The patellar tendon spans from the top, front of the tibia to the base of the patella. It is critical in the ability to extend the leg. When the quadriceps muscle contracts, it forces the quadriceps tendon, patella, patellar tendon, and tibia to work together to move the knee from a flexed position to an extended position. If the patellar tendon ruptures, the patella is pulled out of position by the quadriceps muscle. This not only causes intense pain but makes it impossible to extend the leg.
Patellar Tendon Injury
- severe pain
- immediate bruising
- inability to extend the leg
- inability to bear weight
- deformity in the leg
Patellar Tendon Repair / Replacement
A patellar tendon rupture must be treated surgically. The patellar tendon does not usually respond well to repair, making patellar tendon replacement surgery the best option.
A semitendinosus (posterior femoral muscle) graft is used. A hole is drilled transversely through the base of the patella. One end of the graft tissue is sutured to the patellar tendon that remains attached to the tibia. The other end of the graft tissue is then threaded through the drilled hole in the patella, looped back down, and sutured next to the other end. This pulls the patella back into position.
The main complications with this surgery are:
- the patella may fracture
- the graft may be cut too short
- the patellar tendon may pull out from its position in the tibia
The knee should be in a cast or brace for 6 weeks following reconstruction, then an additional 6 weeks in a hinged brace. Full range of motion and quadriceps strength can be regained with diligence and effort.
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