What is Patellar Tendon Tear?
Patella tendon tear is an extremely disabling injury resulting in an inability to extend the knee. The tear can be partial, with only some fibres torn, or complete tear of the tendon that runs from the patella’s inferior pole to the tibial tubercle.
Clinical Presentation of patella tendon tear:
- Infra patella knee pain
- Swelling
- Difficulty with weight-bearing
- Difficulty straightening the leg
- They may report an audible “pop” or the sensation of their knee giving way during an event with sudden quadriceps’ contraction with the knee in a flexed position
How to assess patellar tendon tear?
Physical examination should begin with inspection, inspect patella height and compare the affected and unaffected sides. A patella tendon rupture will likely be associated with an elevation of the patellar height compared to the uninjured side, followed by palpation of the knee and surrounding structures for signs of trauma, tenderness and swelling.
The Insall-Salvati ratio or index is the ratio of the patella tendon length to the length of the patella and is used to determine patellar height. There is always a palpable defect below the inferior pole of the patella and localized tenderness about the infrapatellar aspect of the knee.
- A/B, if the ratio higher than 1.2, it considered as elevation of patellar height.
What is the treatment for patellar tendon tear?
1. Surgery
Surgery remains the best treatment and should not be delayed whenever local and general conditions permit. An early repair, within 2 to 6 weeks, may prevent the tendon from scarring and tightening in a shortened position.
2. Physical therapy management can be sub divided into:
- non-surgical treatment
- postoperative rehabilitation
Non-surgical management is employed in partial patella tendon tear with an intact knee extensor mechanism and it involves immobilization in a cylindrical cast in extension for 6 weeks with a progressive weight bearing exercises. While for postoperative rehabilitation, ROM exercise, strengthening, balance and proprioceptive drill will be given.
Prepared by
Yi Zuang
Your Physio Johor Bahru