I'm in the same boat as you, 30yo and twisted/tore my patella on Go Skate Day 2023. Took like 5-6 weeks off and felt my range of motion get back and started skating again but any sort of slight tweak or rotational tricks sent the pain back in the knee/inner knee where the twist was. Ignored those obvious red flags and still kept skating and not doing too much weight lifting or plyos like I should've been to help strengthen and condition it to handle impact. After a month and a half of skating through pain, I finally re-injured it full on again missing a nose grind on a small ledge.
Took a month off, got serious with weight lifting and plyos, thought I was good again with and then fell and re-injured it AGAIN from missing a back crook on a ledge. From there I finally had enough and took about 4 months basically without skating (did some flatground here and there but didn't feel ready to come back).
Now I've been back to skating 2 weeks now and I'm scared to commit to almost all my flatground tricks and only landing 1 or 2 flip tricks in a hour long session, and I'm too scared to touch a ledge even though that's my favorite thing to skate, or any real obstacle from fear of even the slightest fall sending me back to square one.
My knee and surrounding muscles are definitely stronger since I started taking those strength training exercises that Skateboard Strength recommends, but so far the lack of confidence and the bit of lingering unstable feeling in my knee have made return to skating so difficult. I'm 10 months removed from the initial injury but I'm hoping that with only skating flatground, continuing my strength training, listening to my body, and being super patient that I will be back to 100% by summer or fall time.
But if I reinjur it again I may finally need to see a physio and get some scans to see if I may need surgery after all- I'm really hoping it does not come to that.
Best of luck on your recovery! Get serious about strength training and doing plyometrics and be patient/smart when you're out there skating! Hope we all stay strong and healthy on the board for years to come.