Anatomy
Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.
Causes of Quadriceps Tendon Ruptures
Quadriceps tendon rupture most commonly occurs in middle-aged people who participate in sports which involve jumping and running. Quadriceps tear occur by a fall, direct blow to the leg and when you land on your leg awkwardly from a jump. Other causes include tendonitis (inflammation of quadriceps tendon), diseases such as rheumatoid arthritis, diabetes mellitus, and infection which weakens the quadriceps tendon. Use of medications such as steroids and some antibiotics also weakens the quadriceps tendon.
When the quadriceps tendon tear, the patella may lose its anchoring support in the thigh as a result the patella moves towards the foot. You will be unable to straighten your knee and upon standing the knee buckles upon itself.
Diagnosis of Quadriceps Tendon Ruptures
To identify a quadriceps tendon tear your doctor will ask about your medical history and perform a physical examination of your knee. Some imaging tests, such as an X-ray or MRI scan may be ordered to confirm the diagnosis. X-ray of the knee is taken to know the position of the kneecap and MRI scan to know the extent and location of the tear.
Quadriceps Tendon Repair Options
Quadriceps tendon tear can be treated by non-surgical and surgical methods. Non-surgical treatment involves use of knee braces to immobilize the knee. Crutches may be needed to prevent the joint from bearing weight. Physical therapy may be recommended to restore the strength and increase range of motion of the knee.
Quadriceps Tendon Repair Surgery
Surgery is performed on an outpatient basis; it cannot be repaired arthroscopically since the tendon is outside the joint. The goal of the surgery is to re-attach the torn tendon to kneecap and to restore the normal function of the knee. Sutures are placed in the torn tendon which is then passed through the holes drilled in the kneecap. The sutures are tied at the bottom of the kneecap to pull the torn edge of the tendon back to its normal position.
Surgical complications include weakness and loss of motion. In some cases, the tendon which is re-attached may detach from the kneecap or re-tears may also occur. Other complications such as pain, infection and blood clot may be observed.
Following surgery, a brace may be needed to protect the healing tendon. Complete healing of the tendon will take about 4 months.