Description of Knee Tendinitis
Tendinitis, or tendinopathy, involves a breakdown of the normal architecture of the tendons around the knee. Most commonly, this is due to overuse, obesity or joint malalignment. The more common forms of knee tendinitis include patellar tendinitis, quadriceps tendinitis, popliteal tendon tendinitis and tendonitis of other structures.
Symptoms of Knee Tendinitis:
• Knee Pain
• Swollen Knee
• Painful to touch
• Pain during or after sports activities – depending on severity
• Pain with lunges
Treatment for Knee Tendinitis
The usual recommended treatment for knee tendinitis is to try to stop the activity that caused the symptoms to develop. Most commonly, this is an overuse-type problem and cutting back on the activity that causes symptoms can be very helpful.
In general, we first recommend cutting back on activities and working with one’s physical therapist on a stretching and strengthening program that would primarily focus on eccentric strengthening. Recalcitrant cases may require the use of an MRI scan to judge the amount of wear. More recently, the injection of platelet-rich plasma (PRP), which contains growth factors that appear to help with healing of knee tendinitis, may be indicated with ultrasound guidance.
Finally, when there is severe tendon degeneration from tendinitis, surgery may be indicated to remove the degenerative portion of the tendon and to reattach it back to the patella or other structures. While surgery is generally uncommon for tendinitis around the knee, it does occur and has found to be beneficial in patients who did not benefit from a non-operative treatment regimen and who had a proper clinical exam, x-rays and MRI scans.
The most common form of knee tendonitis which requires surgery is patellar tendonitis. After this surgery, patients are usually limited to 90 degrees of knee flexion for two weeks and then motion is increased as tolerated. In addition, patients are non-weightbearing for 6 weeks. After 6 weeks, they may start the use of a stationary bike and slowly increase the resistance as tolerated. It is important to avoid activities which can cause recurrent symptoms, such as deep squatting and lunges for a minimum of 6 months after surgery. Most athletes can return to full activities at about 6 months postoperatively.