Should ultrasound-guided needle fenestration be considered as a treatment option for recalcitrant patellar tendinopathy? A retrospective study of 47 cases

Objective: To report the retrospective results of ultrasound-guided needle fenestration for the treatment of recalcitrant patellar tendinopathy. Design: Retrospective follow-up study. Setting: University outpatient sports medicine clinic. Patients: Forty-seven patellar tendons in 32 patients (26 men and 6 women; mean age, 26 years) with recalcitrant patellar tendinopathy. Diagnosis made via history, physical examination, and sonographic examination. INTERVENTION:: Ultrasound-guided needle fenestration after failure of conservative management. Main outcome measures: Pre-treatment and 4-week clinical follow-up determination of functional activity score. Phone follow-up determination of best achievable level of activity and satisfaction score of the procedure. Results: Average time to follow-up was 45 months. Seventy-two percent of patients reported excellent or good results when questioned regarding return to activity. Twenty-eight percent of patients were unable to return to their desired activity level. Six patients subsequently underwent surgical treatment. One athlete underwent surgery to repair a patellar tendon rupture that occurred 6 weeks after the procedure. Eighty-one percent of patients reported excellent or good satisfaction scores. Conclusions: Ultrasound-guided needle fenestration warrants further investigation for the treatment of recalcitrant patellar tendinopathy.