Patellar tip syndrome
| Classification according to ICD-10 | |
|---|---|
| M76.5 | Tendonitis of the patellar tendon |
| ICD-10 online (WHO version 2019) | |
The patellar tip syndrome ( en: jumper's knee ) is an enthesopathy of the origin of the kneecap tendon , which is actually a ligament ( lat .: ligamentum patellae ), at the lower pole of the kneecap (lat .: patella ).
causes
The disease is caused by an acute or chronic overload with simultaneous knee flexion and thus kinking at the tendon insertion. Athletes who jump a lot are most frequently affected (e.g. volleyball, basketball, handball, long jump, high jump) - this is why the term jumper's knee is used in English . Also squats during weight training or in tennis can represent such an overload.
Shortened leg muscles, an axis error of the leg, a leg length difference or a congenital ligament weakness also have a predisposing effect.
Symptoms
With a corresponding sporting load, pain of varying intensity occurs at the lower pole of the kneecap - often at the beginning in the sense of a start-up pain, but also, as the inflammation progresses, in everyday life, for example when climbing stairs or any other extension of the knee joint against resistance.
The region hurts under pressure. Redness or swelling are rarely visible. The ultrasound scan may show thickening of the tendon and surrounding inflammation. In the MRI is also found an edema of the tendon attachment, partly also a can bone marrow edema train at the patella. Conventional X-rays , on the other hand, are usually normal at first, but serve to rule out other diseases, such as Larsen-Johansson disease or Osgood-Schlatter disease . Both cause similar symptoms. Later on, irregularities in the bone contour at the tip of the patella and calcifications in the tendon insertion can appear.
therapy
First and foremost, it is important to prevent. Overloading should be avoided through sensible dosage. Warm-up and stretching exercises should be done before sport, followed by adequate breaks.
Rest and careful muscle stretching are useful for therapy. Also suitable physical therapy and physical therapy with Eiseinreibungen, ultrasound or shock wave applied. If necessary and tolerated, anti-inflammatory drugs in the form of ointments, plasters or tablets can be used. Cortisone injections should not be made into the tendon, at best into the tissue near the tendon, and should not be repeated more frequently, as they are associated with a risk of tendon tears .
An orthosis ("patella band" or "patella bandage"), which uses a pad centered over the tendon to exert local pressure on the tendon attachment, can also be helpful.
literature
- Carl Joachim Wirth (ed.): Practice of orthopedics. Volume 2: Operative Orthopedics. 3rd, completely revised edition. Georg Thieme, Stuttgart et al. 2001, ISBN 3-13-125683-4 .
