The patellar tendon connects the kneecap (patella) to the tibia and is the terminal attachment of the quadriceps mechanism that Patellar Tendon Rupture
A patellar tendon rupture is a complete tear of the patellar tendon. The quadriceps (thigh) muscles become a tendon above the patella (kneecap), attach to the patella, and continue as the patellar tendon from the patella to the tibia (lower leg bone).
When the patellar tendon ruptures, continuity between the quadriceps muscles and tibia is lost, resulting in loss of quadriceps function when trying to straighten the knee.
What Is a Patellar Tendon Rupture?
The patellar tendon connects the patella (kneecap) to the tibia (lower leg bone) and is part of the connection between the quadriceps muscles and the lower leg.
The quadriceps muscles help forcefully straighten the knee and slow the knee during bending or squatting. When the patellar tendon completely tears, this connection is disrupted and the quadriceps muscles can no longer function normally to straighten the knee.
Causes and Risk Factors
A patellar tendon rupture may result from:
- Sudden stressful activity, such as jumping, hurdling, or starting a sprint
- A direct blow or injury to the knee
- A fall that causes forceful bending of the knee
Risk factors include:
- Sports requiring sudden, explosive muscle contraction, including jumping, quick starts, running, and contact sports
- Poor physical conditioning, including strength and flexibility
- Previous patellar tendon injury
- Untreated patellar tendinosis
- Cortisone injection into the patellar tendon, potentially
- Fall risks
Symptoms
Signs and symptoms may include:
- A pop or ripping sensation at the knee or below the kneecap at the time of injury
- Pain, tenderness, swelling, warmth, or redness around the patellar tendon
- Pain when trying to forcefully straighten or bend the knee
- Inability to straighten the knee while seated
- Crepitation, or a crackling sound, when the tendon is moved or touched
- Bruising around the patellar tendon and knee after approximately 48 hours
- A defect or loss of firm fullness where the tendon has ruptured
- Inability to stand, walk, run, navigate stairs, or rise from a chair
Treatment
Initial treatment includes avoiding walking on the affected leg, icing the area, applying a compressive elastic bandage, elevating the injured leg, and obtaining an MRI to evaluate the pattern of the tear.
Definitive treatment requires surgery within three weeks to repair the tendon. Surgery usually involves sewing the ends of the tendon back together.
After surgery, the knee typically is immobilized in a long leg brace for six weeks. Physical therapy usually is needed afterward to regain knee motion and strength.
Nonsteroidal anti-inflammatory medications such as aspirin and ibuprofen, or minor pain relievers such as acetaminophen, are often recommended as directed by a physician. Pain medication may also be prescribed when necessary.
Cold can be used to relieve pain and reduce inflammation. It may be applied for 10 to 15 minutes every two to three hours and immediately after activities that aggravate symptoms.
Recovery and Outcomes
With early and appropriate surgical treatment, patients typically can return to their pre-injury level of competition.
Formal rehabilitation following surgical repair generally takes approximately four to six months. Overall recovery requires approximately six months.
Potential complications may include quadriceps weakness, re-rupture of the tendon, prolonged disability, knee stiffness or weakness, and persistent knee symptoms.
When to See Dr. Chudik
Contact Dr. Chudik’s office if symptoms worsen or if a patellar tendon rupture is suspected following an injury that causes loss of the ability to straighten the knee.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.