The patellar tendon connects the kneecap (patella) with the leg bone (tibia) and its function, along with the quadriceps tendon, is to straighten the knee. A patellar tendon can rupture as a result of sports injuries, accidents at home or car accidents. A complete tear occurs when the patellar tendon is completely separated from the kneecap.
A patellar tendon tear can be caused by injuries at home, such as a fall from height directly onto the knee, or a jump with awkward landing. It can also be a result of a sport injury or a consequence of a road traffic accident. It is also common in patients with diseases that disrupt the blood supply, which weakens the tendon overall, predisposing it to rupture with minimal trauma. These conditions include diabetes, chronic kidney failure (especially if on dialysis), rheumatoid arthritis or lupus, etc. Steroid use can also lead to tendon weakness.
Patients commonly experience a sensation of tearing or popping during the rupture, followed by swelling and bruising, as well as inability to weight bear. A palpable gap can often be felt just below the kneecap.
The doctor will take a thorough history and perform a careful physical exam. An x-ray may show a patella alta, meaning that your kneecap is in a higher position than usual. Ultrasound or MRI are the confirmatory imaging tests of choice.
Most people with a complete tear of the patellar tendon require surgery to regain their function. Surgery is done on an outpatient basis, which means that you may go home a few hours after the procedure if you wish. Your surgeon will typically place sutures in your tendon, will pass those sutures through drill holes on top of the patella and tie them. Alternatively, your surgeon can use suture anchors instead of tunnels. Your knee will be protected for a few weeks with a knee immobilizer, with an intent to fully weight bear after 6 weeks. A rehabilitation plan will be customized for you by your doctor and physical therapist.
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