Quadriceps Tendon Tear

Complete tears affect middle-aged men more than women and are caused by a sudden force that overloads the tendon such an awkward landing from a jump, a fall or direct hit on the front of the knee.

Risk Factors include:

• People who are middle-aged are at a higher risk of a quadriceps tear.
• Activity. People who participate in sports that require running and jumping are at a higher risk for this type of injury, especially if they are middle-aged.
• Certain types of medications, such as corticosteroids and fluoroquinolone (an antibiotic), are associated with quadriceps tendon tears. Steroid use has been linked to increased muscle and tendon weakness.
• The muscles and tendons supporting your knees can lose strength and flexibility after a prolonged period of inactivity.
• Tendon Weakness. Tendon weakness can be caused by repetitive stress that causes tendinitis, inflammation, and microscopic tears.
• Chronic disease. Diseases that disrupt the blood supply, such as renal (kidney) failure, gout, and rheumatoid arthritis can weaken tendons.

There is frequently a tearing or popping sensation in the quadriceps at the moment a tendon tear occurs. Afterwards, pain and swelling typically occur. If the rupture is a complete tear, you will not be able to straighten your knee. Other symptoms include:

• A concavity or gap in the area above your kneecap
• A sagging or drooping kneecap
• Difficulty walking (the kneecap buckles or gives way)
• Cramping, bruising, or tenderness

In order to diagnose a quadriceps tendon tear, Dr. Patel will conduct an orthopaedic examination of your knee including testing how well you can bend and straighten the knee. He will discuss your symptoms and medical history with you to identify risk factors and will want to know if you have previously injured your knee or a quadriceps muscle. He will order imaging studies including x-rays and magnetic resonance imagining (MRI) scan to confirm the diagnosis.

Treatment will typically depend on your age, activity level, and whether it is a complete or partial tear. Small, partial tears respond well to nonsurgical treatment such as immobilization (wearing a knee brace) and once the swelling has subsided, physical therapy. A complete tear will likely require surgery to reattach the torn tendon to the top of the kneecap.

In rare situations, significant time may go by before the diagnosis is made and this can be a difficult situation to manage as the tendon retracts. These chronic tears often require complex augmentation or reconstruction surgeries. Dr. Patel is one of the few surgeons who manages these complex situations. He has published on this topic and other surgeons often turn to Dr. Patel for his expertise in these cases.