Patellar Tendon Tear/Disruption

Patellar tendon tear or disruption is a complete rupture of the patellar tendon. This structure is the tendon attachment of the quadriceps (thigh) muscles to the leg. The quadriceps muscles becomes a tendon above the kneecap (patella), and the tendon attaches into the patella; then another tendon goes from the patella to the tibial tubercle (the bump on the upper part of the lower leg). There is loss of continuity between the quadriceps muscles and the leg bone and thus loss of function of the quadriceps muscles when trying to straighten the knee. The function of the quadriceps muscles is to forcefully straighten the knee or slow the knee during bending or squatting. There is pressure on the patellar tendon with quadriceps contraction and with the knee bent.

Initial treatment consists of not walking on the affected leg, icing the area, applying a compressive elastic bandage, and elevating the injured leg to eye level. Definitive treatment requires surgery to repair the tendon. Quadriceps muscle contraction prevents the tendon ends from healing to each other without surgery. Thus, there is no role for nonsurgical treatment. Surgical treatment usually involves sewing the ends of the tendon back together, followed by immobilization in a long leg cast or brace for varying periods. After surgery and immobilization, physical therapy is usually needed to regain knee motion and strength.

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