Challoumas et al. 2021, Management of patellar tendinopathy: systematic review and network meta-analysis of randomised studies

A network meta-analysis of 37 randomised controlled trials covering 33 interventions for patellar tendinopathy found that eccentric loading with or without adjuncts should remain first-line treatment; extracorporeal shockwave therapy showed no superiority over sham when eccentric exercise was included. Topical glyceryl trinitrate and hyaluronic acid injection combined with eccentric or slow-resistance exercise had the highest probability of being most effective, though both require further high-quality trials before routine adoption. Moderate evidence.