运动员髌腱病的临床管理：诊断、治疗与重返运动的叙述性综述
简介
这篇叙述性综述综合现有证据后指出，运动员髌腱病尚无标准化诊断共识（尤其影像学评估）或明确的临床实践指南，影像异常常与症状共存但也常见于无症状运动员，偶发发现可能导致过度诊断和不必要的影像引导处理。治疗上，运动疗法研究最广、可考虑作为合理一线选择，但无单一加载模式显示明确优势且证据确定性低至极低；注射治疗机制和证据强度不一，多数数据来自短期研究且常与运动联合，…
英文摘要
Patellar tendinopathy affects approximately 18% of athletes and up to 45% of volleyball players, representing a common cause of load-related anterior knee pain and functional limitation in jumping and landing sports. Clinical diagnosis relies primarily on history and physical examination. However, no consensus has yet been established on standardized diagnostic criteria, particularly for imaging-based assessment, and no definitive clinical practice guideline currently exists; imaging abnormalities frequently coexist with symptoms but are also common in asymptomatic athletes, and incidental findings may carry a risk of overdiagnosis and unnecessary imaging-guided management. This narrative review synthesizes the current evidence on the clinical management of patellar tendinopathy in athletes, spanning diagnosis, treatment, long-term prognosis, and return to sport; the literature was identified through structured searches of PubMed, Web of Science, and Google Scholar, with the final search conducted on 1 July 2026. Exercise therapy represents the most extensively studied conservative approach and may be considered a reasonable first-line option, although no single loading mode has demonstrated clear superiority and the underlying evidence is of low to very low certainty; injection strategies differ in mechanisms and evidence strength, but most data come from short-term studies. These studies commonly combine injections with exercise, making the injection's isolated effect unclear. Additionally, shockwave therapy is not supported by current evidence as a first-line or stand-alone option. Because structural imaging changes and clinical symptoms frequently diverge, functional outcomes rather than imaging endpoints should guide load progression and return-to-sport decisions. This review provides clinicians with a practical synthesis of the currently available evidence for treatment selection and patient management, and identifies remaining uncertainties, particularly in adolescent populations and long-term outcome prediction.