Role of orthobiologics in managing patellar tendinopathy: A narrative review

Abstract

Patellar tendinopathy is a relatively common cause of anterior knee pain in athletes. It is predominantly seen in sports involving jumping, running, abrupt change in direction like basketball, volleyball, soccer, sprinting and jumping. The main pathophysiology is considered to be repetitive microtrauma at the inferior pole of patella along with a poor healing response. Although eccentric exercises have shown to be beneficial, the improvement is often slow and may result in a less than satisfactory outcome. There is a growing interest of orthobiologics, mainly platelet-rich plasma (PRP) in multiple chronic musculoskeletal pathologies. This narrative review aimed to analyse the current evidence on the role of orthobiologics in the management of recalcitrant patellar tendinopathy. Multiple studies have shown significant clinical improvement with negligible adverse effects on PRP injection for patellar tendinopathy. Most studies assessed report that the effects of PRP are sustained. However, among all studies evaluated, there is a considerable heterogeneity in terms of PRP composition, number of injections, dosage interval and postinjection rehabilitation protocol, pointing to the need for further research to enable standardisation of PRP therapy. Stem cells too have shown potential to be effective as a treatment modality for chronic patellar tendinopathy, but there is limited data to recommend its use outside of research setting or to enable a meaningful comparison to PRP. There is a promising role of orthobiologics in management of chronic patellar tendinopathy not responding to conventional treatment.

Level of evidence: Not applicable (narrative review).

Keywords: Jumper's knee; orthobiologics; patellar tendinopathy; platelet‐rich plasma; stem cells.