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.

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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.

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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.

12 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!

  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

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