Patellar Tendon Tears

A tear can occur at any age; however, it is most common in males that are less than 40 years old who participate in running and/or jumping sports such as basketball and volleyball.  These injuries can also frequently occur in the setting of a trauma, such as a fall or accident.  Patellar tendon injuries occur on a spectrum.

• Patellar Tendonitis: This involves inflammation of the tendon, and possibly small micro tears. The actual structural integrity of the tendon remains intact. This may cause pain with going up and down stairs, walking long distances, and running. This is always treated nonoperatively initially, and almost always can be resolved without surgical intervention.
• Partial Tears: Partial tears typically occur from the same mechanism as complete tears, but only involve some of the tendon fibers. This can result in pain, instability, and weakness, with difficulty extending your knee. Treatment for these injuries is very patient and tear specific. Tears that include >50% of the tendon are more seriously considered for surgery in certain patients, though in-general, these tears are treated nonoperatively.
• Complete Tears: A complete tear is either completely detached from the born (more common) or where the tendon itself ruptures into two torn pieces. This injury results in an inability to extend your knee. This leads to difficulty walking and going up and down stairs. Complete quadriceps tendon tears almost always require surgical repair to restore function and reduce pain.

• Immediate, severe pain: A sharp pain below the kneecap at the time of injury.
• Swelling and bruising: Rapid swelling in the knee area, often accompanied by bruising.
• A popping sensation: Many patients report hearing or feeling a popping sensation when the tendon tears.
• Difficulty in knee extension: Difficulty or inability to straighten the knee, which is a key indicator of a severe tear.
• Indentation at the site of the tear: In the case of a complete tear, there may be a noticeable gap where the tendon has ruptured.

Dr. Kaplan will take a detailed history of the injury, your symptoms and evaluate your risk factors. He will perform an orthopedic examination of the affected knee checking for swelling and palpating for gaps in the tendon and use certain tests to evaluate the function of the tendon. X-rays will be ordered to reveal fractures and other knee injuries. An MRI will be necessary to determine the type and extent of the rupture.

A torn patellar tendon severely limits function. Prompt diagnosis and surgical repair are critical to restore function for walking. Acute tears may be able to be surgically repaired, while chronic tears typically require tendon reconstruction.

The length of recovery depends on the type of surgery performed. Recovery can take up to six months. Rehabilitation after surgery typically involves a period of immobilization followed by physical therapy to restore strength and range of motion in the knee.