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The patellar tendon, which may also be called the patellar ligament, is a type of fibrous tissue that connects the knee cap (patella) to the shin bone (tibia). The tendon works with the muscles at the front of the thigh, known as the quadriceps muscle, to extend your knee.
The patellar tendon plays an important role in the lower limb extensor mechanism. Along with the patellar tendon, this mechanism includes the quadriceps muscle, quadriceps tendon and the knee cap. By working together, the extensor mechanism enables you to run, jump and kick with significant force.
When the patellar tendon is damaged, normal functions, such as walking and climbing the stairs become difficult to perform.
If you have experienced patellar tendon pain when walking or running and depending on your medical history your consultant may recommend surgical repair if they have identified a patellar tendon injury. The injury may be a partial patellar tendon tear or a patellar tendon rupture. This can occur when there is violent force exerted by the contracting of the quadriceps muscle, such as when landing from a jump.
During the surgery, the edges of the torn patellar tendon are cut away and the remaining tendons are stitched back together using specialised sutures. For a complete rupture, your consultant may decide to replace the torn tendon with a reconstructed graft using part of the patient’s own tendon or that from a donor. Either the hamstring tendon or the Achilles tendon can be used for the graft.
Patella tendon repair surgery will reduce pain in the knee and increase your stability. By repairing the patellar tendon, later problems in the knee joint, such as degenerative arthritis may be prevented.
When properly rehabilitated and your repaired tendon is able to transfer the load generated by your quadriceps muscles again, you should be able to return to a normal level of function.
As with any injury that requires surgery, you will experience some pain after the procedure. However, this is completely normal and is part of your recovery.
Prescribed pain and anti-inflammatory medication will help you manage any discomfort following the operation. Managing the pain and swelling will also help you get the most out of your physical therapy sessions. However, if you feel you aren’t receiving enough relief from pain and swelling in the knee, then please inform a member of your healthcare team.
Rehabilitation is typically split into three phases following your operation. It’s important to remember that it may take several months before you can walk without pain. The recovery time following knee revision surgery usually takes longer than your first knee replacement surgery.
Phase one
The first phase of your recovery will focus on managing your swelling and pain. This is to allow the specialised sutures and the tendon repair to heal and strengthen.
You will be provided with elbow crutches to help with you balance and stability when weight bearing and walking. The healthcare team will also ask you to wear a knee brace when walking. This is to prevent your knee from flexing and to ensure that the patellar tendon repair is not placed under excessive load. You may also be asked to limit the amount of weight you place on your operated leg.
Over the initial 2-6 weeks after surgery, your physiotherapist will guide you to appropriately increase the range of motion in the brace, discard the brace and take full weight on your operated leg as your muscle strength and control allow.
Regular icing and compression of the knee is encouraged at this stage to bring down swelling and bruising. Your physiotherapist will guide you through some initial activation exercises for your quadriceps and hamstrings. This will help to support your knee and prevent excessive muscle wasting post-operatively.
Phase two
The second phase of your recovery will focus on enabling you to be able to walk with a more normal gait pattern, increase the range of motion in your knee and strengthen your hip and knee muscles, particularly your quadriceps. Regular stretching of the knee is encouraged to regain full range of motion by 12 weeks after surgery.
Your physiotherapist will give you some appropriate strengthening exercises. These will feature a range of resistance and loading exercises for the quadriceps muscles. This is to encourage the tendon repair to heal and quickly increase quadriceps strength and control to support rehabilitation.
Weight-bearing exercises such as wall slides, squats and lunges may commence gradually to begin strengthening your operated leg muscles in weight-bearing positions.
Phase three
The third phase of your recovery will begin once you have enough strength and flexibility in your operated leg to start more complex movements and impact work.
Typically, this phase will involve you starting some light impact work, such as jogging on the treadmill or straight leg raises. You will also increase the vigour of your existing exercises, such as squats, lunges and leg presses:
Your physiotherapist will guide you through the appropriate exercises, but under normal circumstances once the strength of your operated leg is equal to your non-operated leg, activity or sports specific rehabilitation exercises can be commenced. This may include progression to sprinting, jumping and rotational movements depending on the sport desired.
Our hospitals are equipped with a variety of high-tech equipment to help you with your long-term rehabilitation.
The types of machines available include:
- The Game Ready Ice Machine, which uses compression and temperature to help heal the knee
- Electric muscle stimulator, which stimulates the muscles in the leg
- AlterG anti-gravity treadmill, which is a specially designed treadmill that reduces stress on injuries and joints in the lower body while exercising
- Hydro Physio aqua-jogger, which is an aquatic therapy treadmill
- 3D Gait Analysis, which is a non-invasive method of measuring the way you move
- Sports exercises equipment, such as the Concept2 rower.
- Plus one-to-one physio treatment may help rehabilitation following a patellar tendon repair surgery.
The cost of this patellar tendon repair surgery varies between locations. It also depends on other important factors, such as:
- Which Circle Health hospital you receive treatment in;
- The reason why you are getting this treatment, and
- Your individual healthcare needs.
The cost includes all your hospital visits, such as initial consultation, the surgery and recovery afterwards when you are an inpatient. We provide high-quality care throughout and we reflect that within our costs.
We also understand that your treatment needs to be tailored to your needs, both physical and emotional. This no one-size-fits-all approach means that the cost of patellar tendon repair surgery often varies from person to person.
