Left: An X-ray shows the normal location of a kneecap. Right: The kneecap has moved up the leg due to a patella tendon rupture. (These are not Kurtley Beale’s X-rays). Photo: Supplied. Down and out: Kurtley Beale was stretchered off in the opening minute of the Waratahs’ game against the Bulls. Photo: Getty Images
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With an unsettling pop, the pain would have been instant as Kurtley Beale’s patella tendon tore clean off the bone in the opening minute of the Waratahs’ game against the Bulls last Saturday.

But that clean tear was the best possible outcome, as far as patella avulsions go, because the ligament itself was left intact.

That strong, whole band of connective tissue capable of withstanding the stress and tension of a rugby regimen gives Beale his best chance of making a full recovery.

A doctor might describe the patella tendon as a ligament that connects the patella to the tibia. In layman’s terms, it’s the thing that holds your kneecap to your shinbone.

The giveaway on an MRI or X-ray is a dislodged kneecap that appears to have floated up the thigh, with nothing to anchor it to the shinbone.

A complete tear of your patella tendon won’t just keep you off the rugby field, it’ll put you on the couch for months. You can’t walk, you can’t run, you most likely can’t even straighten your leg. Surgery is the only option.

And Beale’s surgery was a success, the Waratahs camp says. His surgeon reattached the tendon to the patella using sutures with a bullet-like tip to thread the stitches through the ligament.

The good news kept coming, with Beale’s scans showing no other injuries to his knee.

Patella tendon ruptures are a relatively rare lower extremity injury for rugby players, more common in jumping sports such as basketball, AFL and volleyball, said Professor Evangelos Pappas, physiotherapist and expert in lower extremity injuries at the University of Sydney.

It’s far less common than the ubiquitous ACL or MCL tear on the rugby field, which usually saddles players with a recovery time of up to nine months, Professor Pappas said.

Beale’s expected recovery time is four to six months, a fair slog, which he’ll spend in a leg brace slowly building up his range of movement.

“It’s quite likely that he will make a full recovery,” said Professor Pappas, who is not part of Beale’s treating team.

“He’ll have to deal with the consequences of the surgery more than anything else because he is going to lose a lot of muscle strength, he’s going to lose a range of motion,” he said.

“Working with a physiotherapist to recover strength and movement safely and quickly is going to be a matter of balance.

“You don’t want to be too aggressive early on and compromise the quality of the surgery and the tissue healing process, but you also don’t want to delay too much because then it’s going to be much more difficult to recover completely,” he said.

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