Knee
Patellar Tendon Rupture
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Patellar Tendon Rupture
See Also
Patellar Tendinopathy
Risk Factors
Patellar Tendinopathy
may predispose to Patellar Tendon Rupture
Mechanism
Forceful knee flexion against resistance
Signs
Large
Knee Effusion
Defect between tibial tubercle and inferior
Patella
Difficult active knee extension
Some knee extension may be maintained if
Patella
r
Retina
cular fibers are intact
Differential Diagnosis
Patellar Dislocation
Quadriceps tendon rupture (elderly)
Tibial tuberosity avulsion (adolescents)
Imaging
Knee XRay
Insall-Salvati Ratio for
Patella
evaluation
Distance ratio between
Proximal tibial tubercle
Inferior pole of the
Patella
Normal ratio: +1 or -0.2
Interpretation: Severe
Patella
alta (high riding)
Suggests
Patella
r ligament rupture
Other findings
Patella
avulsion
Fracture
Imaging
Advanced
Knee
Bedside Ultrasound
Ruptured tendon will appear hypoechogenic with a separation between tendon ends
Dynamic views may better define the tendon ends
Knee
MRI
Definitive study to identify extent of rupture and plan surgical repair
Management
Surgical Correction within 10 days of injury
Cast immobilization for 6 weeks following surgery
Physical therapy
Complications
Associated with delayed surgery
Quadriceps contracture shortens extensor mechanism
References
Hoppman and Shannon (2021) Crit Dec Emerg Med 35(11): 16-7
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