Patellar tendon tear: Difference between revisions
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== Medical Management <br> == | == Medical Management <br> == | ||
The treatment depends of the age, the activity level and the size of the tear of the patient. <br><br>Surgical repair reattaches the torn tendon to the kneecap. It’s better that the repair is performed early after the injury. An early repair, within 2 to 6 weeks, may prevent the tendon from scarring and tightening in a shortened position. In delayed diagnoses, more than 6 weeks after the rupture, quadriceps contracture and fibrous adhesions make the surgical repair and restoration of the patellar tendon length more complicated. Surgical repair is necessary to reestablish optimal extensor function.1, 4, | |||
Link 5 | |||
== Physical Therapy Management <br> == | == Physical Therapy Management <br> == |
Revision as of 12:53, 8 March 2012
Original Editors
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Search Strategy[edit | edit source]
Pubmed
Web of knowledge
Google ( books/scholar)
Definition/Description[edit | edit source]
A patellar tendon tear can be partial or complete.
A partial patellar tendon tear means that the soft tissue will not be completely disrupted. Some fibers are torn.
A complete patellar tendon tear means a total separation between the patellar tendon and the kneecap.
When a tear is caused by a medical condition, like tendonitis, the tendon usually tears in the middle.
Clinically Relevant Anatomy[edit | edit source]
add text here
Epidemiology /Etiology[edit | edit source]
Injury
A patellar tendon rupture can be caused by a sudden contraction of the quadriceps against resistance.
When a strong force affects the knee, a tear can arise. This can happen when movements like jumping, falling, weight lifting,… are performed. It’s most common that a tear arises when the knee is bent and the foot planted on the floor, f.e. when a basketball player lands of a jump. A tear can also arises by the great impact to the front of the knee by a fall.
Surgery
There’s a higher risk for a tear when a previous major knee surgery is done, like a total knee arthroplasty and an anterior cruciate ligament construction with central one third patellar tendon autograft.4
Tendon weakness
Caused by:
- Patellar tendonitis 4 (Link 1)
- Chronic diseases like chronic renal failure, hyper betalipoproteinemia, rheumatoid arthritis (Link 2), systemic lupus erythmatosus (SLE) (Link 3), diabetes mellitus (Link 4), infection.1
- Steroid injections2
- Tendon calcification2
- Collagen disorders2
- Fatty tendon degeneration2
- Metabolic disorders2
Characteristics/Clinical Presentation[edit | edit source]
The following symptoms are typical for someone with a patellar tendon tear:
- The patient is unable to continue activity 4
- The patient can’t resume weightbearing or does so only with assistance 4
- An indentation at the bottom of your kneecap where the tendon tore.1
- Bruising1
- Cramping1
- Tenderness
- A proximally displaced patella, because it’s no longer anchored to your shinbone 4
- Incomplete extensor function
- Walking will be difficult, due to the knee buckling or giving way 1
- Hemarthrosis 4
Sometimes people can feel a tearing or popping sensation, followed by pain and swelling.1
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Examination[edit | edit source]
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Medical Management
[edit | edit source]
The treatment depends of the age, the activity level and the size of the tear of the patient.
Surgical repair reattaches the torn tendon to the kneecap. It’s better that the repair is performed early after the injury. An early repair, within 2 to 6 weeks, may prevent the tendon from scarring and tightening in a shortened position. In delayed diagnoses, more than 6 weeks after the rupture, quadriceps contracture and fibrous adhesions make the surgical repair and restoration of the patellar tendon length more complicated. Surgical repair is necessary to reestablish optimal extensor function.1, 4,
Link 5
Physical Therapy Management
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Key Research[edit | edit source]
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Resources
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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