Follow-up treatment and prognosis
After every surgical treatment of a patellar tendon rupture, it is necessary to immobilize the knee joint. Tendon tissue is not well supplied with blood, which makes a long healing phase necessary. Immobilization can be achieved, for example, with the help of an extension orthosis or a thigh tutor splint.
An extensor orthosis is a splint made of aluminum, which is usually padded and keeps the knee stable and fixes it at a preset knee flexion angle. A thigh tutor splint also serves to immobilize the knee joint by applying a plaster cast from the ankle to the groin at a certain knee flexion angle. With the stretching orthosis applied, the leg can be fully loaded again immediately after the operation, but only a knee flexion of up to 30 degrees is recommended for the first two weeks after the operation.
The angle is then increased to 60 and 90 degrees for two weeks at a time.From about the seventh postoperative week, knee training can also be done without splinting. Early post-operative treatment, during which the function of the knee joint can be restored, is made more difficult by immobilization. Nevertheless, mobilization and strength exercises should be performed early on to avoid complications.
Immobilization also increases the risk of thrombosis or embolism, and muscle loss (atrophy) of the quadriceps muscle and soft tissue damage from the splint may be observed. In this case, intensive physiotherapy in particular serves to prevent thigh muscle atrophy and to maintain the mobility of the knee joint. Often there is a limitation of knee extension, which can usually be remedied by active physiotherapy exercises.
For a favorable prognosis, consistent therapy and follow-up treatment of the patellar tendon rupture is necessary. In most cases, however, the function of the extensor apparatus can be completely restored. Early full loading of the knee can have an unfavorable effect on the healing process, which can cause the cerclage wire to break off.
A wound infection after the operation can also prolong the healing process. Particularly in the case of degenerately damaged patella tendons, renewed ruptures of the tendon may occur. If the patellar tendon rupture heals without complications, active sports can be practiced later without problems.
