Although the majority of patients with patellar tendinopathy (PT) can be treated nonoperatively, operative management may be indicated for recalcitrant cases. While several surgical techniques have been described, there is limited understanding of postoperative outcomes and expectations regarding return to activity and sport. The purpose of this study was to characterize the clinical outcomes associated with the surgical management of PT with an emphasis on return to sport (RTS) rates. We hypothesized that surgical management would lead to clinically important improvements in patient-reported outcomes (PROs) with high rates of RTS and RTS at the same level. A comprehensive search of the PubMed, Medline, and Embase databases was performed in December 2020. Level of evidence studies I through IV, investigating results of surgical management for PT (PRO, functional outcomes, pain, and/or RTS), were included. The search was performed in accordance with the Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Forty clinical studies reporting on surgery for PT satisfied inclusion criteria, with 1,238 total knees undergoing surgery for PT. A comparison of pre- and postoperative Victorian Institute of Sport Assessment, patellar tendon (VISA-P) scores (mean difference: 41.89, p < 0.00001), Lysholm scores (mean difference: 41.52, p < 0.00001), and visual analogue scale (VAS) pain scores (mean difference: 5, p < 0.00001) demonstrated clinically and statistically significant improvements after surgery. The overall RTS rate following operative management was 89.8% (95% confidence interval [CI]: 86.4–92.8, I ² = 56.5%) with 76.1% (95% CI: 69.7.5–81.9, I ² = 76.4%) of athletes returning to the same level of activity. Surgery for PT provides meaningful improvement in patient reported outcomes and pain while allowing athletes to RTS at high rates with levels of participation similar to that of preinjury. Comparative studies of open and/or arthroscopic surgery are still limited but current evidence suggests better rates of RTS for arthroscopic surgery compared with open surgery. This is a systematic review of level-I to -IV studies.

尽管大多数髌腱病（PT）患者可以通过非手术治疗，但对于顽固病例可能需要手术治疗。虽然已经描述了几种手术技术，但对术后结果以及恢复活动和运动的期望的了解有限。本研究的目的是描述与 PT 手术治疗相关的临床结果，重点关注重返运动 (RTS) 率。我们假设手术治疗将导致临床上重要的患者报告结果 (PRO) 改善，同时 RTS 发生率较高且 RTS 处于同一水平。2020 年 12 月对 PubMed、Medline 和 Embase 数据库进行了全面检索。包括 I 级至 IV 级证据研究，调查 PT 手术治疗结果（PRO、功能结果、疼痛和/或 RTS）。检索是根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南进行的。40 项报告 PT 手术的临床研究满足纳入标准，共有 1,238 个膝关节接受了 PT 手术。维多利亚运动评估研究所的术前和术后比较、髌腱 (VISA-P) 评分（平均差：41.89，p  < 0.00001）、Lysholm 评分（平均差：41.52，p  < 0.00001）和视觉模拟量表（ VAS）疼痛评分（平均差：5，p  < 0.00001）证明手术后临床和统计学上有显着改善。手术治疗后的总体 RTS 率为 89.8%（95% 置信区间 [CI]：86.4–92.8，I ²  = 56.5%），其中 76.1%（95% CI：69.7.5–81.9，I ²  = 76.4%）运动员恢复到相同的活动水平。PT 手术可以显着改善患者报告的结果和疼痛，同时使运动员能够以与受伤前相似的参与水平进行高比率的 RTS。开放手术和/或关节镜手术的比较研究仍然有限，但目前的证据表明，与开放手术相比，关节镜手术的 RTS 率更高。这是对 I 级至 IV 级研究的系统回顾。