Patellar Tendon Tears Treatment Options

What are patellar tendon tears?

Patellar tendon tears are significant injuries that occur when the tendon connecting the patella (kneecap) to the tibia (shinbone) tears partially or completely. These tears often result from sudden, forceful contractions of the quadriceps muscles against a fully extended knee, commonly during activities involving jumping, landing, or direct impact to the knee. Symptoms typically include sudden, sharp pain in the front of the knee, swelling, bruising, and difficulty bearing weight on the affected leg, as well as an inability to straighten the knee or perform activities such as walking, climbing stairs, or jumping. Treatment may involve conservative measures such as rest, immobilization, and physical therapy for partial tears, while complete tears often require surgical repair to restore tendon continuity and function. Proper rehabilitation is essential to optimize outcomes and facilitate a safe return to activity following patellar tendon tears.

What are the treatment options?

The treatment of patellar tendon ruptures depends on various factors, including the severity of the injury, the patient’s age, activity level, and overall health. Conservative treatment may be considered for partial tears or low-demand individuals and typically involves rest, immobilization with a knee brace or splint, pain management with medications, and physical therapy to regain strength and range of motion. However, complete tears or tears in active individuals often require surgical intervention to restore tendon continuity and function. Surgical options for patellar tendon ruptures may include:

Primary Repair:

Primary repair involves surgically reattaching the torn ends of the patellar tendon to the patella and tibia using sutures or anchors. This procedure may be performed through an open incision or arthroscopically, depending on the extent of the tear and surgeon preference. During the repair, the tendon is carefully reapproximated and secured to the bone to facilitate healing and restore knee function.

Augmentation Techniques:

In cases of chronic or degenerative tears, where the tendon tissue may be weak or insufficient for primary repair, augmentation techniques may be used to reinforce the repair and improve tendon strength. This may involve using autograft or allograft tissue, synthetic materials, or biological adjuncts to supplement the repair and enhance tendon healing.

What does rehabilitation entail?

Rehabilitation following patellar tendon repair plays a crucial role in optimizing outcomes and restoring knee function. The rehabilitation protocol typically begins soon after surgery and focuses on protecting the repair while gradually increasing range of motion, strength, and functional activities. Early mobilization exercises such as gentle knee range of motion exercises and quadriceps sets are initiated to prevent stiffness and promote healing. As healing progresses, progressive strengthening exercises targeting the quadriceps, hamstrings, and hip muscles are introduced to improve muscle function and restore knee stability. Gradual return to weight-bearing activities, walking, and functional movements is guided by the surgeon and physical therapist based on individual recovery progress and surgical technique.

What is the prognosis?

The prognosis for patellar tendon ruptures depends on several factors, including the extent of the injury, the timing of diagnosis and treatment, the patient’s age, overall health, and compliance with rehabilitation protocols. With prompt diagnosis, appropriate treatment, and diligent rehabilitation, many patients can achieve satisfactory outcomes and return to their previous level of activity. However, delays in diagnosis or treatment, incomplete healing, or persistent weakness may lead to long-term functional limitations, recurrent symptoms, or complications such as patellar tendonitis or patellar maltracking. Close collaboration between the patient, surgeon, and physical therapist is essential throughout the treatment and rehabilitation process to optimize outcomes and facilitate a safe and successful return to activity following patellar tendon rupture.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of patellar tendon tears. If you believe you are affected by a patellar tendon tear, schedule a consultation today with our experienced orthopaedic care team.