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Randomized Controlled Trial
. 2025 Jun;53(7):1568-1576.
doi: 10.1177/03635465251336466. Epub 2025 May 12.

Long-term Prognosis of Athletes With Patellar Tendinopathy Receiving Physical Therapy: Patient-Reported Outcomes at 5-Year Follow-up

Jie Deng  1   2 , Jelle J Oosterhof  3 , Denise Eygendaal  1 , Stephan J Breda  1   2   4 , Edwin H G Oei  2 , Robert-Jan de Vos  1
Affiliations
Randomized Controlled Trial

Long-term Prognosis of Athletes With Patellar Tendinopathy Receiving Physical Therapy: Patient-Reported Outcomes at 5-Year Follow-up

Jie Deng et al. Am J Sports Med. 2025 Jun.

Abstract

Background: Patellar tendinopathy (PT) is a highly prevalent injury among jumping athletes. The long-term prognosis of athletes with PT following physical therapy is unknown.

Purpose: To assess self-perceived recovery rate and the 5-year change in pain levels, disability, and sports participation, and to explore the prognostic factors associated with self-perceived recovery.

Study design: Cohort study; Level of evidence, 3.

Methods: Athletes with PT who were previously enrolled in a randomized trial and received education, load management advice, and exercise therapy instructions at baseline were eligible. An online questionnaire was sent 5 years after inclusion. Self-perceived recovery was assessed by a dichotomized 7-point global rating of change (recovery was defined as "significantly improved" to "completely recovered"). Pain levels during sports (0-10 points) and disability assessed by the Victorian Institute of Sport Assessment-Patellar (VISA-P) score were recorded at baseline and 5 years. Sports participation was categorized into return to performance, return to sport, return to participation, and quitting sports. Nonparametric tests were performed to compare scores at baseline and 5 years. Logistic regression models were used to identify prognostic factors.

Results: Of 76 eligible participants, 58 (76%) responded (mean age, 30 years [SD, 4 years]; 28% female). At a mean follow-up of 5 years, 76% of participants felt recovered. Pain levels during sports (median, 7 points [IQR, 7-8 points] to 2 points [IQR, 1-4 points]) and VISA-P score (median, 57 [IQR, 45-66] to 82 [IQR, 74-97] points) significantly improved from baseline to 5 years (all P < .001). In total, 41 participants (71%) returned to their desired sports (68% to performance and 32% below preinjury level), 12 participants (21%) returned to participation in other sports, and 5 (9%) completely ceased sports participation. Participants who felt unrecovered had higher levels of pain and disability and lower return to performance (all P < .05). No prognostic factors were identified that were associated with self-perceived recovery.

Conclusion: Athletes with PT after physical therapy can expect a generally acceptable long-term prognosis. However, almost one-quarter did not feel recovered and perceived worse patient-reported outcomes. Clinicians treating athletes with PT may use these findings to estimate the average prognosis.

Keywords: knee injury; loading; recovery; treatment.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: The baseline data for this study were from the original trial, which was funded by collaboration of GE HealthCare and the National Basketball Association (NBA) for this project. GE provided the ultrasound equipment. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart of study design.
Figure 2.
Figure 2.
Types of sports participation at (A) preinjury and (B) 5-year follow-up based on the level of physical demand.
See this image and copyright information in PMC

References

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