**8. Conclusions**

Patellar tendinopathy is essentially a degenerative condition and the management should be based on the clinical assessment. Imaging appearances, although aids in the diagnosis but should not determine the treatment. Conservative treatment forms the mainstay of management, while surgery is indicated only after a dedicated period of appropriate conservative measures have been instituted, usually around 6–9 months. These include physical modalities such as local application of ice and graduated strengthening physiotherapy protocol such as functional exercises and eccentric strengthening; the latter are done only after the patient is pain free. Although there is a lack of level I evidence, eccentric training appears to be the most promising modality. Peritendinous corticosteroid or aprotinin infiltration may also be useful as an adjunct for the treatment of this condition. Although scientific consensus is lacking percutaneous needling appears to be the least invasive procedure, followed by percutaneous longitudinal tenotomy. Arthroscopic debridement has been proposed, but, although early results are encouraging, its efficacy is still under scrutiny.
