Patella tendon rupture

What is it?

Patella tendon rupture refers to a complete tear of the tendon which joins the kneecap (patella) to the shin bone (tibia).

How does it happen?

Complete tears of the patella tendon often occur when the thigh muscle (quadriceps) is forcibly contracted. The function of the patellar tendon is to transmit forces produced by the thigh muscle to the shin bone. Forcible contraction of this muscle can overstress the patella tendon, resulting in it breaking or completely tearing.

How does it feel?

A complete tear of the patella tendon results in instant pain felt in the front of the knee just below the kneecap. Associated with this may be a feeling of something tearing or snapping. Following a complete tear of the patella tendon, you will be unable to continue your activity or sport due to profound weakness in the thigh muscle. You may also be unable to stand on the injured leg without it collapsing or giving way.

What should you do?

A complete tear of the patellar tendon is a serious injury which requires surgical repair. Therefore, if you have or suspect you have a complete tear of the patellar tendon, it is advised you seek the assistance of a sports medicine professional as soon as possible (i.e. on the same day as the injury). In the meantime, you can commence early treatment to limit the amount of bleeding and swelling within and around the torn ends of the tendon. To control the amount of swelling the RICE regime should be commenced (Rest, Ice, Compression, Elevation). This will help to reduce blood flow to the injured area, thereby reducing the extent of swelling and tissue damage. Rest involves ceasing your activity or sport, and limiting any weight you put through your leg. Crutches will be required. Ice should be applied to the injured site for 15–20 minutes every 1–2 hours. Ideally, it should be applied using crushed ice wrapped in a moist cloth or towel. Compression involves the application of a firm elastic bandage around your knee. It should be firm but not tight enough to cause pain. Elevation involves lying with your knee resting comfortably on a chair or pillows so that it is above the level of your heart. You should continue the RICE regime until you consult a sports medicine professional, preferably on the same day as the injury.

Could there be any long-term effects?

A complete tear of the patella tendon is a serious injury which does not heal by itself without appropriate treatment. Appropriate treatment often involves surgical repair. Following surgery, the rehabilitation period is prolonged and it may be a number of months before you can walk on the injured leg. It may be a further number of months before your muscle flexibility and strength return to satisfactory levels to enable return to your activity or sport. Even then there is often some residual disability.

Management

The assistance of a sports medicine professional is important in the treatment of a complete tear of the patellar tendon. Initially, they will diagnose the problem and establish the severity of the tear. Imaging techniques such as ultrasound or MRI may be used. From this, the sports medicine professional will be able to determine an appropriate treatment plan. In the majority of cases this will involve surgical repair. Following surgery, the sports medicine professional will be able to rehabilitate your tendon so that you can return to your activity or sport. This may involve the use of soft tissue treatments such as massage and stretching, and a progressive rehabilitation program.