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Laser therapy with exercise in the treatment of patellar tendonitis

Three Part Question

IN [adults with chronic patellar tendonitis] IS [exercise and laser more beneficial than exercise alone] AT [decreasing pain and improving function]?

Clinical Scenario

A 29 year old patient presents with a 3 month history of patellar tendonitis. You are planning to use an eccentric contractions based exercise regime but have heard from a colleague involved in sports medicine about laser and you wonder if it will help speed things up.

Search Strategy

MEDLINE 1966-10/04, CINAHL 1982 10/04, AMED 1985-09/04, SPORTDiscus 1830-09/04, EMBASE 1996-09/04, via the OVID interface. In addition the Cochrane Library, Issue 4 2004 and the PEDro database were also searched.
Medline, CINAHL, AMED, EMBASE: [{(exp tendonitis OR tendinosis.mp OR tendinopathy.mp) AND (exp Patella)} OR "jumper's knee".mp] AND [(low level laser.mp OR laser therapy.mp OR therapeutic laser.mp) AND (exp exercise OR exp therapeutic exercise)] LIMIT to human AND English language
SPORTSDiscus: exercise therapy
Cochrane: (Laser therapy OR therapeutic laser) AND (exercise therapy OR therapeutic exercise) AND (musculoskeletal injury).

Search Outcome

No papers were found that had studied the effect of laser either alone or in combination with therapeutic exercise in the treatment of chronic patellar tendonitis. There was one paper using laser on patellar tendonitis, but this involved laser acupuncture and was in German.

Comment(s)

It would seem that the justification for using therapeutic laser treatment on patellar tendonitis is based on its effect on other tendon structures in the body. The use of laser therapy in other tendons warrants a further BET (http://www.bestbets.org/cgi-bin/bets.pl?record=00852).

Clinical Bottom Line

Presently, there is no evidence for the use of low level laser therapy either alone or in combination with exercise in the treatment of patellar tendonitis.