Both the quadriceps tendon and patellar tendon are thick fibrous tissues. Unlike muscle, these tendons do not expand and contract. They are strong tissues meant to transmit the pulling force of the quadriceps muscle.
How does the quadriceps tendon or the patellar tendon rupture?
Typically, patients who experience this injury fall on to a partially bent knee. When the quadriceps muscle contracts to break the fall, the quadriceps tendon or patellar tendon cannot withstand the force and ruptures. This injury is most common in middle-aged (30-60 year olds), part-time athletes (weekend warriors). That said, some injuries to the quadriceps tendon and patellar tendon occur in non-athletes, performing non-athletic activities.
What are the symptoms of a quadriceps tendon or patellar tendon injury?
Patients usually know something is wrong, but they are often unsure of what happened. Some patients are able to walk following this injury, but many cannot. If the tendon is completely ruptured, the patient will be unable to straighten the knee without help and he or she will be unable to perform a straight leg raise. Most patients will have swelling of the knee and a palpable defect at the location of the tear.
Do I need to go to the ER if I have this injury?
You should have a suspected quadriceps or patellar tendon injury evaluated by a physician and x-rays should be obtained. It is often difficult to distinguish without x-rays a patellar (kneecap) fracture from a patellar tendon or quadriceps tendon injury. Diagnosis of this injury can be difficult, especially in obese patients.
What is the treatment for a quadriceps tendon or patellar tendon rupture?
Initially, patients are placed in a knee immobilizer, given crutches, and instructed to ice and elevate the injured leg. The treatment for complete rupture of the quadriceps or patellar tendon is to surgically repair the torn tendons. This procedure is done in an operating room and lasts about an hour.
The tendon usually tears off the bone of the kneecap, and to repair it, strong sutures are tied to the tendon and then passed through holes drilled in the kneecap. These strong sutures are tied in place to pull the torn edge of the tendon back to its proper attachment on the kneecap.
What is the rehabilitation following surgery?
Post-operatively, patients will be placed in a brace to cast to protect the healing tendon. Depending on the strength of the repair, some motion is usually started within a few weeks, and gradually progressed over time. Complete healing of the tendon will take 8 to 12 weeks.
Last updated: 02/18/2006
References:
- Lyle, J. "Quadriceps Tendon Rupture" eMedicine, 3/18/2005.
- Annunziata, C. "Patellar Tendon Rupture" eMedicine, 12/30/2002.
