Patella Tendon Injuries Specialist

Description 

Patellar tendon injuries can cover a large number of issues from tendonitis to tears.

The patellar tendon is often injured at the place where it attaches to the kneecap, and has direct pain at this point

Cause

A weakened patellar tendon is more likely to injure. Several things can lead to tendon weakness.

• Falls - Direct impact to the front of the knee from a fall or other blow is a common cause of tears.
• Jumping - The patellar tendon usually tears when the knee is bent and the foot planted, like when landing from a jump or jumping up.
• Patellar tendinitis - Inflammation of the patellar tendon weakens the tendon and causes pain. This condition is most common in people who participate in activities that require running or jumping. It is sometimes referred to as "jumper's knee."
• Previous Treatments - Including prior surgery or Corticosteroid injections have been linked to increased tendon weakness and increased likelihood of injury.
• Certain Chronic Disease or Medications - Can disrupt blood supply or weaken the tendon. Issues such as Lupus, Diabetes, infection or the use of a certain class of antibiotic can increase the chance of patellar tendon injury

Anatomy

 

Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). The patella lies in front of your knee and assists in bending of your knee.

A tendon is connective tissue that connects a muscle to a bone, and the patellar tendon connects the patella to the tibia on the tibial tuberosity.  Above the patella, the quadriceps muscles attach to the patella. Working together, the quadriceps muscles, quadriceps tendon and patellar tendon straighten the knee.

Symptoms

• The main symptom of patellar tendonitis is pain and tenderness just below the kneecap.
• The pain usually starts after exercise, and continued exercise will likely increase the discomfort. Jumping, running, and landing are likely to make the pain worse.
• You may begin to notice weakness in the knee, particularly during exercises that put pressure on this part of the body.
• When the leg is straight, the area below the knee may feel tender to the touch. The area around the knee can also feel tight or stiff, particularly in the morning.
• A tear of the patella tendon is a serious injury, and may separate the tendon from the kneecap. A person may hear a tearing or popping sound, and will feel significant pain. Walking may be difficult and a person may be unable to straighten the leg.

Physical Examination

During your first visit, be prepared to explain how you hurt your knee and how it feels since the injury.  The more you can explain to your provider, the more they can understand your symptoms and medical history.

At your visit, your provider will perform a physical exam and evaluate all the structures of your knee.  You will receive an x ray to determine if there are any fractures present.  X ray can assist with evaluating the bone structures and assist with determining the cause of the patellar tendon issues.

Many patella tendon injuries can be diagnosed with a thorough physical examination of the knee, but other tests, such as a Magnetic Resonance Imaging (MRI) scan may be ordered. The MRI creates better images of soft tissues like the tendons.  These images allow the physician to determine if this injury requires non-surgical or surgical treatment.

Treatment

Treatment for Patella tendon injury is most often Non-Surgical first.  After exhaustive non-surgical treatment, surgery may be needed to correct the problem.

If the tendon has been torn off the attachment, the first step is to surgically attach the tendon to its proper place.

Non-Surgical Treatment

Initially, the standard treatment is the RICE protocol.  This stands for:

• Rest. Take a break from the activity that caused the injury. You may need to use crutches to avoid putting weight on your leg.
• Ice. Use cold packs for 20 - 30 minutes at a time, several times a day.
• Compression. To prevent additional swelling apply an elastic compression bandage.
• Elevation. Lift your leg up higher than your heart.

In addition to the RICE protocol, there are many types of non-surgical treatment options for Patellar tendon injuries and all have their advantages and disadvantages.  Your Orthopedic Specialist can review these options and assist you in determining which will be most effective in treating your injury:

• Non-steroidal anti-inflammatory medicines
• Physical Therapy
• Bracing
• Taping
• Orthotics
• PRP (Plasma Rich Protein) injections
• Stem Cell Therapy

Surgical Treatment

If the symptoms persist after exhaustive non-surgical treatment, you may need surgical treatment to correct the Patellar tendon injury.  There are many possible procedures to correct this issue, the best option is dependent upon the cause to the patella tendon injury.  The Orthopedic Surgeon may clean the tendon area, or they may correct bone abnormalities.  All the options will be discussed if non-surgical treatment does not rectify the Patellar tendon injury.  

Rehabilitation

The first line of treatment is always rehabilitation.  A physical therapy program will guide you in regaining knee strength and function.  This may occur in conjunction with bracing or taping.  Your rehabilitation specialist will assist in the decision-making process for the best options.