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The patellar tendon connects the bottom of the kneecap to the shinbone. It is the last link in the extensor mechanism, which straightens the knee. A complete patellar tendon rupture means you can no longer straighten the knee on your own, and surgery is needed to restore function. Dr. Andrew Dold, a board-certified, fellowship-trained sports medicine surgeon in Frisco, Texas, repairs patellar tendon ruptures in athletes and active adults.

Time matters. If you have been diagnosed with, or think you have, a torn patellar tendon, contact us right away. Repair is most successful when it is done early, ideally within about 2 weeks of the injury. Call 469-850-0680 or request an appointment; our team usually responds within an hour during business hours.
On this page:How it happens · Symptoms · Diagnosis · Surgical repair · Recovery protocol · FAQs · Research
At a glance

  • Most common in active people under 40, often during jumping or landing
  • You typically cannot straighten the knee, and the kneecap rides high
  • Surgical repair, ideally within about 2 weeks, gives the best results
  • Most patients regain near-full motion; re-rupture is uncommon
  • Return to sport usually takes 6 to 9 months

How does the patellar tendon rupture?

Ruptures usually happen during sport, when the quadriceps contracts forcefully against a bent knee, such as landing from a jump. They are most common in people under 40, and the tear often follows a period of tendon degeneration from repeated stress, sometimes after patellar tendinitis (jumper’s knee). Systemic illness and steroid medicines or injections can also weaken the tendon.1 In a review of 970 patients, almost 94% were men, with average ages between 32 and 45.2

Symptoms

  • A pop and sudden pain below the kneecap
  • Swelling and bruising
  • Inability to straighten the knee or lift the leg with the knee straight
  • The kneecap sitting higher than on the other side
  • A gap you can feel below the kneecap

Diagnosis

The diagnosis is usually clear on exam: a painful gap in the tendon, inability to straighten the knee against gravity and a high-riding kneecap (patella alta) on a side-view X-ray. Ultrasound or MRI helps when the diagnosis is in doubt, the tear may be partial or old, or other injuries inside the knee are suspected.1

Surgical repair

The tendon is repaired back to the kneecap (where most tears occur) with strong sutures through small bone tunnels or with suture anchors. Tears in the middle of the tendon are sewn end to end, and the repair may be reinforced when the tissue is weak. Dr. Dold chooses the technique for your tear.

  • In a review of 970 patients, repair restored motion, with average bending of 128° to 143°, an overall re-rupture rate of 3.9% and a re-operation rate of 5.7%.2
  • Bone-tunnel, suture-anchor and end-to-end repairs all produced good function scores.3
  • In laboratory testing, suture-anchor repairs of the patellar tendon showed less gapping than bone-tunnel repairs.4

Why early repair matters

The outcome depends largely on how soon the tendon is repaired. Delayed repair risks loss of knee bending and quadriceps strength, and old tears may need reconstruction with a graft.1

Watch Dr. Dold explain patellar tendon repair

Recovery after repair: Dr. Dold’s protocol

The repaired tendon needs protection while it heals to the bone, so knee bending is increased step by step. These are the phases of Dr. Dold’s rehabilitation protocol for quadriceps and patellar tendon repairs:

Phase What happens
0–2 weeks Walk with full weight as tolerated, using crutches, with the hinged brace locked straight at all times except for gentle exercises. Physical therapy starts about 7 to 10 days after surgery. Ankle pumps, quadriceps and buttock tightening exercises.
2–6 weeks Brace still locked straight for walking. Gentle passive bending increases gradually: 0–30° in weeks 2–3, 0–50° at week 4, 0–70° at week 5 and 0–90° at week 6. No active straightening of the knee yet.
6–12 weeks Brace opened to 30–40° for walking, then weaned off crutches. Bending to 115° at weeks 7–8, 130° at weeks 9–10 and 140° at weeks 11–12. Active knee straightening begins at about 10 weeks. Stationary bike and light closed-chain strengthening.
12–16 weeks Walking without the brace, full motion, balance work and strengthening to a 70° squat. No impact yet.
4–6 months Sport- and work-specific training, including gradual impact and jumping drills.
6–9 months Gradual return to sport once quadriceps strength is 95% to 100% of the other leg, with good control and no pain or swelling.

Physical therapy is usually 2 to 3 times a week for the first 3 to 4 months, with daily home exercises. Following the motion limits closely protects the repair from re-tearing. Most patients take aspirin for 21 days after surgery to lower the risk of blood clots.

Possible complications

Complications are uncommon but include stiffness, blood clots, infection and hardware irritation.2 Careful rehabilitation helps prevent stiffness while protecting the repair.

Watch Dr. Dold: patellar tendon repair

Some of these videos show real surgery, so some viewers may prefer not to watch.

Watch on YouTube · surgical video (YouTube sign-in required)
Surgical repair of a complete patellar tendon rupture

More videos on Dr. Dold’s YouTube channel.

What the research shows

  • Who ruptures it: patellar tendon ruptures mostly affect active adults under 40, often during a jump landing, sometimes after a long history of jumper’s knee. Systemic diseases, steroid use and certain antibiotics (fluoroquinolones) increase the risk, especially for ruptures on both sides.
  • Diagnose and repair early: an inability to straighten the knee against gravity with a high-riding kneecap suggests the diagnosis, confirmed with X-rays, ultrasound or MRI. Reviews agree that early repair, ideally within the first few weeks, gives the most reliable results; most complications come from missed or delayed diagnosis.
  • Repair technique: several methods work well, and no single technique is clearly better. Suture anchors show less gap formation in lab studies and lower re-rupture rates than bone tunnels in one clinical series. Augmentation is used selectively.
  • Good outcomes: reviews report high return to work and sport, with re-rupture rates under 5%. Professional athletes may perform below their usual level in the first season but typically recover by the second or third.
  • Late or chronic ruptures often need reconstruction with a tendon graft, with acceptable but less predictable results.

Why see Dr. Dold

  • Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
  • Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
  • Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
  • Published research on knee ligament and meniscus surgery, including The Posteromedial Corner of the Knee (JAAOS, 2017) and transtibial meniscal root repair (KSSTA, 2017)
  • Team physician and surgical consultant to Rugby Canada; has cared for professional athletes from the NFL, NBA, NHL, MLS, PGA Tour and Major League Rugby
  • D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google

Frequently asked questions

Can a torn patellar tendon heal on its own?

A complete rupture does not heal back to the bone on its own, and you cannot straighten the knee normally without repair. Surgery is recommended for complete tears.1

How soon should a patellar tendon rupture be repaired?

As soon as practical, ideally within about 2 weeks. Delayed repair can lead to loss of motion and strength.1

Can I put weight on my leg after surgery?

Yes. You can walk with weight as tolerated right away, with the brace locked straight and crutches for support.

How long until I can bend my knee?

Gentle passive bending begins at 2 weeks and increases gradually, reaching about 90° at 6 weeks and 130° by 9 to 10 weeks.

When can I return to sports?

Usually at 6 to 9 months, after strength testing shows your quadriceps is close to the other leg.

What is the risk of re-rupture?

Low. A review of 970 patients reported an overall re-rupture rate of 3.9%.2

Is a patellar tendon rupture related to jumper’s knee?

Often. Many ruptures occur in tendons weakened by long-standing tendon degeneration from repetitive stress.1 See patellar tendinitis.

How is this different from a quadriceps tendon rupture?

The patellar tendon is below the kneecap; the quadriceps tendon is above it. Patellar tendon ruptures are more common in younger athletes. Repair and rehabilitation are similar.

Research cited on this page

  1. Matava MJ. Patellar Tendon Ruptures. J Am Acad Orthop Surg. 1996;4(6):287-296. PubMed
  2. Dave U, Rubin J, Chang N, et al. Patellar tendon repair restores extensor mechanism function with a low complication rate: A systematic review. J Orthop. 2025;66:146-153. PubMed
  3. Davis G, Fellheimer HS, McCormick C, et al. Repair Techniques for Acute Rupture of the Patellar Tendon: A Systematic Review. Orthop J Sports Med. 2026;14(1):23259671251399844. PubMed
  4. Dankert JF, Mehta DD, Remark LH, et al. Transosseous tunnels versus suture anchors for the repair of acute quadriceps and patellar tendon ruptures: A systematic review and meta-analysis of biomechanical studies. J Orthop Sci. 2023;28(4):821-828. PubMed
  5. Ibounig T, Simons TA. Etiology, Diagnosis and Treatment of Tendinous Knee Extensor Mechanism Injuries. Scand J Surg. 2016;105(2):67-72. PubMed
    Review: risk factors include age, repetitive microtrauma, genetics, systemic diseases and certain medications; diagnosis is mainly clinical.
  6. Maffulli N, Wong J. Rupture of the Achilles and patellar tendons. Clin Sports Med. 2003;22(4):761-76. PubMed
    Review: Achilles and patellar tendon ruptures are associated with steroids and fluoroquinolones among other factors.
  7. Boublik M, Schlegel T, Koonce R, et al. Patellar tendon ruptures in National Football League players. Am J Sports Med. 2011;39(11):2436-40. PubMed
    Study: patellar tendon ruptures occurred in otherwise healthy NFL players, usually from eccentric overload.
  8. Depalma MJ, Perkins RH. Patellar Tendinosis: Acute Patellar Tendon Rupture and Jumper’s Knee. Phys Sportsmed. 2004;32(5):41-5. PubMed
    Review: acute rupture can be the end stage of patellar tendinopathy after landing from a jump.
  9. Pengas IP, Assiotis A, Khan W, et al. Adult native knee extensor mechanism ruptures. Injury. 2016;47(10):2065-2070. PubMed
    Review: patellar tendon ruptures are mostly sports injuries in people under 40, and almost all benefit from early repair.
  10. Brinkman JC, Reeson E, Chhabra A. Acute Patellar Tendon Ruptures: An Update on Management. J Am Acad Orthop Surg Glob Res Rev. 2024;8(4). PubMed
    Review: surgical repair is the mainstay; time to surgery matters for complete tears.
  11. Woodmass JM, Johnson JD, Wu IT, et al. Patellar Tendon Repair With Ipsilateral Semitendinosus Autograft Augmentation. Arthrosc Tech. 2017;6(6):e2177-e2181. PubMed
    Review: acute repair offers the greatest chance of a tension-free restoration of the extensor mechanism.
  12. Kovacev N, Antić J, Gvozdenović N, et al. Patellar tendon rupture–treatment results. Med Pregl. 2015;68(1-2):22-8. PubMed
    Study: timely diagnosis and early repair are key; comorbidities were linked to poorer scores.
  13. Volk WR, Yagnik GP, Uribe JW. Complications in brief: Quadriceps and patellar tendon tears. Clin Orthop Relat Res. 2014;472(3):1050-7. PubMed
    Review: complications and failures arise mostly from missed or delayed diagnoses.
  14. Tandogan RN, Terzi E, Gomez-Barrena E, et al. Extensor mechanism ruptures. EFORT Open Rev. 2022;7(6):384-395. PubMed
    Review: high return to work and sport and re-rupture rates under 5% after repair of native patellar and quadriceps tendon tears.
  15. Haskel JD, Fried JW, Hurley ET, et al. High rates of return to play and work follow knee extensor tendon ruptures but low rate of return to pre-injury level of play. Knee Surg Sports Traumatol Arthrosc. 2021;29(8):2695-2700. PubMed
    Systematic review: high rates of return to play after patellar and quadriceps tendon repair, with low re-rupture risk.
  16. Nguyen MT, Hsu WK. Performance-based outcomes following patellar tendon repair in professional athletes. Phys Sportsmed. 2020;48(1):110-115. PubMed
    Study: professional athletes had reduced performance in the first season after repair that recovered by seasons 2 and 3.
  17. Serino J, Mohamadi A, Orman S, et al. Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis. Injury. 2017;48(12):2793-2799. PubMed
    Network meta-analysis: no single repair method was clearly better for extensor mechanism ruptures.
  18. Fortier LM, Adelstein JM, Sinkler MA, et al. Patellar tendon restoration techniques: a systematic review of outcomes for repair and reconstruction methods. Eur J Orthop Surg Traumatol. 2024;34(8):3827-3845. PubMed
    Systematic review: primary repairs with and without augmentation gave comparable outcomes; cerclage augmentation had lower scores.
  19. O’Dowd JA, Lehoang DM, Butler RR, et al. Operative Treatment of Acute Patellar Tendon Ruptures. Am J Sports Med. 2020;48(11):2686-2691. PubMed
    Study: suture anchor repair had a lower re-rupture rate than transosseous repair.
  20. Onggo JR, Babazadeh S, Pai V. Smaller Gap Formation With Suture Anchor Fixation Than Traditional Transpatellar Sutures in Patella and Quadriceps Tendon Rupture: A Systematic Review. Arthroscopy. 2022;38(7):2321-2330. PubMed
    Systematic review: suture anchors showed smaller gap formation than transpatellar tunnels in biomechanical studies.
  21. El-Desouky II, Mohamed MM, Al Assassi M. Primary repair of ruptured patellar tendon augmented by semitendinosus. J Knee Surg. 2014;27(3):207-13. PubMed
    Study: after primary repair most patients reached 120 degrees of flexion and walked without a brace by 6 weeks.
  22. Seifert C, Vokes J, Roberts A, et al. Simultaneous Bilateral Extensor Mechanism Disruptions: More Than Double the Trouble?. J Knee Surg. 2020;33(9):899-902. PubMed
    Study: simultaneous bilateral ruptures had longer hospital stays and higher repair failure rates than single-side ruptures.
  23. Cimino A, Wall KC, Elphingstone J, et al. Extensor Mechanism Reconstruction for Chronic Patellar Tendon Tears. South Med J. 2023;116(2):208-214. PubMed
    Systematic review: chronic patellar tendon ruptures need reconstruction, often with graft, with acceptable outcomes.
  24. Meheux CJ, Jack RA, McCulloch PC, et al. Surgical Management of Simultaneous Anterior Cruciate Ligament and Patellar Tendon Ruptures: A Systematic Review. J Knee Surg. 2018;31(9):875-883. PubMed
    Systematic review: surgical management of chronic extensor mechanism ruptures with one- or two-stage reconstruction.
  25. Lee D, Stinner D, Mir H. Quadriceps and patellar tendon ruptures. J Knee Surg. 2013;26(5):301-8. PubMed
    Review: rehabilitation commonly allows immediate weight-bearing with the knee locked straight.
Ready to get it checked? Request an appointment online or call 469-850-0680. Our staff will contact you by phone and text within an hour of your request (during business hours, Monday–Friday, 8 am–5 pm). Walk-in visits are welcome Monday, Wednesday and Friday, 8:30–10:30 am at 6700 Dallas Parkway, Suite 100, Frisco, TX 75034. We see patients from Frisco, Plano, McKinney, Prosper, Little Elm, The Colony, Allen, Dallas and across North Texas. Same-day appointments available. Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.

Request an AppointmentCall 469-850-0680

Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.