Patellar Tendon Avulsion in a Pediatric Male: A Surgical Case Report with a Return to Sport

Isolated patellar tendon injuries in the pediatric population are considered rare and lack a well-accepted classification system. This injury pattern in pediatrics occurs more commonly in males around 14 years of age, typically presents with apophyseal involvement, and is frequently associated with athletic activity. The patient, in this case, was a 12-year-old male who sustained an isolated distal patellar tendon injury while running. This case is unique due to lack of apophyseal involvement commonly seen in the pediatric population. On exam, a classic high-riding patella was not seen on initial X-ray, and he was able to actively extend his knee, two clinical clues associated with the diagnostic triad of patellar tendon injury. Magnetic resonance imaging was utilized to confirm the injury pattern which prompted urgent surgical intervention to allow for initiation of rehabilitation with a goal of returning to athletic activities. The patient was able to progress to full weight-bearing at 1.5 months, achieved full range of motion at 3 months, demonstrated symmetric strength with uninvolved lower extremity at 4.5 months, and had progressed back into sporting activities by 5.75 months postoperatively. The low frequency of this injury in the pediatric population requires urgent recognition and diagnosis to allow for prompt surgical intervention followed by rehabilitation for efficient return to play.