How soon should a ruptured knee tendon be repaired?

Why timing matters

When a tendon ruptures, the quadriceps muscle keeps pulling the torn end upwards. In the first days the ends are usually soft and can be brought back together. Over the following weeks the muscle shortens, the tendon end scars down and the gap can widen.

That is why surgeons aim for early repair. It is not a reason to panic and operate the same night, but it is a reason not to wait for the swelling to settle on its own over a month. Most patients are operated on within days of diagnosis, once skin, swelling and medical checks allow.

What the operation involves

Through an incision at the front of the knee, the torn tendon is cleaned and strong sutures are woven through it. These are anchored back to the kneecap, either through small tunnels drilled in the bone or with suture anchors. The surgeon sets the tension so the kneecap sits at the correct height and the knee can bend safely.

The procedure is usually done under spinal or general anaesthesia, and many patients stay in hospital for a short period. The knee leaves theatre in a brace locked straight.

When repair is delayed

If a rupture is diagnosed late, often because it was first thought to be a sprain, direct repair may still be possible. In other cases the gap is too wide and the tendon is reconstructed using a tendon graft, from your own tissue or a donor. Recovery after a reconstruction is usually slower, which is one more reason to be seen early.

When surgery may not be needed

Partial tears where you can still lift the leg straight and the kneecap sits normally can often be treated in a brace with physiotherapy. Some patients with significant medical problems may also be managed without surgery after a careful discussion of the trade-offs.