Patellar tendon rupture
Updates to Article Attributes
Patellar tendon rupture is one of the extensor mechanism of the knee injuries and occurs almost invariably at either the patellar or tibial insertion of the patellar tendon, when in the setting of trauma, and is often associated with a small avulsion fracture. Most commonly, it is at the superior attachment to the inferior pole of the patella. When secondary to systemic illness, then mid-substance tears are more frequent.
PTR is less frequent than a patellar fracture and a quadriceps tendon rupture, and tends to occur in a younger population.
Predisposing factors include:
- chronic microtrauma (tendinopathy): also known as jumper's knee
- prior therapeutic intervention
- direct injection of steroids (for treatment of jumper's knee)
- previous ACL repair
- systemic illness
Radiographic features
Plain radiograph/MRI
On imaging, a complete rupture is usually easily identified, due to significant patella alta where there is an increased Insall-Salvati ratio.
Other features include blurring of the posterior margin of the patella tendon into Hoffa's fat pad and presence of an avulsion fracture.
Ultrasound
ABest imaged with longitudinal scans using high-frequency linear transducers; the tendon rupture may be seennormally appears as a continuous well-defined hyperechoic fibrillar structure bridging the patella and the tibial tuberosity while tears usually appear as hypoechoic regionareas of interruption of the fibrillar pattern 1.
Treatment and prognosis
Early surgical repair is necessary to ensure good functional outcome.
-<p><strong>Patellar tendon rupture </strong> is one of the <a href="/articles/extensor-mechanism-of-the-knee-injuries">extensor mechanism of the knee injuries </a>and occurs almost invariably at either the patellar or tibial insertion of the <a href="/articles/patellar-tendon">patellar tendon</a>, when in the setting of trauma, and is often associated with a small <a href="/articles/avulsion-fracture">avulsion fracture</a>. Most commonly, it is at the superior attachment to the inferior pole of the <a href="/articles/patella">patella</a>. When secondary to systemic illness, then mid-substance tears are more frequent.</p><p>PTR is less frequent than a <a href="/articles/patella-fracture">patellar fracture</a> and a <a href="/articles/quadriceps-tendon-rupture">quadriceps tendon rupture</a>, and tends to occur in a younger population.</p><p>Predisposing factors include:</p><ul>- +<p><strong>Patellar tendon rupture </strong> is one of the <a href="/articles/extensor-mechanism-of-the-knee-injuries">extensor mechanism of the knee injuries </a>and occurs almost invariably at either the patellar or tibial insertion of the <a href="/articles/patellar-tendon">patellar tendon</a>, when in the setting of trauma, and is often associated with a small <a href="/articles/avulsion-fracture">avulsion fracture</a>. Most commonly, it is at the superior attachment to the inferior pole of the <a href="/articles/patella">patella</a>. When secondary to systemic illness, then mid-substance tears are more frequent.</p><p>PTR is less frequent than a <a href="/articles/patellar-fracture-2">patellar fracture</a> and a <a href="/articles/quadriceps-tendon-rupture">quadriceps tendon rupture</a>, and tends to occur in a younger population.</p><p>Predisposing factors include:</p><ul>
-</ul><h4>Radiographic features</h4><h5>Plain radiograph/MRI</h5><p>On imaging, a complete rupture is usually easily identified, due to significant <a href="/articles/patella-alta">patella alta </a>where there is an increased <a href="/articles/insall-salvati-ratio">Insall-Salvati ratio</a>.</p><p>Other features include blurring of the posterior margin of the patella tendon into <a href="/articles/hoffa-s-fat-pad">Hoffa's fat pad</a> and presence of an avulsion fracture.</p><h5>Ultrasound</h5><p>A tendon rupture may be seen as a hypoechoic region.</p><h4>Treatment and prognosis</h4><p>Early surgical repair is necessary to ensure good functional outcome.</p>- +</ul><h4>Radiographic features</h4><h5>Plain radiograph/MRI</h5><p>On imaging, a complete rupture is usually easily identified, due to significant <a href="/articles/patella-alta">patella alta </a>where there is an increased <a href="/articles/insall-salvati-ratio">Insall-Salvati ratio</a>.</p><p>Other features include blurring of the posterior margin of the patella tendon into <a href="/articles/hoffa-s-fat-pad">Hoffa's fat pad</a> and presence of an avulsion fracture.</p><h5>Ultrasound</h5><p>Best imaged with longitudinal scans using high-frequency linear transducers; the tendon normally appears as a continuous well-defined hyperechoic fibrillar structure bridging the patella and the tibial tuberosity while tears usually appear as hypoechoic areas of interruption of the fibrillar pattern <sup>1</sup>.</p><h4>Treatment and prognosis</h4><p>Early surgical repair is necessary to ensure good functional outcome.</p>
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