Symptoms
The patella tendon tear is usually manifested by a sudden pain in the affected person. In addition, the loss of stability makes it difficult to walk and stand, and reduces the strength of the knee joint. The active extension in the knee joint is usually limited or no longer possible. In addition, it can be observed that the kneecap is higher than the opposite side (patella elevation) and a dent can often be felt at the site of the tear. A further phenomenon that occurs with a torn patella tendon is that the kneecap slides up when the thigh muscles are tensed or when the knee joint is bent, since the torn tendon no longer holds it sufficiently in place on the tibia.
Diagnosis of a torn patella tendon
During palpation of the torn patellar tendon, both the elevation of the patella and the palpable dent are noticeable. In addition, the tendon can no longer be palpated in its continuity. The exact nature of the tear can be easily assessed on an X-ray image.
In addition, it can be seen whether or not there is an additional bony tear of the tendon. In addition, the lateral image allows other diagnoses with similar symptoms (e.g. patellar rupture) to be excluded, which is of fundamental importance for further therapy. Finally, the diagnosis is confirmed by means of an ultrasound examination.
In more complicated variants of patellar tendon rupture or to exclude concomitant injuries to the knee joint, further imaging diagnostics may be necessary. These include, for example, an MRT of the knee. Especially in the case of partial tears of the patellar tendon, an MRI of the knee can provide valuable information about the condition of the remaining patellar tendon.
In the acute phase of a torn patella tendon, one can try to relieve the pain with ice and elevate the leg. If the tendon is completely torn, it should always be sutured back together again by means of a surgical procedure. An exception would be if the patient is in acute danger of death or if there is also extensive soft tissue damage.
In this case, it is better to wait a little and stabilize the overall situation of the patient before performing surgery for the torn patella tendon.However, only strains or small tears of the tendon can be treated without any surgical intervention, and these do not cause any relevant reduction in strength. Depending on the location of the torn patella tendon, a different procedure is used. In the case of a deep patellar tendon tear at the transition to the tibia, which frequently occurs in children and adolescents, the tendon suture is performed and the tendon is also fixed to the bone with a suture anchor.
To protect the newly fixed tendon from mechanical overload, a so-called McLaughlin cerclage is usually used. This is a wire sling that is fixed between the kneecap and the tibia to relieve the tendon during the healing process. This allows early treatment to be carried out to restore the full range of motion of the knee joint as quickly as possible.
After three to six months, this wire loop is removed again, unless it has already loosened or detached before. It is also important to ensure that the previous length of the tendon is restored, as too tight a fixation can lead to late consequences such as restricted mobility or arthrosis. Surgery for a torn patella tendon is performed under general anesthesia and usually does not take longer than 30 to 45 minutes. Complications that can occur during this procedure are, as with all surgical procedures, bleeding in the area of the knee joint, possible infection and injury to neighboring structures.