Breaking Down Andre Roberson's Patellar Tendon Rupture

Oklahoma City Thunder lockdown defender Andre Roberson reportedly ruptured the patellar tendon in his left knee Saturday night, an injury that will cause him to miss the remainder of the season.

The patellar tendon is a strong band of connective tissue that, along with the quadriceps tendon, enmeshes the patella (or kneecap) and connects the quadriceps muscle group to the tibia of the lower leg.

The patellar portion of the functionally continuous though anatomically distinct tendon runs from the bottom of the patella to the tibia, while the quadriceps portion runs from the top of the patella to the quadriceps itself. The presence of the patella within the tendon increases the lever arm of the quadriceps muscle, making it so that the muscle can produce a greater force with contraction.

A rupture of the patellar tendon would be classified as a Grade 3 strain, meaning that between 50-100 percent of the tendon’s fibers were torn. A Grade 2 strain would mean that 10-50 percent of the fibers were torn and a Grade 1 that less than 10 percent of the fibers were compromised.

Grade 1 injuries, being the least severe usually heal themselves in a couple weeks, Grade 2 injuries in a month or two, whereas Grade 3 injuries typically require surgical intervention and can hold out players for six months or more.

Typically the patellar tendon ruptures when the quadriceps is forcefully contracted when the leg is bearing weight. Contraction of the muscle causes knee extension (straightening), which is an important component of forceful jumping and running among other things.

Although Roberson’s fall is scary in the video below, the injury occurs right as he is about to take off on his jump. Roberson attempts a single-legged jump with his left leg to catch an alley-oop pass. That action is what led to the rupture.

Something that is interesting to note in Roberson’s case is that he missed eight games earlier in the season with patellar tendinitis in the same knee. Whether or not the condition was a true tendinitis (the -itis suffix infers an acute underlying inflammatory process) or was more of a tendinosis (-osis infers a chronic condition without an inflammatory process), previous patellar tendinopathy (-opathy: disordered state) has been linked with rupture down the line in the scientific research.

The tendinopathic condition weakens the tendon making it more susceptible to rupture.

Now, it should be noted that that doesn’t mean Oklahoma City’s medical staff didn’t handle Roberson’s original tendinopathy correctly. If Roberson passed their objective tests with data suggesting he was healthy — for example, at least 80-90 percent congruency between both legs with single-leg hop distance — and reported minimal to no pain, then he would’ve been cleared to play by any professional medical staff.

It’s just that the link between previous tendinopathy and tendon rupture is worth mentioning.

Magnetic resonance imaging (MRI) or ultrasonography are needed to provide an official diagnosis, but a strong indication leading to a diagnosis of patellar tendon rupture can be obtained without. Typical signs pointing to a diagnosis of patellar tendon rupture include an inability to place weight on the involved leg, elevated patella, inability to extend the knee, significant bruising, and pain/tenderness around the knee.

As mentioned previously, surgical intervention is the path that is taken with complete ruptures of the patellar tendon. The player is typically progressed from partial weight-bear to full weight-bear over the first four-to-six weeks.

Light strengthening exercises — such as isometric quadriceps contractions and straight leg raises — are initiated in the 6-12 week range and running, jumping, and other sport-specific tasks beginning at the four-to-six months post-surgery mark. Players usual return to game action in the 6-10 month range.

Brooklyn Nets guard Jeremy Lin suffered the same injury earlier in the season and San Antonio Spurs point guard Tony Parker suffered a similar injury, though his was a rupture of the quadriceps tendon, at the end of the 2016-17 season.

Hall of Famer Alonzo Mourning also ruptured his patellar tendon late in his career.

Here is a list, though it’s almost 10 years old, of players who’ve had similar injuries.

Losing Roberson, Oklahoma City’s best wing defender and arguably one of the best wing defenders in the league, will be a tough blow for the Thunder, who currently sit in fifth place in the Western Conference. An MRI, which will be taken in the next few days, will likely confirm Roberson’s diagnosis and surgery will be undergone soon thereafter.

From there, Roberson will begin his road towards a full recovery.

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