Patellar Tendon Repair or Reconstruction

What is a patellar tendon injury?

The patellar tendon anchors the patella (kneecap) in place by attaching to the bottom of the patella and the tibial tubercle, a bony prominence near the top of the tibia (shin bone). The patellar tendon functions to straighten the leg with the help of the quadriceps tendon and quadriceps muscle. This tendon can become injured or inflamed generating patellar tendon pain. An injury to the patellar tendon can occur from a traumatic event, patella dislocation, or a sports-related incident causing the tendon to become partially or completely torn. Tendon inflammation seen in patellar tendinitis typically occurs from repetitively jumping onto a hard surface. If this acute inflammatory condition is left untreated, it can further develop into tendinosis, a condition characterized by chronic inflammation and is difficult to treat.

What is the treatment for a patellar tendon injury?

Non-operative therapies, such as joint immobilization and a rehabilitation program, can provide significant relief in patients without knee instability from a partial patellar tendon tear. However, the proper repair of a patellar tendon injury is accomplished through surgical reconstruction. A minimally invasive arthroscopic procedure aims to restore stability to the knee joint. Dr. Ronak Mukesh Patel, orthopedic knee doctor, treats patients in Sugar Land, Pearland, and the Houston, Texas area, who have experienced a patellar tendon injury and are in need of surgical repair or reconstruction.

How is a patellar tendon repair performed?

A patellar tendon repair can be performed as an outpatient procedure. A nerve block is typically administered for anesthesia during the procedure. To begin, Dr. Patel creates an open incision over the torn patellar tendon. When Dr. Patel identifies the area of injury, the damaged portions of the patellar tendon are excised and removed with specialized surgical instruments. The remaining healthy tissue is fastened to the patella with special surgical anchors that secure the tendon in the correct position. Studies have found these surgical anchors to be one of the strongest devices for tendon repairs in addition to providing the best recovery outcomes.

What is a patellar tendon reconstruction?

If the patellar tendon has retracted due to a substantial amount of time between the injury and surgical repair, Dr. Patel may use a tendon graft harvested from the patient (autograft) or donor tissue (allograft). Implementing the tendon graft can lengthen the retracted tendon or be used to reconstruct the patellar tendon in its entirety. Bone tunnels may be drilled into the patella to secure the tendon graft as an alternative to utilizing surgical anchors. The tendon graft is situated as close to the native tissue as possible. Once secured in place, the tendon graft is evaluated for good tension and strength. After the necessary revisions are complete, the incisions are closed with sutures.

What is the recovery period like after a patellar tendon repair or reconstruction?

The recovery period following a patellar tendon repair is determined by the injury severity and the specific surgical technique employed by Dr. Patel. Most patients can expect a full recovery with a return to normal daily activities in approximately 4 to 6 months. The recovery period can be also affected by a patient’s compliance with the post-operative care instructions provided by Dr. Patel. In general, patients in the Houston, Texas area can anticipate the following:

• The knee joint will be immobilized immediately following surgery with a brace or other immobilization device. This device will remain in place for at least 8 weeks.
• A combination of rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs) are encouraged to mitigate post-operative pain and inflammation.
• The key to a successful recovery following a patellar tendon repair is the active participation and completion of the physical rehabilitation program designed by Dr. Patel.