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Patellar Tendon Rupture Surgery and Rehabilitation

Rupture, Tendons

This article is intended to inform you or someone you know with the healing process of a patellar tendon rupture. The information provided is written from knowledge acquired from my own recovery from a bi-lateral (both knees) patellar tendon rupture.

A patellar tendon rupture is; a full tear of the tendon that holds your knee cap in place. The patellar tendon’s connects the two leg bones together. Its primary purpose is to hold your thigh bone (Femur,) to your shin bone (tibia.) Without the patellar tendon, activities such as kicking a ball, walking, or extending your leg would not be possible. Ruptures of the patellar tendon are a rare occurrence. This article will cover how a tendon can rupture, the surgery process to repair a rupture, post operation rehabilitation, and pain management.

The patellar tendon can rupture from complications from knee surgery, but generally a patellar tendon can rupture with prolonged strain of the tendon. A strain happens usually with athletes who over use their legs. A sharp pain in the tendon (tendonitis) is a sign that rest is required. Small tears in the tendon occur when this happens, and will cause scar tissue to develop. Without proper rest, this leaves the knee vulnerable to rupture. A rupture also can happen with blunt force to the knee, and over stretching of the leg causing the tendon to snap.

There is generally no other options for repair except surgery. If left untreated for a prolonged period of time; the odds of full recovery are lessoned. It’s advised to repair the ruptured tendon immediately to avoid being severely disabled. An Orthopedic surgeon will need to sew the tendon back together, and re-attach it to the patellar (knee cap.) This is done by drilling two small holes into the knee cap. (Please reference photos.) The repair can consist of sutras for partial ruptures, and nylon wire repairs for full ruptures. The Orthopedic surgeon will place the patellar into what he/she deems to be the original position. This sometimes will cause the patellar to sit lower or higher after recovery, but that is beyond the scope of this article. Let’s hope your knee cap is placed back to its original position.

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Post-operation is generally the most difficult part of the recovery (6-12months or more). You will not be able to start bending your knee(s) for a minimum of 5-6 weeks. You will be required to wear a knee immobilizer to keep your knees from bending. Generally the surgical incision will be closed with staples. After the first 10 days you’re required to remove the staples. Doctor’s will generally prescribe Vicodin for your pain. You can also use ibuprofen (Motrin, Advil, etc.) Bearing full weight on your legs with this type of injury is possible after a week or two with absolutely no bending of the knees.

Depending on your doctor, you can start the grueling process of physical therapy after 5 weeks. Starting in 5 weeks is generally a more aggressive approach. Either way, there will be a tremendous amount of pain involved during your recovery period. A licensed physical therapist will assist you with starting range of motion and strengthening exercises. The rehabilitation process is very long, so be patient. Being overly aggressive in your rehab will cause tendonitis in your knees.

The key recovery is to endure the pain, but not so much that it’s unbearable. Slowly you will regain your ability to bend your knees; generally 130-140 degrees range of motion is good. At this point your legs would have lost a tremendous amount of strength and muscle. The main purposes of rehab are to restore knee range and strength in the quadriceps, hamstrings, and all of your muscles in your legs. I would suggest you to stop using your immobilizers / splits after 6 weeks; at least while at home.

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There will be lots of complications in between; pain, swelling, soreness, muscle spasms, etc. Here are some tips on managing your pain. The best thing you should do is Rest, Ice, Compress, and Elevate (RICE). Cold packs can help suppress the swelling; heat packs will increase blood flow. Generally during the early stages of rehab, you will require ice. Bear in mind that if you have any pains in your muscles; especially the calf muscle after operation, visit your doctor immediately. There are chances of blood clots; especially after orthopedic surgery. Blood clots can kill you. You will need the support of your family and friends, and it will be frustrating at times. Just don’t give up!

I would love to hear from you, and share ideas about your recovery.