Oguchi Onyewu will have surgery Wednesday to repair a ruptured patellar (patella- knee cap) tendon in his left knee, an injury sustained during last week’s World Cup qualifier against Costa Rica.
The Journal of Bone and Joint Surgery (JBJS) says that a force of 17.5 times the body weight is required to rupture the patellar tendon in a healthy individual. Which means that Gooch was subjected to a force of approximately 3600-3700 lbs.
” The injury most commonly occurs in patients younger than forty years of age who overload the extensor mechanism during athletic activity.”
The diagnosis of patellar tendon rupture should be differentiated between quadriceps tendon rupture and meniscal injury. Diagnosis should be carefully established by thorough physical examination and radiological investigation.
History

• Pain out of proportion to injury

• Inability to stand or walk

• Giving-way of knee joint

Physical examination

• Inability to extend knee

• Palpable defect in patellar tendon

• Effusion (swelling)

Radiographs

• Patella alta

When the patella rides high on the lateral view of a radiograph (as seen in the above figure) it is called patella alta and a ratio establishes the extent of displacement. Patella alta occurs when the patellar tendon ruptures.
Usually surgery is delayed 4-7 days for the swelling to subside and to decrease the chances of wound complications.
Most patellar tendon repairs take 4-6 months to rehab (Gooch’s timeframe is to be determined after surgery) with his physical therapy progressing in stages relying on getting back good active knee control and at the end of the 4th month commence running and sport specific training.