Longitudinal Quantitative Ultrasonic Analysis of Patellar Tendon in a Collegiate Athlete After Bilateral Debridement: A Case Report

Context: A National Collegiate Athletic Association Division I female basketball athlete (age = 20 years, height = 190.5 cm, mass = 87 kg) had chronic patellar tendinopathy. Intervention(s): After undergoing unsuccessful conservative treatments, the athlete underwent bilateral open patellar debridement surgery. Pain and dysfunction were assessed via the Victorian Institute of Sport-P (VISA-P) score with concurrently collected B-mode ultrasound images of the patellar tendon throughout a 12-month rehabilitation. Results: Peak spatial frequency radius (PSFR), a quantitative ultrasound measure previously shown to be correlated with collagen organization, was compared with changes in VISA-P scores. Overall increases in PSFR values across 0 degrees, 30 degrees, 60 degrees, and 90 degrees of knee flexion were observed throughout recovery. Despite increased PSFR values and returning to sport, the athlete reported substantial pain. Conclusions: In this level 3 exploration case report, we provide novel insight into ultrasonically measured structural changes of the patellar tendon after surgery and during rehabilitation of an athlete with chronic tendinopathy. Perceived pain measurements were not necessarily related to structural adaptations.