Jumper's knee is a common problem in athletes participating in sports that involve running and jumping. Typically activity related pain is felt at the proximal insertion of the patellar tendon. Symptoms and findings in the more distal parts of the patellar tendon are unusual. All of the patients in this retrospective study were active athletes suffering from distal patellar tendinosis. There were 19 men and four women. The mean age of the patients was 24 years (range 12-32). All of the patients were operated on after conservative treatment lasting for an average of 23 months had failed. After a mean postoperative follow-up of 42 months 21 of the knees were rated good meaning that the athlete had returned to the prior level of activity without any symptoms. In three knees the result was fair as the patients benefited from the operation but there were some remaining symptoms. No poor results were reported. All patients were able to return to their previous level of sports 8-12 weeks after surgery. Operative treatment seems to give good results in most cases after unsuccessful conservative treatment of the unusual distal patellar tendinosis in athletes.