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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Physical examination of the patellar tendon rupture: Begin by obtaining the patient’s medical history: Injury history to the anterior patella.Surgery history to the knee such as total knee replacement or anterior cruciate ligament reconstruction.General health conditions such as patellar tendonitis.A related medical condition such as kidney failure, rheumatoid arthritis, diabetes mellitus, or systemic lupus erythematosus might predispose the patient to patellar tendon injury.Inspection: Knee effusion or swelling.Surrounding skin for the signs of direct trauma.Hemarthrosis and ecchymosis.Compare the patellar height from the affected to the unaffected knee. The affected patellar is elevated when the tendon ruptures.Palpation: A palpable indentation below the inferior pole of the patella.Tenderness at the infrapatellar aspect of the knee.Range of motion: Loss of active knee extension with a complete tear of the patellar tendon.Unable to perform the active straight leg raise test.
Patellar fracture among elite-level European soccer players: 4-year case-control cohort analysis of return to play, re-injury, and player performance
Published in The Physician and Sportsmedicine, 2023
Sumit Patel, Ophelie Lavoie-Gagne, Nabil Mehta, Ghassan Farah, Avinaash Korrapati, Brian Forsythe
The mean age of incidence for patellar fractures was found to be 26.86 years old in professional soccer players. In comparison to other soccer-related injuries, such as Achilles tendon rupture and patellar tendon rupture, patellar fractures happen at a younger age [10,27]. This is likely due to the fact that patellar fractures are usually traumatic in nature, while the aforementioned injuries have a degenerative component involved along with traumatic elements [7,28]. Our findings were similar to those found for various lower extremity fractures in soccer players [3,4,11]. When stratifying age by position, no significant differences were found between different positions (P > 0.05). These findings were surprising, as attackers are usually younger than their counterparts, as they have a greater need for explosive output and agility in comparison to their peers in other positions [3,11]. However, older athletes are at higher risks of fractures in general, so young attackers may have had less incidence of patellar fracture [5,29,30]. Bone health declines as athletes age due to repetitive loading during strenuous exercise over prolonged periods of time and bone demineralization [31].
Performance-based outcomes following patellar tendon repair in professional athletes
Published in The Physician and Sportsmedicine, 2020
Matthew T. Nguyen, Wellington K. Hsu
This study, along with similar publications documenting performance outcomes from public databases [15,17,31,32], possesses several limitations. Because the players were identified via public sources, imaging reports, exact pathology, and unreported concomitant pathologies were not available. Aspects of care such as the injury severity and exact medical clearance date to return were not provided for all players. Intraoperative factors such as surgeon experience, surgery duration, and surgical technique (i.e utilization of grafts) and rehabilitation methods were unavailable through public databases that may have affected an athlete’s RTP and immediate postoperative performance. Because a successful RTP was defined as the first game in the regular season on an active roster, the exact length of recovery may differ if the medical clearance date predated returning to the field. Furthermore, information from the public record carries an intrinsic risk of reporting errors, omissions, and selection bias. Although this was controlled through corroborating multiple sources, there still exists a potential for inaccurate data. In terms of selection bias, there exists the potential for underreporting as injuries from less ‘newsworthy’ athletes may not have been reported through the media. All participants in this study were male professional athletes, so the conclusions drawn may not be generalizable to female professional athletes. Lastly, the limited sample size for non-American football athletes may have underestimated the severity of a patellar tendon rupture and subsequent repair for these players.
5-year-old child with late discovered traumatic patellar tendon rupture—a case report
Published in Acta Orthopaedica, 2018
Jesper Holbeck-Brendel, Ole Rahbek
Considerable force equivalent to 18 times body weight is required to rupture a human adult patellar tendon and as such is very rare in childhood (Pires e Albuquerque et al. 2015). Ruptures of the tendons in children or adolescents are rare; fractures are more common (Williams et al. 2015, Yousef and Rosenfeld 2017). This usually occurs distal to the patellar tendon by an avulsion fracture of the tibial tuberosity or proximally as a patellar sleeve fracture (Berg 1995). Optimal treatment of acute isolated patellar tendon rupture is prompt surgical repair.