Patellar Tendon Ruptures

The tear may be partial or complete. Small or partial tears can impair walking and the ability to perform daily activities. A large complete tear is disabling. A complete tear often occurs where the tendon attaches at the kneecap. Often a complete tear also breaks off a piece of bone from the kneecap. When the tendon is completely torn the patient will be unable to straighten their knee or bear weight on the knee.

The patellar tendon is commonly injured in middle age (age 40) from running and jumping sports, falls, an awkward landing from a jump, and direct impact to the front of the knee. A complete tear separates the kneecap and prevents the ability to straighten the knee.

Several risk factors can predispose an individual to a patellar tendon rupture, including:

1. Chronic Tendonitis: Repeated stress on the tendon can lead to microtears, weakening the tendon over time.
2. Corticosteroid Use: Long-term use of corticosteroids can weaken tendons, making them more susceptible to rupture.
3. Fluoroquinolone Antibiotics: Certain antibiotics have been linked to an increased risk of tendon rupture.
4. Previous Surgery or Injury: Prior injuries or surgeries involving the knee can weaken the tendon.

• Sudden severe pain and swelling
• A popping or tearing sensation at the time of injury
• Swelling and bruising
• The inability to straighten knee
• Difficulty walking
• Knee buckling
• Sometimes a visible defect when the patella is displaced upward adn a gap opens just below the knee cap.

Diagnosis of a patellar tendon rupture typically involves a combination of a physical examination and imaging studies. Dr. Ahsan will inquire about your symptoms and the cause of your problem. He will review your medical history to identify potential risk factors. Dr. Ahsan will perform a physical exam, during which he will assess the range of motion, strength, and stability of the knee. Imaging studies such as X-rays and MRI scans are often used to confirm the diagnosis and assess the extent of the injury. X-rays can help identify any displacement of the patella. MRI scans provide detailed images of the soft tissues, confirming the presence and severity of the tendon rupture.

The severity of the tear significantly influences the treatment approach, with minor tears often managed conservatively, while complete ruptures typically require surgical intervention.  Surgery works best if done soon after the injury. The choice of the best surgical technique depends on the quality of the tendon.

Complete tears require early surgery to reattach the tendon to the kneecap to prevent scarring and restore knee function. Surgery is typically outpatient and is relatively time sensitive from the initial injury. The surgery uses sutures and other fixation devices to reattach the tendon to bone.

Rehabilitation following a patellar tendon rupture is critical for a successful recovery. Immediately after surgery, the knee is immobilized in a brace to protect the repair. As healing progresses, physical therapy focuses on restoring range of motion, strength, and functional mobility. This process can take several months, and the patient must adhere to the rehabilitation protocol to avoid re-injury. Depending on the severity of the injury and the success of rehabilitation, most patients can return regain full knee function, although this may take six months. Return to sport can take 8-12 months with advanced rehabilitation and sport-specific training.