Patellar tendon tear


Patellar tendon tear or rupture of the kneecap ligament

A patellar tendon tear or rupture of the kneecap ligament is extremely rare, because tendons are very robust, especially the patellar ligament (patellar tendon), which can withstand a tension that is 6 to 7 times greater than the body weight.

Much more often the Achilles tendon, which connects the calf at the back with the heel, ruptures; this fibrous strand is narrower and longer than the patellar tendon.
The kneecap ligament can rupture as a result of a tendon disease, such as chronic tendinitis or a tear.

With a slow degeneration of the kneecap ligament, it can happen that it then tears even with slight overstretching; older people are particularly at risk here because the tendon ages over the years and the fibers change their structure, are discontinuous and no longer parallel.
Anatomical deformities or axis malpositions, such as X-legs or a different leg length (heterometry), can lead to incorrect tendon work and thus promote inflammation.
Athletes may suffer this injury as a result of functional overload due to repeated jumping, shooting, frequent changes of direction and abrupt deceleration; football players are affected (known is the case of the exceptional footballer Ronaldo Fenômeno), weightlifters, handball, basketball, volleyball players, etc.

What is the kneecap ligament?

The kneecap ligament, also called patellar tendon, is located in the knee joint and connects the kneecap and quadriceps tendon to the shin.
Tendons are structures of fibrous connective tissue that originate from the muscle, attach to the bone and thus represent the connecting element of these two units.
The patellar tendon is an abnormal tendon because it resembles more of a ligament: a fiber cord that connects two bones, the kneecap and shin.
Actually, the patellar tendon is the continuation of the quadriceps tendon; their task is to transfer muscle power to the shin and extend the knee joint.
Due to its size and resistance, it is used to reconstruct the anterior cruciate ligament; the middle third is removed and attached instead of the cruciate ligament.

What are the symptoms of a torn kneecap ligament?

A patellar tendon rupture causes very severe pain, the knee joint can no longer be bent or stretched.
The kneecap is shifted upwards by the quadriceps because it is no longer anchored to the shin.
The knee is swollen, reddened and overheated.

How is the diagnosis made in case of a rupture of the kneecap ligament?

The doctor first informs himself about the accident and the patient’s medical history; he assesses the extent and exact location of the injury, as well as the movements that lead to an aggravation of the pain.
A typical rupture sign is the impossibility of stretching the knee, because the quadriceps cannot exert its stretching effect because the tendon no longer connects it to the shin.
Ultrasound and magnetic resonance imaging are suitable imaging diagnostic methods for assessing the extent of injury because they show the muscle-tendon tissue, while an X-ray image only shows the bones.

What therapy is used for patellar tendon rupture?

In the case of a partial rupture, i.e. a torn tendon, physiotherapy, protection and water aerobics are recommended.
Physical therapies such as Tecar® and laser therapy help against pain and swelling.
One can live with a slight injury to the kneecap ligament, after all, the middle third of this ligament is often used in the repair of the cruciate ligament and only two narrow, parallel, outer stripes remain.
Shoe insoles can compensate for foot rolling mistakes; they may become necessary if the tendon has been weakened by misalignments between the foot and knee.
In case of a complete rupture of the kneecap ligament, the patient must be operated on and a new tendon inserted; this can be an endogenous tendon from the leg (goosefoot tendon) or a donor tendon.

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