The patella tendon runs from the patella (kneecap) to the tibia (lower leg bone) to provide the distal (end) attachment of the quadriceps muscle to the tibia (lower leg bone). When the patellar tendon is injured, there is loss of continuity between the quadriceps muscles (which straighten the knee) and the tibia (lower leg bone). Therefore, when someone suffers a complete rupture of the patellar tendon, they are unable to straighten their knee, or walk normally without the knee giving out. The patellar tendon is usually torn by a sudden episode of violent quadriceps muscle activity, such as with jumping, hurdling, or starting a sprint. Repairing the tendon back to the patella is necessary to allow normal gait and perform other daily activities.
The goal of the surgery is to repair the torn patellar tendon back to the patella and restore normal knee mechanics. Dr. Chudik identifies the torn end of the tendon through a limited incision just over the knee cap. Once identified, he places strong sutures through the tendon in order to grasp it and reconnect it back to the patella. He drills three small tunnels through the patella and passes the sutures through the tunnels and ties them to reconnect the torn tendon. It is important to protect the repair by keeping the knee straight locked in a brace.