Treatment of recalcitrant patellar tendinosis: can the peignage technique be a viable alternative?

Abstract

Objective. Patellar tendinopathy typically affects young athletes engaged in running and jumping activities. If conservative therapy fails at one year, surgery generally leads to therapeutic success. This study evaluated the clinical effectiveness of the “peignage” technique combined with PRP infiltration. Methods. Since 2018 we have treated 7 active patients with open patellar “peignage” technique, excision of degenerations, micro-perforation,s and PRP infiltration, subsequently subjected to a standardized 3-month rehabilitation protocol. Results. There was a reduction in the mean VAS pain from 7.2 to 2.5 points and functional improvement on the VISA-P-I scale from 49 to 85% between pre- and post-operative periods (1 year follow-up), with statistically significant differences. Conclusions. In resistant cases of patellar tendinopathy, the combined use of surgery and orthobiologics allows the athlete to return to pre-injury activities, with good results regarding pain and function. The lack of high-quality evidence studies does not allow systematic conclusions on patellar “peignage” to be drawn; however, the case series present in the literature underline good clinical efficacy. Level of evidence. IV, Case series, prospective.