AANA/SOMOS Enduring Knee Program 2025-Debate: 20-Year-Old Cadet with 25% Proximal Patellar Tendon Partial Tear and Chronic Symptoms x 2 Years

Debate: 20-Year-Old Cadet with 25% Proximal Patellar Tendon Partial Tear and Chronic Symptoms x 2 Years

Video Transcription

Video Summary

The transcript discusses patellar tendinopathy, common in athletes (especially basketball/volleyball) and anyone doing repetitive acceleration/deceleration and direction changes, including military populations. Histology shows degenerative changes (disorganized collagen, mucoid degeneration, neovascularization), not just inflammation. Key risks include weakness, obesity, mobility/control deficits, metabolic issues, and modifiable overuse with poor recovery. Classic exam finding is focal tenderness just distal to the patella with “startup pain.” First-line treatment is load reduction plus a structured rehab program emphasizing eccentric loading, progressing intensity, and correcting strength/proprioception deficits; ~75% improve long term. Adjuncts include shockwave and PRP (possible short-term benefit). Surgery is generally avoided but may be considered after 6–12 months of failed conservative care impacting duty/sport; techniques vary, with return to sport often 4–8+ months.

Asset Caption

Debate: 20-Year-Old Cadet with 25% Proximal Patellar Tendon Partial Tear and Chronic Symptoms x 2 Years
PRP, Rest, PT: Robert Waltz, M.D.
Patellar Tendon Debridement/Repair: Grant Cochran, M.D.

Keywords

patellar tendinopathy

jumper's knee

eccentric loading rehabilitation

shockwave therapy and PRP

surgical management after failed conservative treatment