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Quadriceps and Patellar Tendon Ruptures

About Your Quadriceps and Patellar Tendon

The quadriceps tendon connects the front thigh muscle (quadriceps) to the top of the kneecap (patella). The patellar tendon connects the bottom of the kneecap (patella) to the shin bone (tibia). The quadriceps, quadriceps tendon, and patellar tendon function together to straighten the knee. Quadriceps and patellar tendon injuries are rare and require urgent surgical treatment.

How Injuries Happen

The risk of a rupture increases if the tendon was already weakened from prior injury or an underlying condition. The most common mechanism for a quadriceps or patellar tendon rupture is the quadriceps muscle suddenly and forcefully contracting with the knee bent. In athletes, this can occur with sudden twisting while running or abnormal jumping and landing. In non-athletes, ruptures can occur from falling or other traumatic injuries.  

How It Feels

When the injury occurs, the patient may hear a “pop” or feel a tear. Patients with a quadriceps tendon tear or patellar tendon tear will often feel severe front knee pain around the knee cap. Typically, the knee swells, bruises, and has fluid in the joint. A gap may be felt where the tendon is torn. Patients are unable to straighten their leg and usually cannot walk.  

How We Fix It

Quadriceps and patellar tendon ruptures require early surgery to prevent long-term problems with mobility and more extensive surgery. For more complex and severe tears or chronic ruptures (more than a couple of weeks from the injury), tendon reconstruction may be required. A tendon from the patient’s knee (autograft) or tissue from a donor (allograft) may be used for reconstruction. In very rare cases when the patient has only a partial tear of the quadriceps tendon or patellar tendon and strength is normal, non-operative treatment can be considered. This may include physical therapy. 

What to Expect After Quadriceps and Patellar Tendon Surgery

Quadriceps and patellar tendon repairs are outpatient procedures, so the patient goes home the same day as the surgery. Patients use crutches and are immobilized in a brace for 6 to 10 weeks to protect the repair. Patients can bear weight partially. Strict adherence to physical therapy is required to regain function and quadriceps strength. Rehabilitation includes exercises to regain quadriceps strength, balance, and range of motion. Recovery usually is 4 to 6 months after surgery, and most patients are fully recovered 12 months after surgery, if not sooner.

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