Evolution of Technology

Patella Tendon Repair

Suture anchor technology is one of the more modern ways surgeons fix a torn patellar tendon back to the patella itself. The overall function of these devices is to fix tendons and ligaments to bone. While originally developed more than 3 decades ago, suture anchors have undergone multiple modifications to increase its strength and applicability. From shoulders, to hips, to knees the use of suture anchors is ubiquitous in orthopaedics.

Further innovations in suture anchor design have seen the advent of knotless anchors, especially useful in minimally invasive surgery. The newest products are the all-suture anchors which show impressive strength whilst reducing the iatrogenic (surgeon produced) damage caused by insertion. Because of the low-profile nature of anchors, this technique more accurately re-creates the footprint at the patella and avoids articular cartilage penetration and injury to the surrounding soft tissue seen with bone tunnels.

Evolution of Procedure

Patella Tendon Surgery

There are multiple ways to surgically treat patellar tendon ruptures depending on the location of the tear. Most of the time the tears happen at the interface of the kneecap and the tendon, but sometimes it can occur in the middle of the tendon. If the tear happens in the middle of the tendon it can simply be repaired with a thick non-absorbable suture. Tears at the tendon-bone interface are more of a challenge to clinicians. These type of tears are classically fixed with either bone tunnels to connect the tendon to the bone, or bone anchors which secure the tendon to the bone. While it is extremely rare for these injuries to be treated without surgery, some reasons for non-operative management may be seen in patients with partial tears or those too sick to undergo surgery.

Evolution of Diagnosis

Patella Tendon Rupture

The patella tendon is located near the knee and connects the patella (kneecap) to the tibia (shinbone). Its function is to allow an individual to straighten out the leg during everyday activities, and therefore loss of this ability can be severely debilitating. A patella tendon tear/rupture is an injury more common in younger patients (<40 years old) as the result of direct trauma or a sports related injury such as a jumping from height. A history of patellar tendinitis, kidney disease, diabetes, and steroid use are all independent factors that can increase the risk for a patella rupture. Typically, patient’s report the sudden onset of knee pain, swelling, and difficulty walking after sustaining such an injury. Acute ruptures are amenable to primary repair whereas chronic ruptures often require tendon reconstruction.