Definition
Pain in the patella tendon is an unpleasant, sometimes stabbing or pulling sensation in the area of the patella tendon. Anatomically, the patellar tendon is a rough ligamentous structure between the underside of the patella and the tibia, more precisely at the tibial tuberosity, a roughened bony process at the front of the tibia. The patellar tendon is involved in movements in the knee joint because it is part of the joint capsule. The patella tendon is particularly stressed during jerky stopping movements and/or rapid changes of direction.
Causes of pain in the patella tendon
Pain in the patella tendon can be caused by various diseases or injuries. In general, however, the patellar tendon itself, the patella or structures in the vicinity are usually affected. Specific clinical pictures worth mentioning that typically trigger pain in the patellar tendon are patellar tip syndrome, retro-patella arthrosis, a tear or partial tear of the patellar tendon and inflammation.
In addition, painful sensations in the patella tendon often occur after cruciate ligament surgery. In order to choose the right therapy in each individual case, an exact diagnosis is essential, since there are several possible causes for pain in the patellar tendon. Based on overloading the knee, chronic wear and tear of the patella tendon can occur, which is accompanied by severe pain.
This clinical picture is called patellar tip syndrome, if the pain is preferably located at the lower tip of the patella. Synonyms for patellar tip syndrome include “patellar tip syndrome”, “Jumpers knee” and “Tendinitis patallae”. The cause of the disease is excessive tensile stress on the patellar tendon.
As the synonym “jumper’s knee” already suggests, some sports are predisposed to the development of patellar tendon syndrome. These include volleyball and basketball, and in athletics long jump and high jump. Patellar tendon syndrome can, however, develop independently of the factors mentioned above due to age or other primary pathologies in the knee and patellar tendon area.
Typical symptoms are pain that occurs in a mild stage, initially under heavy strain, and at a more advanced stage already under low strain such as climbing stairs or even at rest. The pain is usually located in the lower part of the patella, i.e. at its distal pole. This is precisely where the patella tendon has its origin.
If the patellar tendon is in pain, a doctor should therefore clarify whether patellar tendon syndrome is a possible cause and then treat it accordingly. A tear of the patellar tendon as a cause of pain in the patellar tendon is rather rare, as this is a less common clinical picture or injury pattern. However, depending on the previous damage to the patellar tendon or depending on the strength of overloading and lifting effect, a tear of the tendon may occur.
The tear, known in medicine as a rupture, can manifest itself at various points. In younger age, the patella tendon tends to tear at the base of the tibia, but in older age it tends to tear at the origin, i.e. at the lower edge of the patella. In both cases, affected persons complain of sudden onset of pain, which is preferably localized in the vicinity of the patella.
In addition, movement in the knee joint is restricted to the extent that complete extension is no longer possible. In the case of a complete rupture of the tendon, a raised kneecap, i.e. the patella, can also be seen in comparison to the healthy side. Various diagnostic measures can be used to evaluate whether the patella tendon is only torn or completely torn.
The treatment then depends on this. Pain in the patella tendon is often associated with cruciate ligament surgery or cruciate ligament plastic surgery. The reason for this is the fact that part of the patellar tendon is used as a graft, i.e. as a replacement for the destroyed cruciate ligament.
The surgical procedure is performed through a small skin incision at the front of the knee near the patellar tendon. A small bone part of the kneecap and a bone block of the lower leg are then removed, since the patellar tendon is stretched between the two bony parts.This can then be used to replace the cruciate ligament after modulation. Alternatively, part of the semitendinosus tendon can be selected as a graft, but the patella tendon has a greater tear resistance, so that it is used preferentially.
However, by removing part of the patellar tendon, patients may experience pain in the area of the patellar tendon after surgery. This pain can sometimes last only a few months, but unfortunately it can also last longer. As long as the pain remains in the patellar tendon, extreme bending movements such as kneeling down or sports that place heavy strain on the patellar tendon such as volleyball and basketball should be avoided.
Inflammation of the patella tendon is usually caused by overloading the knee joint. Often athletes are affected, especially from stop-and-go sports, but runners can also suffer from patellar tendon inflammation. The inflammation expresses itself primarily through pain in the patella tendon.
In addition, there is often redness and swelling of the affected region, and often the knee is overheated. The painful inflammation usually leads to a restriction of movement of the affected knee joint. The Hoffa fat body lies between the kneecap and the tibia.
The patella tendon passes over it. Inflammation of the patellar tendon can spread to the Hoffa fat body, and vice versa, the fat body can also become inflamed first and then transfer the inflammation to the patellar tendon. Usually, such an inflammation is due to overloading of the knee.
Between the Hoffa fat body and the patella tendon, a certain amount of friction occurs with every movement of the knee joint. The more often this friction occurs, the greater the risk of irritation of the tendon or fatty body. This becomes noticeable after a certain time as an inflammation. Such Hoffitis is usually accompanied by pain below the kneecap. Swelling, redness and overheating are also possible
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