Are Landing Patterns in Jumping Athletes Associated with Patellar Tendinopathy? A Systematic Review with Evidence Gap Map and Meta-analysis.

Despite the voluminous literature, large number of participants, multitude of investigated parameters, and consistent research focus on landing biomechanics, only a few associations can be identified, such as reduced ankle dorsiflexion-plantarflexion range. Further, the quality of the existing literature is inadequate to draw strong conclusions, with only four high-quality papers being found. We were unable to determine biomechanical factors that predicted PT onset, as longitudinal/prospective studies enabling causal inference are absent. The identified gaps indicate useful areas in which to explore causal relationships to inform intervention development. Therefore, high-quality prospective studies are essential to definitively determine whether landing biomechanics play a part in the development, recurrence, or management of PT and represent a potential therapeutic or preventive target alongside non-biomechanical factors.