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It also does not appear to bind to the extracellular matrix, and researchers suggest that its low molecular weight may help it travel comparatively long distances through tissues

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Neither is supported by strong evidence.52 Surgery is a last resort treatment for refractory cases of patellar tendonitis,53 when all non-surgical options have been exhausted and the patient fully understands the risks and benefits of the respective procedure.54 It requires a longer rehab time of 6 to 12 months,55 but the long-term results are promising.56 For example, in one study surgery improved symptoms in 57% of patients.57 However, for non-recalcitrant cases of patellar tendonitis an exercise-based approach is a far superior option58 and performed correctly, it can produce outstanding results