Non-surgical treatment of patellar tendinopathy: A systematic review of randomized controlled trials.

Patellar tendinopathy, often called jumper's knee, is common in athletes and can be stubborn to treat without surgery, so clinicians have long debated which non-surgical approaches actually help. This review pulled together nine randomized controlled trials published over a five year span, all measuring pain on a visual analogue scale and most also tracking function with a patellar tendon specific questionnaire, to compare exercise, taping, and injection based treatments. The overall picture was that several approaches showed short-term benefit for pain and function, including isometric exercise, patellar strapping, sports taping, eccentric exercise, dry needling, and injections such as platelet rich plasma, autologous blood, and even saline. Only eccentric exercise, dry needling, and the injection treatments showed sustained improvement at longer follow-up.

The main limitation is that this rests on nine separate trials rather than one large, unified study, so confidence in any single treatment's superiority remains limited.

If you've dealt with patellar tendinopathy, also known as jumper's knee, you know how frustrating it can be when pain lingers despite trying different exercises or treatments. This review looked at nine separate studies testing non-surgical options like specific exercises, taping, needling, and injections, all measuring how much they eased pain and improved knee function. The encouraging part is that many of these approaches, including certain exercises, taping methods, needling, and injection treatments, showed some benefit for pain relief soon after treatment.

But only a smaller group of these, namely eccentric exercise, dry needling, and injections, showed benefits that lasted longer term based on the studies reviewed. It's worth keeping in mind that this conclusion comes from combining nine separate, relatively small trials rather than one large study, so the findings give a useful direction but not a definitive answer about which treatment works best for everyone. Individual responses can vary, and this review doesn't tell us which specific treatment is right for any one person.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review of nine randomized controlled trials, all using visual analogue scale pain scores and most using the VISA-P questionnaire, offers a level 1 evidence synthesis of non-surgical patellar tendinopathy management from 2012 to 2017. Isometric exercise (three studies) and patellar strapping or sports taping (one study) demonstrated immediate pain reduction, while eccentric exercise, dry needling (two studies), and injections with platelet rich plasma, autologous blood, or saline showed more sustained pain and functional improvements at longer follow-up. Notably, saline injection also produced sustained benefit alongside the active injectable comparators, which raises questions about placebo or needling effects contributing to outcomes in those trials.

The review does not report a direct head-to-head ranking establishing one intervention as superior to another; each was generally compared against its own control condition. Given the small number of trials per intervention type and the heterogeneity in comparators and follow-up periods, clinicians should interpret the sustained-effect findings for eccentric exercise, dry needling, and injections as encouraging but derived from a limited and heterogeneous evidence base rather than a large, consistent body of high-certainty research.