Title: Effects of ASTM AdvantEDGETM on Tendon Morphology Related to Functional Outcomes in Patients with Patellar Tendinopathy. Study Design: Prosepective, randomized, controlled, blind clinical trial. Objectives: The purposes of the present study were to evaluate the effects of ASTM AdvantEDGE on morphological changes in tendon morphology and its relationship with functional outcomes and perception of pain in cases of patellar tendinopathy. Background: Patellar tendinopathies have been traditionally treated as an inflammatory process. ASTM AdvantEDGE constitutes an alternative approach that treats these conditions degenerative processes. ASTM AdvantEDGE triggers a localized inflammatory response, which is hypothesized to facilitate the resorption of degenerative or excessive connective tissue creating a window of opportunity to align new collagen fibers when therapeutic exercises before cross linking occurs. Methods and Measures: Sixteen knees of 9 patients with bilateral or unilateral degenerative patellar tendinopathy who completed this study were randomly assigned either to ASTM or exercise only groups. They underwent repeated testing with ultrasonograms for tendon thickness, hypoechoic areas and blood flow, along with functional assessment tests. In addition, all patients rated their pain before and during functional testing using a visual analogue scale. Results: Paired T-test for pre-post treatment perception of pain, tendon thickness, and hypoechoic area, and a pre mid-post term multivariate analysis of variance nested in each group with repeated measures for functional testing showed no significant difference, except for single leg jump test for time in favor of the ASTM group, although with unusual observations. Conclusions: ASTM AdvantEDGE appears to be as effective as therapeutic exercises only for the treatment of patellar tendinopathy in the young adult and the teenage patient population with sonographic edivences of patellar degeneration without inflammation. Further investigation with larger samples and longer treatment periods with different age groups to determine a potential difference in the approaches presented in this study are recommended.
