A Patellar Tendon Rupture

A patellar tendon rupture can be caused by a sudden contraction of the quadriceps against resistance.

When a strong force affects the knee, a tear can arise. This can happen when movements like jumping, falling, weight lifting, are performed. It's most common that a tear arises when the knee is bent and the foot planted on the floor, f.e. when a basketball player lands of a jump. A tear can also arises by the great impact to the front of the knee by a fall.

Nonsurgical treatment of a patellar tendon tear:
This kind of treatment takes place by patients with a small, partial tear.Immobilization is important in this treatment. Incomplete lessions are treated with a cylindrical cast in extension for 6 weeks. This will keeps your knee straight to help it heal. Crutches are used to help you in avoiding putting all of your weight on your affected knee. As heeling progresses, the amount of flexion allowed by the brace may be increased. Exercises to strengthen the quadriceps muscles can be done. In addition straight leg raises can be executed. When the brace is unlocked, the patient can exercise with a higher range of motion and more strengthening exercises will be done to restore the strength and range of motion.

Postoperative rehabilitation of a patellar tendon tear.
Classic rehabilitation involves the use of a cylinder cast for 6 weeks. The patient is allowed to bear weight as tolerated with crutches in the cast. Active flexion to 45 with passive extension may be started short after the operation, as well as isometric quadriceps and hamstring exercises. After 6 weeks the patient is converted to a control-dial hinged knee brace. The brace begins at 0 to 40 degrees and advanced to 10 degrees per week over the next 6 weeks. In this period, progressive quadriceps, hamstring strengthening and gait training are also performed. The brace is discontinued when the patient has adequate quadriceps function and 90 degrees of motion. Resistive strengthening and continued range-of-motion activities may be done after the brace is discontinued. When the patient has an adequate quadriceps control, isokinetic exercices and sport-specific functional rehabilitation may be started.

Rehabilitation should focus on regaining range of motion and quadriceps control, followed by increasing muscle mass and sport-specific functions.

It's generally accepted that the knee should be immobilized in extension postoperatively for the tendon to heal without tension on the repair. Therefore, 6 weeks of immobilization in a cylinder cast was done routinely by many surgeons with generally good results.

More and more surgeons are starting passive knee motion immediately after surgery, controlled movements early after the repair. An early range of motion would reduce the risk of stiffness and the need for secondary manipulation.

The timeline for physical therapy and also the type of exercises will be individualized to the patient. It's based on the type of tear, surgical repair, medical condition, and the specific needs of the patient.

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