Tendons act as a link between muscles and joint-forming bones. They create the connection to transfer the tensile effect of the muscles to the skeletal system.
This makes movement possible and allows you to lift an arm or stretch a leg, for example. Injuries to the tendon apparatus therefore usually cause restricted movement and pain.
The patellar tendon connects the lower kneecap to the lower leg. Together with the so-called quadriceps tendon, the knee joint can be extended . If the patellar tendon is injured or ruptured, extension of the knee joint is no longer possible.
The patellar tendon is a ligament that connects the lower tip of the kneecap to the tibia @ designua /AdobeStock
A patellar tendon rupture occurs when the tendon is overstretched . This often occurs during sport, which is why a patellar tendon rupture is also considered a classic sports injury.
Men between the ages of 20 and 50 in particular suffer patellar tendon ruptures. In many cases, the patellar tendon is already damaged, which increases the risk of a partial tendon rupture or a patellar tendon rupture.
A patellar tendon rupture rarely occurs spontaneously. One of the following causes can usually be found:
A patellar tendon rupture is associated with local or radiating pain in the area of the knee. At the same time, there is usually a loss of strength in the joint. It is no longer possible to stretch the knee joint.
Bruising (hematoma) and swelling can also occur in the knee joint. The kneecap (patella) can often be displaced as there is no connection with the patellar tendon on the lower leg. A visit to the doctor is then advisable.
Specialists have various diagnostic procedures at their disposal for the diagnosis of "patellar tendon rupture". In the case of a patellar tendon rupture, the clinical picture alone can confirm the diagnosis. This includes corresponding findings such as patellar displacement.
The doctor can then confirm the suspected tendon rupture on an X-ray: A patellar elevation is usually noticeable here, as the intact quadriceps tendon pulls the patella, which is now free at the bottom, upwards with it.
The patellar tendon specialist can use ultrasound to determine whether it is a partial patellar tendon tear or a continuous patellar tendon rupture.
With the help of magnetic resonance imaging (MRI), the doctor can check for further damage around the knee joint. He examines whether there is an accompanying joint effusion.
If the patellar tendon is torn, the knee is very swollen and painful; if only part of the tendon is torn, the symptoms are less severe @ PixelGallery /AdobeStock
Treatment of the patellar tendon can be conservative or surgical, depending on its severity.
Conservative treatments for a patellar tendon rupture are
- Physiotherapy
- Immobilization for 6 to 8 weeks
- Pain medication
However, conservative treatment is only an option for a partial tear of the patellar tendon. If there is a complete patellar tendon tear, surgery is unavoidable.
During patellar tendon surgery, the specialist reconnects the ends of the torn tendon. Doctors refer to this as a tendon suture.
Wire cerclage according to McLaughlin is used to support the procedure. The additional connection relieves the tendon and enables healing and early rehabilitation with the help of physiotherapy.
After accidents, the knee joint and parts of the bone at the tendon insertion can also be injured. In such cases, the doctor can additionally stabilize the tendon with a screw or tension-belt osteosynthesis. These are screws in the area of the knee joint that stabilize the knee and relieve the tendon.
In most cases, a torn patellar tendon can be treated well. The function of the tendon is usually fully restored after the operation.
Early intervention and physiotherapy or adequate training after the operation are important. It is usually possible to be fully fit for sport with a corresponding recovery period after a few months to a year.
After conservative treatment for a partial tear, however, you must expect a permanent loss of strength in the knee joint. A repeated patellar tendon rupture is also possible.
As with any operation, complications can also occur in rare cases with a patellar tendon tear:
- Bleeding
- infections
- Wound healing disorders: Are particularly common after accidents with simultaneous injury to the bones and articular cartilage.
In addition, adhesions of the tendon and tendon shortening can occur during the healing process. Both can restrict freedom of movement in the knee joint .
Patellar tendon ruptures are classed as sports injuries. The following areas are therefore responsible:
It is important that you go to a specialized center for treatment. The doctor's surgical experience is also an important factor in the outcome of treatment for a patellar tendon rupture. Patellar tendon rupture specialists are sports physicians, orthopaedists and trauma surgeons.
