An NCAA Division I female basketball athlete (20 years, 190.5 cm, 87 kg) suffered from chronic tendinopathy. After failed conservative treatments, the athlete underwent bilateral open patellar debridement surgery. Pain and dysfunction were assessed via the Victorian Institute of Sport-P (VISA-P) with concurrently collected B-mode ultrasound images of the patellar tendon throughout a 12 month rehabilitation. Peak spatial frequency radius (PSFR), a quantitative ultrasound parameter previously shown to correlate to collagen organization, was compared to changes in VISA-P scores. An overall increase in PSFR values across 0, 30, 60, and 90° of knee flexion were observed throughout recovery. Despite increased PSFR and returning to sport, the athlete still reported significant pain. This level 3 exploration case report provides novel insight into ultrasonically-measured structural changes of the patellar tendon following surgery and during rehabilitation of an athlete suffering from chronic tendinopathy. Perceived pain measurements were not necessarily related to structural adaptations.

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