Introduction:This study highlights the case of a 75-year-old female patient with a history of bilateral knee replacements who presented with a subacute patellar tendon rupture that occurred after falling on her left knee. Case Report: The patient had a left total knee replacement one year previously and came in for her one-year follow-up. She presented 3 weeks after her injury with a high-riding patella and a small tibial tubercle avulsion fracture on X-ray, yet she did not experience much pain nor any loss of active extension of her left knee. Despite the severity and subacute presentation of the patient’s patellar tendon injury, conservative measures that included physical and occupational therapy was recommended instead of surgery due to her paradoxical retention in gross function of her left knee. Conclusion: Showcasing this patient’s case may provide further understanding of patellar tendon ruptures and tibial avulsion fractures, specifically factors that allow the patient to retain strength and extensor function in her knee to curb the need for surgery.