Conservative treatment in patellar tendinopathy

What is the evidence?

This review found only low to very low quality evidence to support the short- and medium- term effect of exercise, dry needling, and iontophoresis for patellar tendinopathy (PT).

The authors warn that the available randomized controlled trials (RCTs) have major methodological shortcomings and that well-designed trials with pain and function as primary outcomes are urgently needed.

Low certainty evidence was found that exercise improves function at 6 months and low to very low certainty evidence was found that iontophoresis and dry needling may improve pain at 3 and 6 months, respectively.

The authors state that this was the first review about this topic performing a meta-analysis and - considering the effect of small sample sizes - therefore showing a truer isolated effect of each CT modality.

> From: Mendonça et al., Br J Sports Med (2019) (Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.

Expert opinion by José Pedro Correia

The results of this review should come as a serious warning regarding the current state of evidence-based practice on patellar tendinopathy.

Despite the number of studies being published, evidence for any effect of conservative treatment on pain and function remains of low certainty at best after pooling results.

While the findings should not be interpreted as meaning that conservative treatment modalities have no effect, it should warn practitioners to interpret the findings of the available RCTs more carefully.

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