Patellar Tendinopathy When Leukocyte-Rich PRP Injection Has Not Reduced Anterior Knee Pain
When leukocyte-rich platelet-rich plasma (LR-PRP) injection into the patellar tendon has failed to achieve reduction of anterior knee pain, a defined next-line protocol applies. The following outlines the failure condition that triggers escalation and a partial overview of the approach at this stage.
Previous Treatment — Failure Condition
Prior line did not meet its target
Prior treatment: Leukocyte-rich platelet-rich plasma injection into the patellar tendon under ultrasound guidance.
Target not reached: Reduction of anterior knee pain at the patellar tendon.
Next-Line Approach — Partial Overview
For severe, chronic patellar tendinopathy unresponsive to prior injection-based management, surgical intervention targeting the affected tendon tissue is the next step. The complete protocol — covering the specific operative technique, eligibility criteria, and repair considerations — is available in full via the link below.
Treatment Goals
- Pain relief and return to sport participation between 7 and 12 months postoperatively.
References
DOI: 10.4085/1062-6050-0049.21
- In the most severe and chronic cases of advanced patellar tendinopathy, surgical intervention may be warranted.
- Surgery is typically not considered unless extensive conservative management for more than 6 months has failed to relieve symptoms.
- Open debridement with or without repair remains a reliable procedure.
- Surgical techniques involve identification of the macroscopically abnormal tissue with excision back to normal-appearing tissue borders.
- Depending on the volume of tissue involved and surgeon preference, subsequent repair of the tendon back to the patella can be undertaken.
- Returned to participation between 7 and 12 months postoperatively.