Dent under patella (kneecap)

@jsjsbw Hello and welcome to Connect. Waiting for a medical verdict is hard, isn't it? That is really all you can do at this point, but I would echo your concern about a possible tendon or ligament tear. The knee cap is the only bone in the body that is enclosed within a tendon to the thigh and a ligament that connects it to the main bone of the shin (tibia). You can palpate your good leg to understand how it connects and feel the patella inside the connections. Right under the knee cap, you will be able to press and feel the spring from the broad ligament connection. If you no longer see the shape of that connection under the skin of the injured knee, it is possible that it was torn away from the bone and you need that MRI imaging to tell you how much damage there is. There could also be damage to other ligaments inside the knee. My hunch is that your orthopedic surgeon will offer a surgical repair. Recovering from an injury to your legs is hard because the loss of function affects mobility as you are experiencing now. Getting back your strength in rehabbing after surgery and immobilization is also tough. I just did that with an ankle fracture that happened in 2020, and a few months ago surgery to remove the titanium plates that were bothering me. My husband also partially tore his Achille's tendon which didn't require surgery because it mended back together. All of these recoveries are long and require rehab afterward.

I know that this is kind of frightening to think about. I have had 2 injuries where I heard the tear happen with a popping sound. One was my shoulder when I reached behind me from the driver seat of my car to yank on something, and I had a pop sound and instant pain. That was a cartilage tear in my shoulder that healed itself over time and didn't require surgery. The other was much more serious. I had a whiplash years ago, and I had a bulging spinal disc in my neck for years. I was stretching my neck with my head turned, and I heard the popping sound and my head suddenly turned farther than its limit. That was when the bulging disc ruptured spilling the jelly like contents into my spinal canal. It felt weird, but wasn't painful. Over the next year, the inflammation from the herniation and the instability of the damaged disc caused bone spurs to grow next to it inside the spinal canal. That lead to spinal cord compression and spine surgery at Mayo that was a great success.

If you are shopping for a surgeon, you may want to research now if you have a choice about by whom or where you can have treatment. Find the best surgeon that you can that is covered by your insurance. You can even call your insurance and they may be able to recommend one of the surgeons recognized for getting good results. Also ask doctors you trust for their recommendations. I am surprised that it has been a few weeks, and this imaging was not done then to diagnose the problem. After traumatic injuries, surgeons often wait for the swelling to go down before they go in and cause more swelling. That was true with my ankle fracture. I had an external cage screwed into the bones to stabilize the ankle for a 2 and a half weeks that was done from the emergency room admittance. I decided to come back to Mayo for the fixation ankle surgeries because I was already a Mayo patient, and I asked my Mayo spine surgeon for a recommendation to an orthopedic trauma surgeon. That is a sub-specialty of orthopedics for surgeons with more trauma training. Certainly do ask questions about how and why surgeries can fail. I am not saying that to cause worry, but the answers may give you an indication of your surgeon's experience. Ask how many surgeries they have done for similar injuries and what their success rate is for those surgeries, and what your odds of success may be in your specific case of your health status and age. Success is subjective, and your results may never be what was your normal before the injury even though the surgery is successful in restoring function.

Is this the first time you have had an orthopedic trauma injury? What questions do you think would be good to ask the surgeon? Do you have an evaluation scheduled with a specialist?