Overuse injuries of the extensor mechanism of the knee are common in both athletes and nonathletes and usually occur during activities associated with repetitive loading, stress, and knee extension.Historically, they have been labeled as Jumper's knee due to the high prevalence seen in the athletic community. In many published reports, the name "patellar tendinopathy" is used to describe this disorder of the quadriceps tendon at the patellar insertion, and the names are often used interchangeably. Numerous reports have been published describing extensor mechanism injuries in athletes, but there is a paucity of studies that focus on quadriceps tendinopathy. In addition, there is no universally accepted classification system for tendon pathology. Therefore, we performed a comprehensive literature review of these studies. This review consists of 2 parts. In the first part we review: (I) epidemiology and (II) diagnosis of quadriceps tendinopathy in the athlete as well as the general population. In the second part we discuss: (I) classification;(II) prognosis; and (III) treatment results.

The purpose of this article is to report 3 cases of Kager's fat pad scarring and tethering to the deep surface of the Achilles tendon in patients with Achilles tendinosis symptomatology. The 3 patients were diagnosed sonographically by the use of a dynamic maneuver we described and named the "Kager's squeeze" technique. The key finding for diagnosis is the deformation and bowing of the deep fibers of the Achilles tendon during dynamic squeezing of Kager's fat pad. After diagnosis, the patients were treated with ultrasound-guided hydrodissection and scar release to restore normal motion between Kager's fat pad and the Achilles tendon. All 3 patients experienced significant clinical improvement shortly after treatment. Therefore, we suspect that Kager's fat pad scarring with Achilles tendon tethering may mimic or exacerbate Achilles tendinosis symptomatology and should be considered a possible diagnosis when conservative treatments for Achilles tendinosis fail. We demonstrate that Kager's fat pad scarring with Achilles tendon tethering can be diagnosed and treated with a simple in-office hydrodissection technique, leading to improved patient outcomes.

Overuse injuries of the extensor mechanism of the knee are common in both athletes and nonathletes and usually occur during activities associated with repetitive loading, stress, and knee extension. Numerous reports have been published describing extensor mechanism injuries in athletes, but there is a paucity of studies that focus on quadriceps tendinopathy in the non-athlete population. In addition, there is no universally accepted classification system for tendon pathology. Therefore, we performed a comprehensive literature review of these studies. This review consists of 2 parts. In the previous part we reviewed: (I) epidemiology and (II) diagnosis of quadriceps tendinopathy in the athlete as well as the general population. In this part we discuss: (I) classification; (II) prognosis; and (III) treatment results.

Telemedicine has become an emerging necessity in the practice of orthopaedic surgery following the paradigm shift that was brought on by the COVID-19 pandemic.» Physical examination is an integral component of orthopaedic care and plays a crucial role in diagnosis.

Background Increased popularity in long-distance running over the last 30–40 years has induced an increase in the incidence of running-related injuries (RRI). Among others, running experience could be a determining factor in the RRI incidence. Objective To explore whether novice runners sustain more RRI than experienced runners and to determine RRI risk factor variables. Design Prospective epidemiological study. Setting A 27-week follow-up of runners at the Luxembourg National Sport Centre ending on the ING-Europe (semi)Marathon of Luxembourg (05.15.2010). Participants 39 compliant runners (40.2±8.5 years) out of the initial cohort (n=85). Assessment of risk factors Extrinsic, training-related characteristics (context, volume, etc). Main outcome measurements Running and other sports data were recorded using an innovative internet-based diary. Similarly, RRIs, which were defined as any pain or physical complaint impeding or altering a training session for at least 1 day, were recorded. Results From the 39 athletes, 14 were classified as novice runners (ie, <3 months of regular running during the 12 months before the training period). Overall RRI incidence was evaluated at 8.07 RRI/1000 h of running. The RRI incidence was 3.3 times higher (95%CI 1.27 to 8.54) in novice than in experienced runners (16.8 and 5.1 RRI/1000 h of running, respectively; p=0.009), confirming the initial hypothesis. Dichotomous RRI risk factors such as gender or running experience were not significant. RRI incidence was significantly associated with a lower competition volume per week, a lower number of training session, a lower percentage of competition run on a soft surface and a higher average work rate (av. HR/(220-age) during competition. A logistic regression including all individual variables with a p-value<0.2 yielded no significant results. Conclusion Although the initial hypothesis was confirmed, no risk factors were significant within the logistic regression. In order to be able to construct an individual RRI risk profile, a greater sample size is necessary to provide more conclusive results.