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Patellar Tendon Repair Surgery

Patellar tendon repair is a surgical procedure that reattaches a torn patellar tendon, restoring knee functionality and preventing complications. It's especially crucial when sports activities or knee injuries result in partial or complete tears of the tendon. If you're experiencing knee difficulties, don’t hesitate to consult with Pristyn Care’s orthopaedic experts. Book an appointment at Pristyn Care for a comprehensive evaluation.

Patellar tendon repair is a surgical procedure that reattaches a torn patellar tendon, ... Read More

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What Is Patellar Tendon Repair?

Patellar tendon repair is a surgical intervention aimed at reattaching a torn patellar tendon. This tendon plays an essential role as it connects the kneecap (patella) to the shinbone (tibia), facilitating knee movement. Unfortunately, it’s susceptible to injuries which often result from sports activities or knee injuries. This can lead to partial or complete tears of the tendon.

For complete tears, surgical treatment helps to restore knee function and prevent complications like scarring and tightening of the tendon. The operation involves attaching sutures to the torn tendon and securing it back to the kneecap or using suture anchors. The decision between these techniques depends on the location and complexity of the tear.

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What Are the Types of Patellar Tendon Repair?

Patellar Tendon Repairs are generally carried out using one of two surgical techniques:

  • Transosseous Repair: In this procedure, the doctor attaches sutures to the torn tendon and drills small holes into the patella. The sutures are then threaded through these holes to secure the tendon back onto the kneecap. This method is often employed for tears located near the kneecap.
  • Suture Anchor Repair: Small implants known as suture anchors are inserted into the patella. The sutures from the tendon are threaded through these anchors to reattach the tendon. This method is used for tears further away from the kneecap or more complex due to associated knee injuries.

The selection of technique depends on the tear’s location and severity.

Diagnosis Before Torn Patellar Tendon Surgery

Before undergoing patellar tendon repair, the doctor must confirm the diagnosis of a torn patellar tendon. This is typically done through a combination of medical history, physical examination, and imaging tests. Some of these tests include:

  • Medical History Evaluation: Patients experience a “pop” sound or knee sensation giving way during an abrupt action, such as jumping or stumbling. Pre-existing pain at the level of the patella or patellar tendon may suggest underlying tendinosis.
  • Physical Examination: This might reveal an indentation at the bottom of the kneecap where the tendon tore. Bruising, swelling, and the kneecap moving up into the thigh can also be observed. A defect below the inferior patella pole and localised tenderness about the infrapatellar aspect of the knee can often be palpated. The main cause for concern is loss of active knee extension.
  • Imaging Tests: X-rays can show displacement of kneecaps and are typically sufficient to diagnose complete tears. However, an MRI provides better visualisation of soft tissues and can highlight the extent and location of the tear.

What Is the Procedure for Patellar Tendon Repair?

Patellar tendon repair is a surgical procedure designed to mend a torn patellar tendon. The general steps involved in this treatment are as follows:

  • Transosseous Repair: In this technique, sutures are attached to the torn tendon and threaded through small holes drilled in the kneecap. This helps to secure it back into position. This is predominantly used for tears close to the patella.
  • Suture Anchor Repair: In this procedure, small implants called suture anchors are inserted into the kneecap. The tendon sutures are threaded through these anchors to reattach the tendon. This method is preferred for tears further from the kneecap and more complex injuries.
  • Recovery Period: Following either technique, the knee is immobilised for about 6-12 weeks to allow healing. Post this, physical therapy is introduced to restore motion and strength.

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Who Is the Right Candidate for Patellar Tendon Repair?

Patellar tendon repair is not for everyone. The decision for surgery should be made after evaluating the patient’s condition and discussing potential risks and benefits with a doctor. Generally, suitable candidates for this procedure include:

  • Severe Symptoms: Patients who experience significant pain or difficulty moving their knee are typically considered for patellar tendon repair.
  • Impact on Daily Activities: Surgery is recommended if the condition interferes with the patient’s ability to perform daily activities, like walking or climbing stairs.
  • Extent of Injury: If the tear is complete or large enough, surgery may be required to ensure the knee functions properly.
  • Attempts at Non-Surgical Management: Those who have tried non-surgical patellar tendon management techniques without success may consider surgery as the next step for treatment.

What Are the Benefits of Patellar Tendon Repair?

Patellar tendon repair is a significant surgical procedure that can enhance the quality of life with a torn patellar tendon. It offers several crucial benefits:

  • Restoration of Function: One of the primary advantages of patellar tendon repair is the restoration of knee function. Post-surgery, patients typically regain their ability to walk, run, or even indulge in sports activities.
  • Pain Relief: The repair procedure can significantly alleviate the pain associated with the injury, particularly during movement.
  • Prevention of Long-term Complications: Prompt surgical intervention can avoid complications like tendon retraction and scarring. These complications may cause chronic knee instability and pain in the long run.
  • Improved Outcomes: Research has shown that early repair can lead to better functional outcomes and lower re-rupture rates than delayed surgery.

How to Prepare for Patellar Tendon Repair?

Preparing for patellar tendon repair involves several critical steps:

  • Medical Evaluation: A thorough medical history check and physical examination are essential. Imaging studies such as MRI or X-rays may be needed to assess the extent of the injury.
  • Anesthesia Consultation: Discuss your anaesthesia options (general, regional or spinal) with your surgeon to choose the best approach for your surgery.
  • Preoperative Instructions: You might need to stop certain medications (like blood thinners) before surgery. Also, make arrangements for transportation home after surgery.
  • Physical Preparation: Engaging in prehabilitation exercises can strengthen surrounding muscles and improve recovery outcomes.

What Are the Recovery Tips and Precautions to Follow after Patellar Tendon Repair?

After undergoing patellar tendon repair, certain precautions and recovery tips can facilitate smooth healing:

  • Immobilisation: Your knee will typically be immobilised in a brace or cast for 3 to 6 weeks to ensure proper healing.
  • Pain Management: Use ice and rest adequately post-surgery. You might also be prescribed medications for managing pain and swelling.
  • Physical Therapy: A tailored rehabilitation program is crucial. It starts with gentle range-of-motion exercises and progresses to strengthening exercises as healing allows.
  • Gradual Weight Bearing: You will be advised to use crutches initially and gradually increase weight-bearing activities as tolerated by your body.

Potential Risks or Complications Associated with Patellar Tendon Repair

Like any surgery, patellar tendon repair can also have some potential risks or complications:

  • Weakness and Loss of Motion: Post-surgical weakness and reduced motion range are common, and require diligent rehabilitation.
  • Rerupture: There is a risk of the repaired tendon tearing again, with rates varying between 2% to 50% depending on various factors.
  • Infection and Wound Complications: As with any surgery, there are risks of infection and issues related to wound healing.
  • Changes in Kneecap Position: The alignment of the kneecap may change post-surgery, possibly affecting function.

What Is the Cost of Patellar Tendon Repair in India?

The cost of arthroscopic patellar tendon repair surgery typically varies based on several factors:

  • Hospital and City: The choice of hospital and city can significantly impact the cost.
  • Complexity of the Procedure: The nature of your patellar tendon injury can affect the cost. More complex cases that require extensive repair may demand higher charges.
  • Surgeon’s Experience: Skilled surgeons with years of experience and a reputation for success often charge more for their services.
  • Additional Costs: Don’t forget about costs beyond surgery, such as those associated with preoperative tests and postoperative care.

Is Patellar Tendon Repair Covered Under Insurance?

Yes, most health insurance policies in India cover patellar tendon repair. However, the extent of coverage varies based on your specific policy. Generally, insurance policies provide coverage for:

  • The surgery itself
  • Hospitalisation costs
  • Preoperative tests like MRIs and blood panels
  • Postoperative care including follow-up consultations

Your policy may not cover costs associated with non-essential treatments or procedures. If you have any pre-existing conditions that lead to complications, your policy may not cover these additional costs. Additionally, certain advanced surgical techniques may not be covered under basic plans.

FAQs

What is my daily routine going to be like after a Patellar Tendon Repair?

After a patellar tendon repair, your doctor will advise you to rest and elevate your leg to minimise swelling. You must follow their advice and avoid putting any weight on the leg initially.

How long does it take for the patellar tendon to heal completely after the repair?

Healing times can vary, depending on factors such as the patient’s overall health condition, age and adherence to post-operative instructions. A full recovery from patellar tendon repair takes between six months to a year.

How does Physical Therapy contribute to my recovery after the Patellar Tendon Repair?

Physical therapy is an integral part of the treatment following patellar tendon repair. It helps re-establish strength and flexibility in your knee, restoring its normal function.

Can I return to active sports after the Patellar Tendon Repair?

Yes, most individuals can return to active sports after fully recovering from a patellar tendon repair. However, this depends on one’s adherence to physiotherapy and the healing process.

Will I experience pain during the Patellar Tendon Repair recovery phase?

You might experience some discomfort or pain post-surgery. This can be effectively managed with prescribed pain relievers and regular icing sessions under the supervision of your doctor.

Are there non-surgical alternatives for Patellar Tendon treatment?

In some cases, a non-operative approach may be recommended before considering surgery. This generally includes physiotherapy, rest, application of ice, wearing supportive devices like a knee brace, and taking anti-inflammatory medications.

What is the role of nutrition in Patellar Tendon Repair recovery?

A balanced diet high in protein, vitamins and minerals can facilitate the healing process post-surgery. Consuming foods rich in Vitamin C, for instance, can help produce collagen, a primary component of tendons.

Can I drive after undergoing a Patellar Tendon Repair?

Your ability to drive will be affected initially after surgery. You should not drive until you’re capable of making emergency stops without pain and have regained full control of your leg.

Will there be visible scarring post-Patellar Tendon Repair?

There may be a small scar at the site of the surgery, typically hidden in a skin fold. However, most scars fade significantly with time and are not easily noticeable.

How often should I follow up with my doctor after the Patellar Tendon Repair?

Follow-up visits are usually scheduled at regular intervals after the surgery to monitor your progress. The frequency of these visits can vary based on your doctor’s recommendations and how well you’re healing.

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