Patellar Tendinopathy

Evidence: Not Typically Recommended — ASPN 2024: Level II-3 · Grade D

CAUSES

• Repetitive jumping or sprinting (volleyball, basketball, track)
• Sudden increases in training load
• Tight quadriceps or weak hip and thigh muscles that overload the tendon
• A history of prior tendon injury

SYMPTOMS

• Pain at the bottom tip of the kneecap, provoked by activities including jumping, squatting, or stairs
• Tenderness when pressing directly on the tendon
• Stiffness after rest that eases with warm-up
• Aching that returns the day after activity

IMAGING

Ultrasound can show tendon thickening and the changes typical of tendinopathy. MRI is an alternative when a partial tear is suspected or the diagnosis is unclear.

CAN PRP HELP?

The current consensus view is more cautious than some earlier individual studies. Older head-to-head comparisons and one network meta-analysis had ranked leukocyte-rich PRP among the more effective nonsurgical options for patellar tendinopathy. ASPN’s 2024 multispecialty panel, reviewing the fuller body of evidence, reached a more conservative conclusion.

Leukocyte Preparation: Not applicable

Dosing: No protocol recommended

ASPN 2024 CONSENSUS GUIDELINE

ASPN grades patellar tendinopathy Level II-3, Grade D: conflicting, low-quality evidence, and the consensus panel does not recommend PRP as an adjunct to conventional therapy for this condition at this time. For jumper’s knee, we don’t currently offer PRP as a first-line recommendation. It may still be reasonable to discuss case-by-case for a patient who has exhausted other conservative measures, with clear expectations that current evidence doesn’t support PRP for this use.

Sources: D’Souza et al. (ASPN Consensus), Journal of Pain Research, 2024 · Chen et al., Arthroscopy, 2019 · Herrero et al., Bulletin of the Hospital for Joint Disease, 2024

FREQUENTLY ASKED QUESTIONS

Is PRP recommended for patellar tendinopathy?

Not currently. ASPN’s 2024 multispecialty panel grades this Level II-3, Grade D and does not recommend PRP as an adjunct to conventional therapy for patellar tendinopathy.

Did earlier research support PRP for jumper’s knee?

Some of it did. Older head-to-head comparisons and one network meta-analysis had ranked leukocyte-rich PRP among the more effective nonsurgical options. ASPN’s panel, reviewing the fuller and more recent body of evidence, reached a more conservative conclusion.

What’s recommended for patellar tendinopathy instead of PRP?

Eccentric loading exercise programs and shockwave therapy remain the established conservative measures. PRP may still be worth discussing case-by-case for a patient who has exhausted those options, with clear expectations that current evidence doesn’t support it.