Patellar Tendon Tear

Introduction

The Patellar Tendon connects your kneecap to your leg. An athlete can tear his or her tendon playing sports that require jumping or running, or because of certain other medical conditions, such as tendonitis. While smaller tears may heal themselves, without surgical treatment, most patellar tears do require surgery.

Knee Anatomy

Bones in the Knee

The knee is one of the more structurally complex areas of the body. The knee is composed of three bones:

  • The Tibia, or shinbone
  • The Femur, or thighbone, sits on top of the tibia, the larger leg bone.
  • The Patella, or kneecap, glides in a groove on the end of the femur.

Muscles in the Thigh

Large muscle groupings in the thigh give the knee its strength and stability:

  • The quadriceps muscles-group of muscles on the front of the thigh that straighten and rotate the leg.
  • The hamstring muscles- located on the back of the thigh and bend or flex the knee.

Ligaments Surrounding the Knee

Ligaments are strong tissues that provide stability and allow the leg to move. They also enable flexibility while maintaining balance. Four ligaments connect our knee bones together:

  • The medial collateral is located on the inside of the knee, and the lateral collateral is at the outer side of the knee. These two ligaments help the joint to resist side to side stress.
  • The anterior cruciate ligament and the posterior cruciate ligament cross each other inside of the knee joint. These ligaments help to keep the joint aligned. They also counteract forward and backward forces and keep the bones in place. They also control rotation of the tibia.

Cartilage, Synovium, and Nerve Fibers

Two cartilage disks, Menisci, are located on the end of the tibia. This cartilage forms a smooth surface, allowing the bones to glide easily during motion. The menisci act as shock absorbers when we walk or run.

A smooth tissue capsule covers the bones in our knee, and a thin synovial membrane lines this capsule. The synovium secretes a liquid known as synovial fluid. The synovial fluid acts as a cushion and lubricant between the joints, which allows the knee to move painlessly. Proprioceptive nerve fibers are inside in the ligaments and joint capsules, sending signals throughout the body.

Patellar Tendon Tear Causes

An individual can either tear his or her patellar tendon completely or partially.

Typically, the complete patellar tendon tears detach at the kneecap.  Such injuries occur from a strong impact to the knee or during sports that require running or jumping.

Partial tendon tears are usually a side effect of patellar tendonitis, chronic disease, or even steroid use. This is because weak and inflamed tendons are more likely to tear.

Patellar Tendon Tear Symptoms

Patients often complain of a “popping” sensation when they have a patellar tendon tear. Pain and swelling in the knee usually follow these tears. You may notice your kneecap looking unusual or higher than normal. Other symptoms of a patellar tendon tear include:

  • Bruising of the Knee
  • Knee Cramps
  • Knee Buckling
  • Having Difficulty Walking
  • Inability to Straighten Your Knee

Patellar Tendon Tear  Diagnosis

Your doctor will more than likely order an X-ray to check knee alignment and evaluate arthritic changes.  In some cases, your doctor may order a CAT scan or MRI to evaluate the tracking of the patella or to better see the cartilage surfaces.

Patellar Tendon Tear Treatment

Minor tears located on the outer sections of the knee should be able to heal on their own. Most doctors tell their patients to use the RICE (rest, ice, compression, elevation) to help these times of tears. The doctor may also recommend physical therapy as it can help strengthen the muscles that move the knee joint.  Your doctor may recommend a knee brace for sports or custom shoe inserts to support the arch of the foot

Patellar Tendon Tear Surgery

Most of the individuals with a patellar tendon tear will require surgery. This surgery will require the patient to stay in the hospital overnight, even though it normally is considered an outpatient surgery. Your doctor may perform the surgery under regional anesthesia or general anesthesia.

First, your surgeon makes an incision right over the kneecap. Then, the surgeon reattached the patellar tendon to the kneecap with either sutures or hardware, depending on the location and severity of the tear.

Patellar Tendon Tear Recovery

Like most accidents and surgeries, the recovery from a patellar tendon tear varies depending on the individual and on a variety of factors, including the cause and the treatment method you receive. Your doctor will give you pain medication and recommend the RICE treatment (rest, ice, compression, elevation). Complete recovery can take around 6 to 12 months, depending on the severity of the tear.

Sports Physicians Orthopedics and Rehabilitation of Texas