Patellar Tendon Rupture & Quadriceps Tendon Rupture Overview
Muscles, tendons, bones and ligaments compose the extensor mechanism and allow the leg to straighten and function. The quadriceps muscle, quadriceps tendon, patellar tendon and patella are the main extensor mechanism structures. The quadriceps tendon and patellar tendon are the large tendons that connect the quadriceps (thigh muscles) to the patella (kneecap) and the leg. When a patellar tendon rupture or a quadriceps tendon rupture occurs, it may become difficult to walk, run and compete in sports activities. Dr. Brian Waterman, knee specialist, is well trained in treating knee tendon ruptures and returning athletes to play.
A patellar tendon rupture and quadriceps tendon rupture are relatively uncommon. They are typically found in patients over the age of 40 who experience a fall or forced flexion of the knee during sports activities. Athletes may sustain a tendon tear as a result of a hard landing from a jump when the quadriceps muscle is contracted and the knee is forced to bend.
Weakened tendons are at an elevated risk of tearing in many patients. A patellar tendon rupture and quadriceps tendon rupture can be either partial or complete. A partial tear does not completely disrupt the soft tissue. The tissue may experience a tear but it remains in one piece. A complete tear completely disrupts the soft tissue into two pieces, which significantly compromises function.
Symptoms of Knee Tendon Ruptures
Patients who experience a knee tendon rupture will typically have a painful, swollen knee shortly after the traumatic event. Most describe a painful “pop” during the injury and are unable to ambulate after. Some patients may also have difficulty straightening the leg and functioning while walking or standing.
Diagnosis of Knee Tendon Ruptures
During a consultation with Dr. Waterman, he will perform a thorough physical examination, including a straight leg test, to look for a tendon gap. The tendon gap may appear just above the kneecap in a quadriceps tendon rupture or below the kneecap in a patellar tendon rupture. X-rays and an MRI are also performed in most cases to rule out fractures, evaluate ligament damage and confirm the diagnosis.
Treatment of Knee Tendon Ruptures
Dr.Waterman will determine the appropriate treatment depending on the type and size of tendon tear, patient’s age and patient’s activity level. If a tendon tear is left untreated, it commonly leads to chronic knee weakness and stiffness.
Very small, partial tears may respond well to non-surgical measures such as knee immobilization with a brace and a physical therapy recovery program.
Most patellar tendon ruptures and quadriceps tendon ruptures require surgery to regain full leg function. During a surgical repair, Dr. Waterman will sew the ends of the torn tendon to secure them and then reinforce the repair by bringing sutures through the patella bone. After surgery, it typically takes 6-8 weeks for the tendon tear to heal. Post-operative therapy is used to allow patients to regain range of motion, strength and function. Patients will require a brace for the first six weeks after surgery to protect the repair, and are generally ambulating normally without a brace or crutches after 8 weeks. Most patients return to athletics or sports participation approximately six months after repair.