Paediatric Patella Tendon Rupture: A Systematic Review

The patella tendon is an important part of the extensor mechanism, and ruptures can lead to significant impairment. The condition is rare in children and adolescents, and as a result, the paediatric literature is limited. Injury patterns may differ from those seen in adults. This systematic review therefore aims to evaluate the presentation, diagnosis, management and outcomes of patella tendon ruptures in children and adolescents. A literature search was performed using PubMed, Medline and Embase to identify studies based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search period included all studies up until the 22nd May 2026. A total of 350 studies were identified from the initial literature search after duplicates were removed. Five studies covering 28 patients met the eligibility criteria and were included. Over 95% of patients with a patellar tendon injury were male. Basketball was the most common sport where ruptures occurred, and axial loading was the most commonly reported mechanism of injury. Distal patellar tendon ruptures were more common than proximal or mid-substance tears. Over 70% of cases had an associated tibial tubercle fracture, although this was affected by selection bias since 3 of the 5 studies specifically enrolled patients with tibial tubercle fractures. Three studies noted patella alta, or a high-rising patella, in all 10 documented cases of injury in which it was assessed. All patients were managed surgically predominantly via the use of transosseous tunnels or suture anchors. Reported outcomes were generally favourable and included active range of motion, the ability to weight bear, and quadriceps strength. To conclude, paediatric patella tendon ruptures are uncommon but should be considered in children presenting with acute knee trauma and extensor mechanism dysfunction, particularly where tibial tubercle fractures are diagnosed. Larger multi-centre studies with standardised diagnostic, operative and outcome reporting are needed in future research.