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Patellar Tendon Tear

What is a Patellar Tendon Tear?    

A patellar tendon tear is a significant injury affecting the knee joint and is commonly seen in athletes and individuals engaged in activities that involve jumping, running, or sudden directional changes. The patellar tendon connects the patella (kneecap) to the tibia (shinbone) and plays a crucial role in the extension of the knee. The patellar tendon is composed of collagen fibers, which provide strength and elasticity. Its primary function is to transmit forces from the quadriceps muscle to the tibia during activities such as walking, running, and jumping. This tendon is susceptible to injury due to its high load-bearing capacity and its role in dynamic movements.

Types of Patellar Tendon Tear

Patellar tendon tears can be classified into two types based on severity:

  • Partial Tear: This involves the disruption of some collagen fibers while maintaining tendon continuity.
  • Complete Tear: This is characterised by a complete rupture of the tendon, leading to a loss of function.

Mechanism of Injury of Patellar Tendon Tear

Patellar tendon tears often result from acute trauma or chronic overuse. 

  • Acute Injury: A sudden force applied during activities such as jumping or landing, often resulting from eccentric loading of the quadriceps.
  • Chronic Overuse: Repetitive stress on the tendon, often seen in athletes, leading to tendon degeneration and increased susceptibility to tearing.

Symptoms of Patellar Tendon Tear

Patellar tendon tears typically present with the following:

  • Acute Pain: Sudden onset of pain in the knee, often described as sharp or stabbing.
  • Swelling and Bruising: Localized swelling around the patellar region and potential bruising.
  • Functional Impairment: Difficulty in extending the knee, bearing weight, or performing physical activities.
  • Palpable Defect: In complete tears, a palpable gap may be noted in the tendon.

Diagnosis of Patellar Tendon Tear  

Diagnosis of patellar tendon tear involves a comprehensive evaluation done by your healthcare provider, including:

Clinical Examination: This involves assessing the range of motion, strength, and stability of the knee.

Imaging Studies:

  • X-rays: This is to rule out associated fractures.
  • MRI: This is for visualizing soft tissue injuries, which allows for assessment of the extent of the tear and associated conditions.

Management of Patellar Tendon Tear  

The management of a patellar tendon tear depends on the severity of the injury and your activity level:

Conservative Treatment:

  • Avoiding activities that exacerbate your symptoms and rest.
  • Physical therapy such as strengthening exercises and rehabilitation to restore your knee function.
  • The use of a knee brace to support the joint.

Surgical Intervention: This is indicated in cases of complete tears or when conservative treatment fails. The torn tendon is reattached to the patella using sutures. In some cases, small holes are drilled into the kneecap to anchor the sutures securely.

Rehabilitation: This involves: 

  • Early range of motion exercises to prevent stiffness.
  • Strengthening exercises focusing on the quadriceps and surrounding musculature.
  • A gradual return to activity can be tailored based on individual recovery and functional assessment.

Prognosis of Patellar Tendon Tear  

The prognosis for a patellar tendon tear varies based on the type of tear and the treatment approach. With appropriate management, you can expect a return to your previous level of activity, although complete recovery may take several months.

  • Southern Orthopaedic Association
  • The Steadman Clinic
  • American Academy of Orthopaedic Surgeons
  • UNC School of Medicine
  • Gold Foundation
  • UVA Health