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Knees following ACL reconstruction surgery. A patellar tendon graft was used. Discoloration of the left leg is from swelling that drained from the knee to the shin. The patellar tendon connects the patella (kneecap) to the tibia (shin). The graft is normally taken from the injured knee, but in some circumstances, such as a second operation, the ...
The patellar tendon is a strong, flat ligament, which originates on the apex of the patella distally and adjoining margins of the patella and the rough depression on its posterior surface; below, it inserts on the tuberosity of the tibia; its superficial fibers are continuous over the front of the patella with those of the tendon of the quadriceps femoris.
ACL injury used to be a career-ending injury for competitive athletes; however, in recent years ACL reconstruction surgery followed by physical therapy has allowed many athletes to return to their pre-injury level of performance. [62] Long term complications of ACL injury include early onset arthritis of the knee and/or re-tearing the ligament.
During the immediate post-operation phase, the knee is protected at all times. Patients do not bear weight on the knee for the first two weeks after surgery, with no range of motion. Typically, after six weeks, the patient starts physical therapy. If the patient is an athlete, their doctor and physical therapist must approve their return to sports.
If the tendon rupture is a partial tear (without the two parts of the tendon being separated), then non-surgical methods of treatment may suffice. The future of non-surgical care for partial patella tendon ruptures is likely bioengineering. Ligament reconstruction is possible using mesenchymal stem cells and a silk scaffold. [5]
The patella is a floating sesamoid bone held in place by the quadriceps muscle tendon and patellar tendon ligament. Exercises should strengthen quadriceps muscles such as rectus femoris, vastus intermedius, and vastus lateralis. However, tight and strong lateral quadriceps can be an underlying cause of patellar dislocation.
A harvested tendon, such as the palmaris tendon [11] from the forearm of the same or opposite elbow, the patellar tendon, hamstring, toe extensor or a donor's tendon , is then woven in a figure-eight pattern through the holes and anchored. [10] The ulnar nerve is usually moved to prevent pain, as scar tissue can apply pressure to the nerve. [11]
Patellar tendinitis is an overuse injury from repetitive overloading or repetitive stress of the patellar tendon of the knee leading to microtears and inflammation that do not have time to heal before the next use. Patellar tendonitis is common in athletes who participate in activities that include a lot of jumping, changing directions, or running.