A rupture of the patellar tendon is usually preceded by a reduction in the mechanical resilience of the tendon tissue as a result of diabetes mellitus, microtrauma and similar weaknesses. Tissue is often removed from the patellar tendon for reconstruction of the anterior cruciate ligament. A patellar tendon rupture becomes noticeable through the kneecap being noticeably displaced upwards and through the inability to straighten the knee joint.
What is a patellar tendon rupture?
The patellar tendon (ligamentum patellae), which is designed more as a tissue band, connects the kneecap (patella) with the shinbone. Due to the short lever arm, it has to withstand enormous forces of over 1,000 kiloponds per square centimeter when stretching from extreme knee bends. Above the kneecap, the ligament continues as the quadriceps tendon and connects to the powerful quadriceps femoris muscle. See foodanddrinkjournal for Undescended Testicles Dictionary Definitions.
When the knee is bent, the patella is used as a kind of reversing lever. With a complete rupture of the patellar tendon, power transmission from the quadriceps to the tibia can no longer take place. When the thigh muscle is tensed, only the kneecap is pulled upwards. The upwardly displaced patella is also one of the main indicators that point to a patellar tendon rupture.
A complete rupture of the ligament due to point overload is rare. A tear is usually preceded by certain previous illnesses that have led to a gradual weakening of the patellar tendon. It is not uncommon for part of the patellar tendon tissue to be used to reconstruct the anterior cruciate ligament, resulting in a temporary weakening.
Causes
In principle, a patellar tendon rupture can occur as a result of a selective overload – especially in an extreme squat position – or as a result of an external injury. Previous damage to the patellar tendon tissue that promotes a rupture or even makes it possible in the first place often takes the form of degenerative changes.
Specifically, it is, for example, diabetes mellitus or arterial occlusive disease (intermittent claudication) or a metabolic disease that chronically undersupplies and weakens the tendon tissue.
A patellar tendon rupture is also promoted by anatomical malpositions such as knock knees or different leg lengths. A patellar tendon rupture mainly occurs in people in the “second half of life” when the elasticity of the ligaments has decreased a little due to the natural aging process. Lack of exercise can also promote the disease, since the ligaments are not sufficiently challenged over a long period of time.
However, too much sport with chronic overloading of the patellar tendon also has an unfavorable effect, because micro-tears occur which promote chronic tendinitis, an inflammation of the patellar tendon. Athletes who frequently have to make abrupt changes of direction or who frequently overload the patellar tendon statically, as is the case with weightlifters, are particularly at risk.
Symptoms, Ailments & Signs
A ruptured patellar tendon is accompanied by severe pain and a swollen knee, making a clear diagnosis difficult. The upwardly displaced kneecap can be regarded as an important key symptom. However, it should be clarified in the differential diagnosis whether it is a question of a patella fracture, which also leads to parts of the patella standing up.
An equally important symptom is the inability to actively straighten the lower leg against the slightest resistance. This is because if the quadriceps tendon is completely torn, there is no connection to the tibia and therefore no force can be transferred in the direction of extension of the lower leg. The strong swelling is caused by reactions of the immune system.
This deploys all available forces to repair the rupture, which of course cannot work with a complete demolition. The two ends at the torn point gape wide and cannot reconnect “by themselves”. As a result of the swelling, the knee appears red and warmer than the surrounding tissue.
Diagnosis & course of disease
If the main symptoms of a patellar tendon rupture described above do not provide sufficient certainty about the type of injury, imaging methods such as X -rays or, even better, magnetic resonance imaging (MRI) can be used. This is often necessary if, for example, it is not certain whether the tendon has been torn or a complete rupture is involved.
The further course of the disease depends to a large extent on whether the tendon has been torn, partially ruptured or completely ruptured. In some cases, the exact diagnosis is difficult because the ligament does not usually show a smooth tear, but frays and a few fibers may still be connected to each other.
In the case of a partial rupture, the patellar tendon can partially regenerate under favorable conditions, which is impossible in the case of a total tear. The forces that bring the two torn ends back together and fuse them together are practically absent.
Complications
In most cases, the patellar tendon rupture causes severe pain. These occur mainly on the knees and can lead to significant restrictions in the life and everyday life of those affected. In most cases, the knee can no longer be fully extended. The pain itself often spreads to other regions of the leg and can lead to significant limitations there.
In the worst case, a complete tear in the tendon can also occur. The knee itself is usually swollen and red. The person affected may also be dependent on walking aids in their everyday life due to the rupture of the patellar tendon. The knee is also heated and those affected often suffer from fever.
A rupture of the patellar tendon is usually treated with physiotherapy. There are no complications. However, the patient may also need surgery to restore full mobility of the joints. The life expectancy of the person affected is not affected by the patellar tendon rupture.
When should you go to the doctor?
Pain in the knee area after a fall or accident is cause for concern. If there are irregularities in the knee joint due to heavy physical exertion, this is also unusual and must be examined. A doctor is required in the event of swelling of the knee, changes in the complexion and a decrease in physical resilience. An examination is advisable as soon as gait insecurity, impairment of locomotion and limitations of general mobility occur. If the leg can no longer bear its own weight as usual, a medical diagnosis is required.
Until a doctor is consulted, the affected knee should be relieved and pain medication should not be taken. If the person concerned suffers from dizziness, tachycardia, disturbances of consciousness or a loss of consciousness, there is a need for immediate action. In these cases, the symptoms lead to sequelae. They need immediate medical attention to prevent a life-threatening condition from developing. In acute cases, an emergency service must be alerted.
Sudden changes in behavior, reddening of the knee, and an internal warmth are other signs of a health disorder. If the pain extends to the lower leg, there is an injury that should be presented to a doctor as soon as possible. A doctor is needed for a displaced kneecap or other optical changes in the skeletal system.
Treatment & Therapy
Treatment of the patellar tendon rupture also depends on whether it is a complete tear or an initial tear. In the case of a tear, depending on the severity of the tear, special physiotherapy is recommended, which is usually combined with water aerobics to enable movements without strain. In addition to physiotherapy, decongestants and pain therapy are also used as needed. In the event of a complete tear, surgery is required.
Various procedures are available to reconnect the two torn ends of the patellar tendon or to implant a replacement tendon made from your own material or from a donor. In order to prevent degradation of the quadriceps, the suture can be relieved by certain surgical procedures, so that functional physiotherapy can be started early after the operation.
Outlook & Forecast
The prognosis of a patellar tendon rupture depends on the cause and the patient’s cooperation in the healing process. Basically, the disease is curable. Full and permanent recovery is also possible.
If the tendon is completely torn, an operation is required. Otherwise, irreversible damage can develop and lifelong discomfort and pain can occur. If the procedure proceeds without further complications, the patient is then accompanied by physiotherapy. In this, the affected person learns how to carry out the optimal movement sequences and can gradually improve his or her state of health. Under optimal conditions, healing is achieved in this way.
If the tendon tears, there is usually no need for an operation. Nevertheless, physiotherapy is scheduled to improve movement sequences and support the healing process. Better results are achieved if the person concerned also carries out independently learned exercises outside of the therapy hours.
In addition, lifestyle is crucial for long-term development. With an unhealthy lifestyle, overweight and improper exercise, the risks of permanent disorders are increased. The risk of developing secondary diseases also increases. Even if healing is achieved, the patellar tendon rupture can recur over the course of life. The prognosis is unchanged if the symptoms return.
Prevention
Active measures to prevent a patellar tendon rupture consist of maintaining fitness through light physical activity training and light to moderate endurance sports. All stressed tendons and ligaments are given an incentive to maintain their strength and elasticity. Passive measures consist of avoiding selective overloading of the knee joint, especially from strong flexion. Likewise, sports such as handball, hockey and volleyball should only be practiced at an advanced age with the necessary caution and prudence.
Aftercare
In the case of a patellar tendon rupture, in most cases the affected person has only limited or few follow-up measures available. Ideally, the person affected by this disease should consult a doctor at the first signs and symptoms, so that there are no further complications or complaints that would reduce the quality of life of the person affected.
A patellar tendon rupture cannot heal itself, so a visit to a doctor is always necessary. Most patients with this disease are dependent on the measures of physiotherapy or physiotherapy. The person concerned can repeat many of the exercises themselves at home in order to continue to alleviate the symptoms and promote the mobility of the body.
In some cases, however, surgical interventions are also necessary to alleviate the symptoms of the patellar tendon rupture. After such a procedure, the affected person should rest and take care of the body. Efforts or stressful and physical activities should be avoided in order not to unnecessarily burden the body. As a rule, this disease does not reduce the life expectancy of the affected person.
You can do that yourself
To reduce the symptoms, the person concerned can pay more attention to their own health. Gaining weight or being overweight should always be avoided so that the joints, bones and tendons are not put under unnecessary strain. Body weight should be within the recommended BMI. In addition, light physiotherapy exercises are recommended after consultation with a doctor or specialist. One-sided physical strain should be avoided so that no further muscle or bone problems develop.
The diseased region must be relieved and sufficiently spared so that the healing process is not interrupted. Force impacts or carrying heavy objects should be avoided as they contribute to a deterioration in well-being. Sporting activities should be restricted or stopped completely until the knee has regenerated. Severe tension in the knee joint and the extensor muscles in the thigh can intensify the symptoms and have a negative effect on healing. The footwear used should also be optimized and adapted to the current physical needs. Wearing high-heeled shoes should be avoided to avoid further symptoms.
The organism needs sufficient vitamins, trace elements and enough liquid for a quick recovery. To strengthen the immune system, a healthy diet is recommended and the consumption of nicotine or alcohol is not recommended.
