Retrospective study of minimally invasive percutaneous ultrasonic tenotomy for chronic patellar tendinosis

Jumper’s knee or patellar tendinosis is a debilitating condition occurring in up to 40% of athletes that perform jumping, rapid acceleration and deceleration movements. Minimally invasive percutaneous ultrasonic tenotomy (MIPUT) provides an efficacious, non-surgical procedure for treating this condition. In this study, we hypothesized that patients with patellar tendinitis would achieve a reduced visual analog scale (VAS) pain score after MIPUT. A total of 42 knees with chronic patellar tendinosis which had previously failed conservative treatment before undergoing MIPUT were retrospectively reviewed. Patient demographics and medical history were recorded and VAS pain score was assessed at the 2-, 6-, and 12-week follow-up visits. Patients were instructed to follow physician specific activity modifications for 1–2 weeks following the procedure. Patients enrolled included 15 males and 27 females, averaging 39 years old. Post treatment, 38 patients were seen at 2 weeks, 24 at 6 weeks, and 10 at 12 weeks. The average VAS pain score pre-MIPUT was 5.12. After MIPUT, the average VAS score was 2.95, 2.96, and 2.60 at 2, 6, and 12 weeks, respectively. There was a statistically significant difference between pre-treatment pain score and all follow-up visits (p = 0.04, observed power of 66.9%). For patients in the 18–39 age group, the average VAS score was 4.54 pre-MIPUT and 2.05, 2.77, and 2.33 at 2-, 6-, and 12-week follow-ups, respectively (p < 0.024). A significant reduction in VAS pain scores was also seen in the 40–59 group when comparing the pre-treatment score of 5.80 to 2.78 and 3.0 at 6 and 12 weeks, respectively (p < 0.032). Overall, there was not a difference in pain score between age groups over the follow-up period (p = 0.681, observed power 6.6%). MIPUT is a safe and effective procedure for pain relief in those with patellar tendinopathy and no complications were seen in this study population. Future research could target longer term outcomes and improvement in quality of life.