Quadriceps Tendon Tear

What is a quadriceps tendon tear?

– The quadriceps tendon can be found just above the kneecap and connects the muscles in the front of the thigh to the top of the knee cap.
– They are generally “high energy” injuries, and occur as a result of vigorous sporting activities, a car accident or falls from a height or standing position .
– The mechanism of this injury is an eccentric (lengthening) contraction of the quads resulting in a painful disabling condition.
– Tears are more common in middle aged populations.
– Tendon weakness caused by tendinitis or chronic disease will result in higher risk of sustaining a quads tendon tear.
– Most large quads tendon tears should be treated surgically.

What are the symptoms of a quadriceps tendon tear?

– Popping or tearing
– Pain and swelling usually immediately after trauma
– Inability to straighten or extend the knee
– An indentation at the top of your kneecap where the tendon tore
– Bruising
– Tenderness
– Knee cramping
– Your kneecap may droop because the tendon is torn
– Difficulty walking due to the knee buckling or giving way

How is a quadriceps tendon tear diagnosed?

– X-rays to rule out bone fractures. X-rays can also show a patellar baja (a knee cap that is lower than normal).
– MRI is the gold standard here, because it can help distinguish between a full and partial tear.

What is the treatment of a quadriceps tendon tear?

Small or partial tears may heal with brace immobilisation, crutches and physical therapy.

– The patient in this case should be able to do a straight-leg raise and exhibit good knee strength during Dr Herald’s examination of their knee.
– In these cases immobilisation should commence immediately for a short period, and range of motion exercises started a few weeks after injury.
– Typically, partial tears will health in about three months. 
– However most complete tears require surgery to repair the torn tendon. 
– Surgery involves reattaching the torn tendon to the top of the kneecap.
– Results are better if the repair is performed soon after the injury to prevent tendon scarring or the tendon shortening and tightening.
– Usually this surgery should be done within a week of the injury if the patient has no other underlying health issues that need to be treated first.
– Recovery generally takes 6-8  months, with physical therapy starting within a few days of surgery.
– The brace is typically discontinued at eight weeks of surgery. 
– The quadriceps muscle is very powerful and if problems are not identified early it can be harder down track to fix with surgical repair.
– Re-tear after surgery is rare, unless there is an injury or fall close to the operative phase.