, may be treated by aspirating the bursa to reduce pain caused by the accumulation of fluid.

  • Non-Surgical Product Considerations

    Knee: Compression Sleeves
    Knee compression sleeves give added support, increasing stability and helping to reduce swelling in an injured knee. Patients that have light sprains may be directed to use a compression sleeve during the early stages of rehabilitation. Other patients that have ongoing knee problems or chronic conditions may be recommended to use a sleeve on a daily basis. These sleeves are less restricting than most other knee supports and can be worn under loose fitting clothing.

    Knee compression sleeves can be used to treat:

  • Light swelling.
  • Light knee strains.
  • Chronic inflammation.
  • Degenerative joint disease.

  • Knee: Support
    A knee support is a sleeve-like support that fits firmly around the knee. The support is used to reinforce the joint during motion and provide compression to aid healing and reduce pain and swelling. Patients suffering from knee strains or inflammation will usually be directed to use a support during daily activities.

    The thin and flexible construction of the support allows for normal movement of the knee and also allows the support to be worn under loose fitting clothing. To prevent harmful pressure to certain structures, the support applies differing compression around the knee. The sides of the joint receive intermittent pressure to help stimulate blood flow while the rear of the support fits relatively loose to prevent constriction of circulation. The kneecap is aided in positioning, but remains free of compression to allow its natural movement.

    Knee supports can be used to treat:

  • Strains
  • Sprains
  • Inflammation
  • Chondromalacia patella
  • Hot/Cold Pack
    The use of hot and cold packs to relieve pain and inflammation is a common method of treatment for many conditions. When the soft tissue groups become strained or irritated the rotating application of hot and cold can be beneficial. Cold therapy numbs the nerves to reduce pain and combats swelling by constricting blood vessels and by slowing blood flow to the site of injury. The application of heat to an injury after a few days of cold therapy and after swelling and redness has been reduced promotes the healing process. Heat therapy speeds up healing by increasing the flow of blood to the site of injury. Heat will also restore flexibility, relieve muscle cramping, and arthritic symptoms.

    Surgical Treatment: ACL Patellar Tendon Graft
    The ACL, unable to regenerate or heal itself, is replaced with a section of the patellar tendon, located on the front of the knee.

    Surgical Product Considerations

    NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
  • Pain resulting from inflammation or swelling.
  • Pain after injury.
  • Joint pain and arthritis.

  • Knee: Cold Therapy
    Cold therapy is used to reduce pain and swelling and is a convenient method to apply cold to an injured or rehabilitating extremity, such as a knee or shoulder. A cuff fits like a sleeve around the extremity and utilizes cold water supplied by a connected thermos or canister to chill the extremity. Water flow into the cuff can be controlled by different mechanisms. The simplest way is gravity; elevating the canister fills the cuff and controls the amount of pressure against the extremity. Water flow may also be controlled by a pump which will automatically circulate the cold water to and from the cuff. After surgery or immediately following an injury, the canister should be refilled with cold water every one to two hours to maintain a proper temperature. The cold therapy may also be used during rehabilitation, especially after physical activity, reducing the inflammatory heat from exercise.

    Cold therapy can be used to treat: Knee, Shoulder, Elbow, Wrist and Hand, Back, Hip, and Foot & Ankle Injuries.

    Knee Examples include:

  • Pre-operative ACL/PCL injuries.
  • Non-surgical ACL/PCL injuries.
  • General knee pain or swelling.
  • Soft tissue injuries.

  • Surgical Hardware Considerations
    This condition does not require surgical hardware.

    Factors in Transplant Source
    This condition does not require the transplanting of tissue.

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