Patella Tendon Rupture

Patellar tendon
The patellar tendon attaches to the bottom of the patella and the top of the tibia (white arrow) and helps to extend the knee.
A patella tendon rupture is a painful and serious injury in sports. It is the tendon that extends from the bottom of the patella to the top of the tibia, and along with the quadriceps muscle, the quadriceps tendon, and the patella (kneecap), it serves to extend the knee.

A traumatic injury is almost always required to tear the patella tendon. This is not an injury that occurs over time. There has been speculation that people with long-standing patella tendinitis or have been taking a certain class of antibiotic might be more likely to suffer a patella tendon rupture, but almost always this is an acute event. There are many ways an athlete can tear his patella tendon, such as landing awkwardly from a jump.

The athlete will know immediately that a serious injury has occurred. He or she will be in a tremendous amount of pain, and he or she will usually be unable to walk or even extend than knee. An athletic trainer or physician on site can usually diagnose the injury by feeling a defect where the patella tendon should be. Often the kneecap will pull back higher than it normally sits due to the disruption of the tendon that links it to the top of the tibia. The knee will be very swollen, and the athlete will have significant pain at the location of the injury. X-rays are usually normal. Although the diagnosis is fairly straightforward just by history and physical examination, sometimes a physician will order an MRI in high-level athletes to confirm the diagnosis as well as rule out any other injuries that occurred at the same time.

Surgery is almost always required for this injury. The tendon does not typically heal on its own. It is an outpatient procedure in which an incision is made over the torn tendon to expose the tear. Stitches are placed in the tendon, and the stitches are passed through drill holes in the patella to anchor the tendon to the patella. The knee will then be placed in some sort of immobilization, such as a cast or a knee brace that holds the knee straight. Keeping the knee straight for a certain amount of time prevents stress on the repair of the tendon while it heals. Over the next few weeks, knee motion is started slowly while still trying to protect the healing tendon. When full motion is restored, more active strengthening of the muscles around the knee is started. Running and then sport-specific drills follow. The entire surgery and rehabilitation process can take 3 to 6 months, so this is almost always an injury that ends the athlete’s season.

30 Responses to Patella Tendon Rupture

  1. I am not an athlete but ruptured my patella tendon when walking my puppy and she wrapped her leash around my legs. I am 67 years old and hope this can be fixed. I have a leg brace and crutches. I see a ortho surgeon 7/2. Reading the information you provide answered a lot of my questions. Thank you.

  2. Hi. Thanks for an informative and to the point article. An MRI confirmed a patella partial tear 6 months ago after falling onto a sharp rock. I am 42 yr old Scotsman living in Thailand. The doctor thought recommended letting it heal on it’s own but after some improvement I still have pain/tightness when walking(especially stairs). Do you think I should request surgery or wait longer? Very grateful for any comment. Regards. Jody Stoddart.

      • Hi. Thankyou for replying. I appreciate it. Sorry, one more question. You said patella tendons typically don’t heal on their own. Mine seems to be detached from the knee in the centre. Is there any chance at all it could repair itself? Thanks again!

      • Hello doc… I’ve got a question… can someone come back to high-level sports after partial patellar tear? Probably will require surgery since it’s healed badly on its own… Jumping lifting weights and dunking etc is what I mean when I say high level sports…

  3. Hi! I ruptured my patellar tendon after i played for several months with a tendinitis. Had surgery one day after the injury and my surgeon insisted that i don t do any kind of therapy until 4 weeks later. The surgery has been 3 weeks ago, and after reading a lol of opinions i’m a little preocupied that dont doing anything but some movement with my foot will cause stifness. Is that something that i should be worried about?

    • We tend to limit motion for a few weeks to protect the repair, and it can vary depending on the specifics of that patient’s surgery. We start range of motion then to restore full motion to the knee.

  4. hi. i ruptured my patella tendon from a motorcycle accident. i had 2 surgerys. the first one was debridement and the second was redebridement. my doctor said that i have a complete tear to my patella tendon and scheduled me for the reconstruction.Is LCL heal on its own?, because i have also LCL injury and its not completely torn. thank you doc.

  5. Hello, I recently tore my tendon just a little over a month ago. I have had surgery on it and had my leg in a cast for two weeks, I am now in a immobilizer, where my knee will basically fully extenede for another two weeks. Is this a normal part of the rehab process? I know therapy can be painful, and I just wanted to know when therapy normally starts, and when I should begin bending my knee at least 30-60 degrees?

    • Generally orthopaedic surgeons often set motion restrictions based on tension on the repair during surgery, and it can be different for different patients.

  6. Hello, interesting article – I was diagnosed with patella tendonitis at Christmas and was been referred to ultrasound, I had this done yesterday and the clinician noted a small 3mm gap in the medial side of the patella tendon. I had achy pain for 6 months until I started a specific strengthening program which I devised with a therapist. I’ve had no pain in the tendon for over 2 weeks but now I’ve seen the ultrasound I am very concerned about doing anything. I’ve now been referred again for physio but I’m concerned I’m at degenerative tendonopathy stage? I’d appreciate any advice or help thanks

  7. Hello Dr G, I had total patellar tear repair 4 weeks ago. Cast for 2 weeks and now brace locked at 0 for 2 weeks. The repair was done down at the tibia using a screw. When does the passive bending rehab usually start, ballpark. Just to have an idea. I know it is up to my surgeon but I was just wondering what the average is. Thank you! Scott

  8. Hello,

    I ruptured mine yesterday and was told I will get an orthopedic appointment in 7-10 days. Isn’t that a long time to wait for surgery? When will I start having concerns about scarring? Should I call back and start pleading for a sooner appointment at an orthopedist?

  9. Hi again, It’s 6 weeks now since my patellar tendon surgery. My surgeon, all he said to me after he had me lift my leg is to throw away the brace and go to physio. That is it. Where I live physio is booked up. So I’m on my own. Do you have any rehab advise for me. I live in Northern Canada.

    • Theres plenty of info on YouTube that may be able to help you with some sort of PT. I tore my patella tendon 2.5 weeks ago and I’ve been doing A LOT of research and watching of videos and rehabbing. Sorry that’s all I can help with. Good luck to you and your bounce back to two healthy legs.

  10. Hi. I had a full tendon rupture 13 months ago. I am 35 years old. I have done over a year of physical therapy, but still struggle with going up-and-down stairs, primarily down. I had a second opinion from an orthopedic surgeon, and he said the repair looked good. Will I ever be able to run hard or play any kind of moderate sport ever again? I feel like I am going to be hobbled forever.

    • Hello I too am 35 and I just had my surgery 3 weeks ago and I’m still in so much pain and they already have me going to physical therapy but I’m getting nowhere without them because I’m scared to bend my knee the pain is SOOOO bad please tell me what you did to bend or what you took to help with pain. I’m at the point where I rather have it numb for me to bend if that’s an option

  11. Patella tendon Lower tendon I believe it’s not all the way torn do I need surgery . If it’s not alway torn.

  12. Completlely ruptured mine Sept 6 and had surgery Oct 8 after 4 months only had about 90 range of motion . March 10 had manipulation and scope done. Now it’s May and I get to about 115 when not warmed up and 120 when warmed up I’m 35 and was very active before injury . I still can not run and I have some pain when squatting and making quick movements will be able to run again? I’m syllable goin to therapy 2 a week

  13. How did any of you get through the pain I’m am soooo weak when it comes to pain and I’m super scared to move and bend my knee and the doctor is telling me to bend now but I can’t and I’ve tried but the pain is too much I’ve also tried every pain med there is but nothing helps….can I get a shot in my knee to numb the pain so I can bend or no?

  14. Hi Doctor David,
    I am now 67 years old and, two years ago, I ruptured the patellar tendon completely at the bottom of the patella while doing competitive vertical jumping. I had always had a very good vertical leap as a younger man and wanted to see if I still could do some of those things. Anyway, the repair method was a Krakow stitch with the two vertically drilled passageways through the patellar and then tied off at the top. My rehab therapists released me as soon as I had a ROM of around 120 degrees, but I think he envisioned me just going for walks for activity. I have always been a very active person and am pretty fit for my age. I have now gone back to vertical jumping with a leap of around 20 inches (I’m 5’8″ at about 175 lbs. I have rehab’d myself using rehab programs from orthopedic surgeon sites that were prescribed for this particular injury. My question is … While I know that serious weight lifting (i.e. squats at 200 lbs) are probably forbidden, and I can easily do 50 parallel squats using bodyweight only, is it okay for me to start adding some weight to my squats … maybe one third of what I had done prior to injury? Currently I can run and jump well but just wanted to make my knee-related muscle groups and thighs stronger. Thanks so much for any help you can give me.

    William Apple

    • Generally patients are allowed to do all of the activities they want to do assuming the knee has full motion and strength to support it.

  15. Am curious what your suggested method of repair would be for avulsion after TKR? Initial repair has been done through original incision, sitch repair with wire thriugh tibia and patella for reinforcement. At 18 days follow up, wire has broken and patella has floated upward. Would you suggest autograft, allograft (cadaver), or something entirely different? Patient is non athletic, 66yrs. Previous surgery includes bone spur removal during achilles repair and aforementioned TKR. Not looking for a consult/diagnosis/treatment plan as much as I am looking for a direction for successful repair. Something to put further research into.

  16. I had Bi-lateral knee replacement in January this year. Third day in rehab at the hospital, I was asked to stand up while sitting on a very low chair without support handles. The pressure while trying to stand up snapped my right knee petella tendon. Prior to TKR, I did have cortisone shots in both knees for a few years which may have weakened that tendon. The first surgical repair (while still healing from knee replacement) on the tendon went well; however wire was used to support the tendon while healing….after a few months, the wire broke and I had to have another patellar tendon surgery using mesh tape (July 1). It has been three months since that 2nd surgery and I still have a lot of weakness. I use to be a ballroom dancer and very active, am a 60 year old female and am curious if there is a possibility I’ll get the use of my right leg back? I’m very disappointed as I cannot straighten the knee but am trying to be positive after going through so much leg trauma. Thank you.

  17. Ruptured my patellar tendon in mid-August and now that I’m at 16 weeks post-surgery I have only reached 60 degrees of bend. I’m working hard at this but only 2 degrees gained over the last 2 weeks. I believe that I should be at full extension by now and working on some sport-specific strengthening, but my joint stiffness has my physio stumped. Any websites or resources where I can learn more about what I can do to overcome this? I do not want to be put under to have my knee “snapped” and will only consider that as a last resort. Thanks in advance.

  18. I tore and ruptured my patellar tendon in Sept of 2016. I had surgery in Dec of 2016. I have started physical therapy and been so since Jan 2017. I am starting the feel the same pains I felt when I first injured it and also after the 2nd week after the surgery. Is that normal?

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