PhD defence S.J. (Stephan) Breda

Summary:

Patellar tendinopathy (PT) is a clinical diagnosis, characterised by pain localised to the patellar tendon and load-related pain that increases with physical activity. The overuse injury is common in athletes participating in sports involving repetitive jumping or cutting manoeuvres, such as basketball, volleyball and football. The prevalence of PT is up to 45% in elite athletes and disease burden is significant due to its chronicity leading to prolonged sports absence and even retirement from sports participation and decreased work productivity. In clinical practice, the role of imaging in tendinopathy is to assist in differential diagnosis as a complementary examination and to confirm the presence of characteristic findings that support the clinical diagnosis. Novel ultrasound (US) and magnetic resonance imaging (MRI) based imaging techniques are developing and their current role in diagnosis and estimating prognosis have not yet been identified. Exercise therapy is the cornerstone treatment in order to improve symptoms and potentially reverse the degenerative cascade that is typically seen in tendinopathy. While eccentric exercise therapy is recommended by clinical guidelines, there is a low level of evidence supporting one specific exercise program over another. The major aims of this thesis were to (1) assess the therapeutic effects of current and new exercise interventions and (2) evaluate novel biomarkers identified using advances imaging modalities that enable tissue quantification.