What Is a Quadriceps Tendon Rupture?
The quadriceps muscles (“quads”) are often what most people think of when they hear the phrase “thigh muscles.” They are the muscles on the front of the leg above the knee and are the main muscles used for extending the knee. They are also among the largest and strongest muscles in the body.
The quadriceps are actually composed of four individual muscles; hence the “quad” part of the name, meaning “four.” These muscles are attached to the patella, or kneecap, at the meeting of these muscles. That attachment is the quadriceps tendon.
A quadriceps tendon rupture happens when the tendon tears. There are two types of tears: partial and full. With a partial tear, the tendon is intact but frayed, like a rope. A complete tear means the tendon has split into two pieces and is no longer attached to the kneecap.
Quadriceps Tendon Rupture Symptoms
Symptoms of a quadriceps tendon rupture include:
- Difficulty walking
- Inability to straighten the leg
- Indentation at the top of the kneecap
Quadriceps Tendon Rupture Causes
Accidents and injuries can cause quadriceps tendon ruptures, but the condition is also associated with chronic diseases. Some of these are:
- Chronic kidney disease and renal failure
- Metabolic disease
- Rheumatoid arthritis
- Systemic lupus erythematosus
Steroid injections, certain antibiotics and prolonged bedrest are other possible causes and risk factors.
Diagnosing Quadriceps Tendon Ruptures
A medical history and physical exam are the first steps in diagnosing a quadriceps tendon rupture. The doctor will want to know about previous injuries to the knee or quadriceps and any history of chronic disease. A physical exam is performed in order to see how easily the leg straightens.
Imaging tests are often used to confirm a suspected diagnosis. An X-ray can show if the patella is out of position, while a magnetic resonance imaging (MRI) scan shows damage to soft tissue, such as the quadriceps tendon.
Quadriceps Tendon Rupture Treatment
Most small and partial tears can usually be treated with conservative, nonsurgical methods. These include immobilization in a brace to straighten the knee and help it to heal, and physical therapy to strengthen the muscles around the knee and increase its range of motion.
Most complete tears require surgical repair. There are various ways to repair a quadriceps tendon surgically. One way is drilling holes in the kneecap and reattaching the tendon with sutures through the holes. The knee is then immobilized with a knee immobilizer or cast. Recovery takes at least four months, with most ruptures healed after six months, but complete recovery may take as long as a year.
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