pathologie: patella tendon rupture

yogabook / pathology / patella tendon rupture

Definition

A patellar tendon rupture is often preceded by a long-standing condition, patellar tendonitis (jumper’s knee) . In a patellar tendon rupture, a patella alta may be visible, whereas in a quadriceps tendon rupture , a patella baja is visible. X-rays may show traction osteophytes , and ultrasound may show an edematous thickened tendon. However, these phenomena are also not uncommon in asymptomatic cases, particularly in older patients. Imaging and clinical findings can differ significantly in these cases. MRI is particularly useful for ruling out other diseases relevant to the differential diagnosis. In both tendon ruptures, an X-ray should rule out a patellar fracture . A transverse fracture can be either a patella alta or a patella baja , which is pathognomonic. In this case, an X-ray must still be performed to the fracture accurately depict before patella surgery is carried out.

In the case of a patellar tendon rupture, treatment is conservative until further notice; after 6 months of unsuccessful treatment, a different approach may be considered. Conservative treatment is particularly promising if the pain occurs only after exercise or during and after exercise. The relevant muscles should be examined; hypertonia of the quadriceps is often present, as is a predisposing factor . A study on 14- to 18-year-old basketball players showed a connection to shortening of the hamstring group . There are no positive studies on NSAIDs, especially since these medications have a detrimental effect on the tendon. However, foot deformities should be treated. Regular, daily training, even several times a day, is one of the most important pillars of therapy. The movements must be performed slowly and cleanly, the eccentric portion of the time can be significant, and flexion must be limited to 60 degrees. As with many other can be tolerated for insertional tendinopathies In rehabilitation training, pain induction up to NRS 3 or 4 with corresponding reverberation . NSAIDs can provide short-term pain relief in these areas, but they pose a significant risk of rupture. Neovascularization of the tendons can be cauterized with medication. A positive effect of PRP and its superiority over extracorporeal shock wave therapy have also been described.

Patellar tendon ruptures are generally treated surgically, as are quadriceps tendon ruptures . Partial quadriceps tendon ruptures, however, can be treated conservatively with appropriate immobilization. In conservative treatment of quadriceps tendon tendinopathy , extracorporeal shock wave therapy must be dosed appropriately, as overdoses tend to damage the tendon.

Causes

  1. traumatic
  2. Flexion trauma of the knee joint with tense quadriceps
  3. high load on the quadriceps with existing tendon damage

Predisposing

  1. Previous damage to the quadriceps tendon
  2. Fluorquinolone
  3. Cortisone therapy
  4. underlying tendon-damaging diseases such as IBD
  5. SUN
  6. Ehlers-Danlos syndrome

Symptoms

  1. Loud, popping noise when ruptured , marked reduction in strength to extend the knee joint, swelling, hematoma, infrapatellar pain, palpable interruption of continuity of the patella alta

Diagnose

  1. Palpation
  2. medical history
  3. I am
  4. MRT

Complications

Therapy

  1. Stop stress, immobilization
  2. Total rupture: OP
  3. Partial ruptures may be treated conservatively