The patellar tendon is a tendon that extends down from the quadriceps muscle in the thigh, and attaches the patella (or kneecap) to the tibia (shinbone). This tendon is also a ligament, as it attaches bone to bone, and not just muscle to bone. Its main purpose is to stabilize the patella, to provide an extension of the knee joint, and is essential for walking. Patella tendon tears can happen through a number of incidents, including general degeneration of the tendon and rupture due to falling or injury. You will need crutches to walk if you’ve injured your patellar tendon, as well as a knee brace, and likely surgery.
Types of patellar tears
A partial tear is similar to a rope stretched so far that some of it is worn out, but the rope still remains in one piece. It is not quite as severe as a complete tear, which is when the tendon tears clear away from the kneecap. This prevents straightening of the knee and walking. Tears can also occur due to conditions such as tendonitis.
Symptoms of patellar tears
There is usually a popping or tearing sensation when you tear your patellar ligament, followed by pain, swelling and tenderness. Additional symptoms include bruising, cramping, instability of the kneecap, and an inability to straighten your leg or put pressure on it.
Causes of patellar tears
- Injury – It takes a lot of force to tear the patellar tendon. If it occurs due to injury, it is likely due to a strong impact to the knee, a fall, or even a cut. Jumping, or landing from a jump, can also cause patellar tears.
- Weak Tendon – A weak tendon is more likely to tear. Tendonitis, which is an inflammatory condition, can cause small tears and weakness. This condition associated with patellar tears is commonly found in athletes that do a lot of running and jumping, such as volleyball, basketball and certain track and field activities. Further, people who get steroid injections in the knee area, or who take oral steroids, have been known to sometimes have tendon weakness, which can contribute to tendon rupture.
- Chronic Disease – If you have a chronic condition that disrupts blood supply to an area of the body, it can result in weakened tendons. Ailments like rheumatoid arthritis, diabetes, lupus and kidney failure can contribute to this.
- Previous Surgeries – Any previous operations in the knee area, including tendons or ligaments, can contribute to weakness and predisposition to rupture.
What to do if you experience a patellar rupture
The first thing you should do is put ice on the injury and contact your doctor. It has been found that patellar tears usually require surgery, but in the case of a partial tear, a cast or brace to immobilize the knee, as well as physiotherapy, may help the injury.The doctor will likely do an X-ray or MRI top determine the extent of the injury.
Complete tears of the patellar tendon will almost always require surgery, as a torn tendon will not likely repair itself. In general, surgical repair involves stitching the torn tendon back together, and re-attaching through bone tunnels that have been placed within the patella.
Recently, a new technique for repairing patellar tendons was developed, involving anchors in the kneecap instead of drill holes. The surgeon uses the anchors to suture the tendon to the kneecap. Since this is still a new technique, research is still investigating its effectiveness. General anaesthetic is typically used when repairing a patellar tendon rupture.
Complications and Recovery
The most common side effect of the patellar surgery include weakness, pain, and immobility. Other side effects, although unlikely, include infection, blood clots, anaesthetic complications or re-tearing of the tendon. Directly after your surgery, you will require ice and pain relief in the form of ibuprofen or other pain medications. Approximately 2 weeks after your surgery, you will have your sutures removed. It will still be several weeks before you can put any weight on your repaired leg – usually around 4 to 6 weeks before it can bear your entire body’s weight. You also will be required to wear a brace, as well as participate in physical therapy to help with healing and range of motion. Complete recovery can take up to 6 months or more. It all depends on the severity of your injury, the responsiveness to the surgery, and your commitment to take care of yourself post-operation.