Patellar Tendon Surgery Question

I'm in the military and am suffering from right knee pain in the patellar tendon area. I have had a PRP injection in the tendon and still suffer from the pain which seems to be worse after having the injection. I have also had physical therapy which did nothing to relieve my pain. My military orthopedic that is treating me looked at a recent MRI I had of my knee and says that I have a "diseased" area of my patellar tendon and wants to perform surgery on my knee to clean up the "diseased" area. He also will be drilling holes in my knee cap to allow bone marrow to help repair the tendon. I am just curious to whether or not this sounds like a proper next step to try and provide me with some pain relief. I have also thought about getting a second opinion from a civilian orthopedic to get their opinion.  

[S. Kaul, MD]

Hi there!

Well, without an evaluation, it would be difficult to comment on the possible next best step of management in your case. While PRP may help with tendon inflammations/ tendonitis and minor tears, they do little to other types of tendon pathologies. I am not sure what your doctor meant by ‘diseased tendon’ and hence it would be inappropriate for me to comment if a surgical intervention would be the appropriate next step, though the situation sounds like a tendon tear. You may like to seek a second opinion with a civilian orthopedician, to be sure of the tendon pathology and the appropriate management.
Hope this is helpful.

Take care!

[saucierm]

Thanks Dr. Kaul for your response. Basically he is calling my tendon "diseased"  but it is actually degenerated. I'm not sure why he refers to it that way other than maybe it is a military thing.

[S. Kaul, MD]

Hi again!

Assuming this to be a focal degeneration of the patellar tendon/ patellar tendinopathy the decision between conservative management and a surgical repair would depend on the severity, response to previous conservative management (atleast 6 months), the healing process and the expected response to a surgical intervention. Aprotinin is a drug that may help prevent further tendon degeneration.  I am still of the opinion to seek a second opinion before confirming to a decision.

Take care!