Objective To determine the effectiveness of conservative treatment (CT) on pain and function in patients with patellar tendinopathy (PT) compared with minimal intervention (MI) or other invasive intervention, or in addition to decline eccentric squat. Methods Searches were performed in MEDLINE, Embase, Cochrane, PEDro, SPORTDiscus, CINAHL and AMED databases. All randomised trials that evaluated CT (any intervention not involving invasive procedures or medication) in individuals with PT were included. Two reviewers screened studies, extracted data and assessed risk of bias of all included studies. Where suitable, meta-analyses were conducted; we assessed certainty of the evidence using GRADE methodology. Results When compared with MI, CT did not improve pain (weighted mean difference (WMD) −2.6, 95% CI −6.5 to 1.2) or function (WMD 1.8, 95% CI −2.4 to 6.1) in the short-term (up to 3 months) follow-up. When compared with invasive intervention, CT did not improve pain (WMD 0.7, 95% CI −0.1 to 1.4) or function (WMD −6.6, 95% CI −13.3 to 0.2) in the short-term follow-up. No overall effects were found for combined CT (when a conservative intervention was added to decline eccentric squat) on pain (WMD −0.5, 95% CI −1.4 to 0.4) or function (WMD −2.3, 95 % –9.1 to 4.6) at short-term follow-up. Single studies showed an effect on pain with iontophoresis at short-term follow-up (d = 2.42) or dry needling at medium/long-term follow-up (d = 1.17) and function with exercise intervention at medium/long-term follow-up (over 3 months) (d = 0.83). Summary/Conclusion Our estimates of treatment effect have only low to very low certainty evidence to support them. This field of sports medicine/sports physiotherapy urgently needs larger, high-quality studies with pain and function among the potential primary outcomes.

中文翻译：

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保守治疗可以减轻髌腱病患者的疼痛和改善功能的证据有多强？随机对照试验的系统评价，包括 GRADE 建议

目的 确定保守治疗 (CT) 与最小干预 (MI) 或其他侵入性干预相比，对髌骨肌腱病 (PT) 患者的疼痛和功能的有效性，或者除了偏心深蹲之外。方法 在 MEDLINE、Embase、Cochrane、PEDro、SPORTDiscus、CINAHL 和 AMED 数据库中进行搜索。所有在 PT 患者中评估 CT（任何不涉及侵入性手术或药物的干预）的随机试验都包括在内。两名审查员筛选研究、提取数据并评估所有纳入研究的偏倚风险。在合适的情况下，进行了荟萃分析；我们使用 GRADE 方法评估了证据的确定性。结果 与 MI 相比，CT 并未改善疼痛（加权平均差 (WMD) -2.6，95% CI -6.5 至 1.2）或功能（WMD 1.8，95% CI -2）。4 至 6.1) 在短期（最多 3 个月）的随访中。与侵入性干预相比，CT 在短期随访中并未改善疼痛（WMD 0.7，95% CI -0.1 至 1.4）或功能（WMD -6.6，95% CI -13.3 至 0.2）。未发现联合 CT（当添加保守干预以减少离心深蹲时）对疼痛（WMD -0.5，95% CI -1.4 至 0.4）或功能（WMD -2.3，95 % –9.1 至 4.6）的总体影响短期随访。单项研究表明，离子电渗疗法在短期随访 (d = 2.42) 或中/长期随访 (d = 1.17) 中对疼痛有影响，在中/长期随访中运动干预对功能有影响-up（超过 3 个月）（d = 0.83）。总结/结论我们对治疗效果的估计只有低到非常低的确定性证据来支持它们。