Patellar Tendon Tear

What is it? 

The Patellar Tendon is is the tendon that stretches between the kneecap and the front part of the tibia(shinbone). On a day to day basis, this tendon sees a lot of stress. If you land from a height or dome down suddenly on your knee, the patellar tendon can tear off its attachment on the kneecap. 

How does it get hurt/damaged?

A patellar tendon tear is a serious injury for elite athletes and can be career threatening if not treated right away. Often, when a patellar tendon tear occurs it is due to an abnormal amount of stress going through the tendon. Even though the patellar tendon goes through a lot of stress, day to day, an excess of stress like landing from a jump or large height, such as while playing basketball, can cause the tendon to rupture. 

How common is a PCL tear?

Patellar tendon tears aren’t as common as an injury like an ACL tear, only occurring about 5,000 times per year in the United States.  

When should you be worried about a Patellar Tendon tear and what to do initially?

A patellar tendon tear can cause a problem for elite athlete if not seen by a medical care provider, immediately after the injury. For the elite athlete, if not handled immediately, there will be a much more difficult road to recovery. Other patients who will experience a patellar tendon tear include include those with diabetes and kidney problems and those who take fluoroquinolone antibiotics.

Patellar tendon tears will present themselves generally as knee pain, swelling, difficulty with weight bearing, instability, and a popping sound at the time of injury. Any of these symptoms should warrant a visit to your primary care provider, when available, or a trip to the emergency room, if the pain isn’t manageable.

Severity of Injury and Treatment options?

In practice, patellar tendon injuries can be classified as acute or a chronic rupture. Patients with an acute patellar tendon rupture will have decreased ROM of the knee due to pain and a lack of ability to use the knee’s extender mechanism. There will also be a loss of knee extension ability and are usually amenable to light repair. A chronic patellar tendon tear, however, indicates that a total reconstruction is needed. Often chronic ruptures will start to present six weeks after the date of injury. In practice, doctors have seen some shredded patellar tendons that are almost impossible to repair. In these circumstances, a more extensive surgery that involves using a hamstring tendon graft through tunnels in the tibial tubercle and kneecap may be necessary, especially to get athletes back to high-level activities.