What are knee tendon injuries?
Tendons connect muscles to bones. They are made of strong, flexible bands of tissue that help your bones and joints to move when your muscles contract.
Sports injuries that affect the tendons are common in football, skiing, lacrosse, hockey, rugby, running, squash, and tennis. Most tendon injuries affect areas near joints and, although they can appear to happen suddenly, in most cases they are caused by a number of tiny tears to the tendon over a long period of time.
Tendinopathy, where tendons around the knee become painful and swollen restricting movement, is usually caused by over-use or repeated minor accidents. Tendinopathy tends to be a long-term (chronic) condition and is unlikely to need surgery. It can often improve with a course of physiotherapy.
Andrew walking & weight bearing 1 day after osteotomy surgery
Kristian Kley performs his new less invasive technique, tibial tubercle osteotomy, which allows patients to mobilise much more quickly.
Patella (kneecap) tendinopathy (jumper’s knee)
This is caused by wear and tear through over-using the knee. This in turn leads to tendon weakness and, in some cases, tiny tears in the tendon. It’s more common in people who run or jump, which is why it’s sometimes known as ‘jumper’s knee’.
Symptoms include pain at the front of the knee, made worse if you jump or hop.
Your consultant will discuss your symptoms with you and examine your knee to check for tenderness, stiffness, swelling and any difficulties with movement. In most cases, they will arrange for you to have a magnetic resonance imaging (MRI) or ultrasound scan to show the extent of the injury and any damage to the surrounding area.
You may need to have treatment over a long period of time to recover completely. Your consultant will be able to discuss your options with you, which may include:
- Intensive physiotherapy
- Steroid or platelet rich plasma (PRP) injections
- Activated Mesenchymal Pericyte Plasma injections (AMPP®)
- Shockwave therapy, a painless procedure where shockwaves are passed into the injured part of the knee to help speed up the healing process
If your symptoms don’t improve, in some cases you may need to have knee tendon repair surgery.
Quadriceps tendinopathy
Less common than patella tendinopathy, quadriceps tendinopathy affects the attachment of the quadriceps tendon to the top of the kneecap (patella) and is more common in older people.
Quadriceps tendinopathy is more common if you repeatedly put stress on the tendon, for example during sports such as running or football. It can, however, also be caused by sudden force affecting the tendon, for example if you suddenly speed up while running or when landing from height.
Symptoms include tenderness, swelling and pain at the front of the knee above the kneecap when the muscle is tightened. Pain may gradually become worse over a period of time.
You may need to have treatment over a long period of time to recover completely. Adrian will be able to discuss your options with you, which may include:
- Intensive physiotherapy
- Steroid or platelet rich plasma (PRP) injections
- Adipose tissue therapy
- Ultrasound shockwave therapy, a painless procedure where shockwaves are passed into the injured part of the knee to help speed up the healing process
If your symptoms don’t improve, Adrian may advise you to have tendon repair surgery.
Kneecap (patella) tendon tear
The kneecap (patella) tendon works alongside the muscles in the front of your thigh so that you can straighten your leg. If the tendon is torn, it can become difficult to walk or carry out other everyday activities.
You may have a partial tear (where the tendon is only partly torn) or a complete tear (where the tendon breaks into two separate parts); this means that the tendon is separated from the kneecap and you won’t be able to straighten your knee. In some cases, a piece of bone can also be torn off.
Tears can be caused by:
- Injuries such as a fall or cut to the knee
- Sports that involve jumping such as athletics or dancing
- Patella tendinopathy which can weaken the tendon
- Long-term (chronic) diseases such as rheumatoid arthritis, diabetes or infection
- Previous surgery such as a total knee replacement or anterior cruciate ligament (ACL) reconstruction, which can put additional strain on the tendon
Symptoms include:
- A tearing or popping sensation
- Swelling and inflammation
- Tenderness and bruising
- Upwards movement of the kneecap towards the thigh
- The knee giving way when you walk
Your consultant will discuss your symptoms with you and examine your knee to check for tenderness, stiffness, swelling and any difficulties with movement. In most cases, they will arrange for you to have an X-ray, magnetic resonance imaging (MRI) and/or ultrasound scan to show the extent of the tear and any damage to the surrounding area.
- Non-surgical treatment includes wearing a knee brace to immobilise the knee for three to six weeks along with a course of physiotherapy. Your consultant may also advise that you have a course of shockwave therapy, a painless procedure where shockwaves are passed into the injured part of the knee to help speed up the healing process. In some cases, Activated Mesenchymal Pericyte Plasma injections (AMPP®) can also help with healing
- Surgery: most people need to have tendon repair surgery in order to regain their normal range of movement and stability. This involves reattaching the torn tendon to the kneecap. The sooner this is carried out after an injury, the higher the success rate. Most people can return to their previous activities after surgery, although complete recovery can take 6-12 months
Quadriceps tendon tear
The quadriceps tendon works alongside the muscles in the front of your thigh so that you can straighten your leg. If the tendon is torn, it can become difficult to walk or carry out other everyday activities. If you have a serious tear, you will probably need to have surgery to regain your full range of movement. Quadriceps tears are more common in middle-aged patients who take part in sports that involve running or jumping.
You may have a partial tear or a complete tear – where the muscle is separated from the kneecap so that knee can no longer straighten when the quadriceps muscle tightens.
Tears can be caused by:
- Injuries such as a fall or cut to the knee, or by jumping
- Patella tendinopathy which can weaken the tendon
- Long-term (chronic) diseases such as rheumatoid arthritis, diabetes or infection
- Immobilisation – the muscles and tendons supporting the knee weaken when they have not been used for a long time
- Previous surgery such as a total knee replacement although this is rare
Symptoms include:
- A tearing or popping sensation
- Swelling and inflammation
- Not being able to straighten your knee
- Tenderness and bruising
- The knee giving way when you walk
Your consultant will discuss your symptoms with you and examine your knee to check for tenderness, stiffness, swelling and any difficulties with movement. In most cases, they will arrange for you to have an X-ray, magnetic resonance imaging (MRI) and/or ultrasound scan to show the extent of the tear and any damage to the surrounding area.
- Non-surgical treatment includes wearing a knee brace to immobilise the knee for three to six weeks along with a course of physiotherapy
- Surgery: most people need to have tendon repair surgery in order to regain their normal range of movement and stability. This involves reattaching the torn tendon to the kneecap. The sooner this is carried out after an injury, the higher the success rate. Most people can return to their previous activities after surgery although complete recovery can take 6-12 months
Knee consultants
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