Patella and Quadriceps Tendon ruptures
What is a patellar tendon tear?
The patellar tendon attaches the bottom of the patella (kneecap) to the top of the tibia (shin bone). The patella is also attached to the quadriceps muscles by the quadriceps tendon. Working together, the quadriceps muscles, quadriceps tendon and patellar tendon straighten the knee. Small tears of the tendon can make it difficult to walk and participate in other daily activities. A large tear of the patellar tendon is a disabling injury. It usually requires surgery and physical therapy to regain full knee function.
What causes a patellar tendon tear?
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Injury – A very strong force is required to tear the patellar tendon. Tears are commonly caused by a traumatic injury like a harsh landing from a jump or impact from a fall.
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Tendon weakness – Tendon rupture can also occur if the individual already suffers from tendon weakness caused by patellar tendinitis, corticosteroid injections or medications, or even certain chronic diseases
What are symptoms?
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Tearing or popping sensation
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Pain, swelling, and bruising
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Difficulty straightening your leg
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An indentation at the bottom of your kneecap where the patellar tendon tore
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Your kneecap may move up into the thigh because it is no longer anchored to your shinbone
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Difficulty walking due to the knee buckling or giving way
How is a patellar tendon rupture diagnosed?
The kneecap moves out of place when the patellar tendon tears, and this is often very obvious on a "side view" x-ray of the knee. Complete tears can often be identified with these x-rays alone.
Dr. Wusu may also order an MRI to further assess the severity of your injury and rule out other concurrent injuries.
What is the treatment for patellar tendon tears?
Very small, partial tears respond well to non-surgical treatment and conservative measures with rest, bracing, protected weight bearing, and physical therapy. With complete ruptures or more severe tears, most patients require surgery to restore the full function of their knee. Surgical repair reattaches the torn tendon back to the kneecap. Those requiring surgery tend to do better if the repair is performed soon after the injury to prevent the tendon from scarring down and tightening into a shortened position.
What is the quadriceps tendon?
The quadriceps tendon is the strong tendon that inserts on the top of the patella (kneecap), and it is a convergence of the four quadricep muscles that function to extend the knee and leg. All four of these muscles come together just above the patella and form a strong, thick tendon. The quadriceps tendon is important, and if injured or torn, the patient will not be able to extend their knee.
What causes a quadriceps tendon tear?
A rupture of the quadriceps tendon occurs relatively infrequently, and is usually seen in patients older than 40 years old. Injuries to the quadriceps tendon can be very disabling, and if not treated appropriately, can have many negative long-term effects. Common causes include:
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Injury – A very strong force is required to tear the quadriceps tendon. Tears are commonly caused by a traumatic injury like a harsh landing from a jump or impact from a fall.
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Tendon weakness – Tendon rupture can also occur if the individual already suffers from tendon pain and weakness prior to the injury
What are the symptoms?
When a quadriceps tendon tears, there is often a tearing or popping sensation. Pain and swelling typically follow, and you may not be able to straighten your knee. Additional symptoms include:
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An indentation at the top of your kneecap where the tendon tore
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Bruising and tenderness
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Your kneecap may sag or droop because the tendon is torn
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Difficulty walking due to the knee buckling or giving way
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Inability to extend the leg (if complete rupture)
How is a quadriceps tendon rupture diagnosed?
Initially a patient who presents with pain and swelling in the knee should undergo x-rays of the affected knee, since the kneecap moves out of place when the quadriceps tendon tears. This is often very obvious on a "side view" x-ray of the knee. Dr. Wusu may also order an MRI scan of the knee to evaluate all of the soft tissue structures in the knee and help distinguish between a complete and partial tear.
What is the treatment for quadriceps tendon tears?
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Partial tears – In some cases, partial tears can sometimes be treated non-operatively. In order for a partial tear to be treated without surgery, the patient must be able to perform a straight-leg raise. If this is the case, treatment consists of immobilization and eventual physical therapy.
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Complete tears – similar to the treatment of partial tears, surgery is necessary if the patient is unable to perform a straight-leg raise. Without surgical repair of the tendon, the patient will be unable to extend their knee and will ultimately have significant long-term disability. Surgery is recommended within a few days to a week following the injury.
