Anterior Knee Pain

Recently had a patient come in after having surgery on his medial meniscus (stitched them together), did physio rehab for a while, got better but not full function then played basketball and re-injured via jumping in the air and then landed to stop and he felt the pain thereafter.

Saw his surgeon and did an MRI, stated that there was nothing but to rest up and go back to rehab.

Below are his complaints:
Pain = where the quad tendon and patella meet at the top.
Walking makes it worse and he feels like it’s going to give.
He walks slowly on it right now and unable to get a full ROM.

On exam:
Passive Knee Flexion – limited and tight
Knee Extension – not the same bounce as his good knee (left)
Rectus Femoris – also limited
Ankle dorsiflexion – limited
Lunge test – had a tough time doing it because he wasn’t able to bend the knee

After working on him for 3 visits, he felt worse on the first day then got better on the 2nd and 3rd visits. He left for vacation for almost a week, texted me today and told me he is feeling the same pain where the “quad tendon and upper patella meet.”

Am I on the right track to keep working on the knee? or do I send him back to his surgeon to look into it again?