Patellar tendon ruptures.

BACKGROUND Isolated rupture of the patellar tendon is a rare injury. Often occurring during a fall in 20- and 30-year olds, patients may have a preexisting medical condition (eg, history of steroid use) or a history of repetitive microtrauma to the knee. A high-riding patella on physical examination and radiographs is pathognomonic. METHODS Immediate orthopaedic referral for surgical repair is necessary to reestablish knee extension. Delay in diagnosis can make surgical treatment more difficult. Current methods of postoperative rehabilitation are evolving. RESULTS Evaluative studies based on rating scales show satisfactory clinical and functional results after surgery. However, time lost from work and recreation may be protracted, and quadriceps atrophy is often evident. CONCLUSIONS Ruptures of the patellar tendon should be diagnosed acutely and immediately referred to an orthopaedic surgeon. The impact of the injury to the patient may be long-standing even after operative treatment. Contemporary surgical and rehabilitative techniques give the best opportunity for restoration of functional activity.