> Quadriceps Tendon Rupture
There are four muscles in the
front of your thigh that make up the quadriceps muscle
unit. These muscles attach to one quadriceps tendon,
which attaches to the kneecap. When you flex your quadriceps
muscles, the quadriceps tendon is what allows them to
pull on the kneecap and straighten your leg. Off-balance
falls or abnormal strain can completely tear your quadriceps
tendon. This rupture usually happens just above the
kneecap, close to where the quadriceps tendon attaches
to the kneecap bone, leaving quadriceps muscles with
nothing to pull on when they flex. Most people cannot
straighten their leg when the quadriceps tendon ruptures.
Quadriceps tendon ruptures are rare
in sports. To rupture the tendon, a large force is required
and your knee usually must be bent well past 90 degrees,
such as falling with your foot caught under your buttocks.
Healthy knees are only at risk of suffering a ruptured
quadriceps tendon during activities that involve high
speeds, direct contact, or twisting like skiing,
football, and basketball. Landing from a jump incorrectly
and heavy weightlifting can also rupture your quadriceps
tendon. People over the age of 50 suffer the majority
of quadriceps tendon tears. But at any age, a history
of repeated knee injuries, previous knee surgery, or
joint disease could put you at greater risk of a quadriceps
tendon rupture. This means that less force could rupture
your quadriceps tendon if you have suffered multiple
microtears, or minor injuries over the years, and especially
if you have a disease like rheumatoid arthritis that
weakens the fiber material (collagen) in your tendons.
Although a ruptured quadriceps tendon is not a life-threatening
emergency, you should seek treatment as soon as possible.
Whenever possible, do not wait to see if your pain goes
away on its own. Physicians generally suggest that you
undergo surgery immediately after a tendon rupture.
Surgery is most effective when performed within several
days of the injury. However, if you wait more than two
weeks to seek treatment, your ruptured tendon may begin
to heal in an abnormal position, which makes repairing
the tendon more difficult and decreases your chance
of returning to activities at full strength. Non-operative
treatments like ice and immobilization are ineffective.
Ruptured quadriceps tendons almost always require surgery
to sew the split tendon back together. Most quadriceps
tendon ruptures occur in older people. However, anabolic
steroid use puts young people at high risk of quadriceps
| Orthopedic Evaluation
There are usually three parts to an
orthopedic evaluation: medical history, physical examination,
and tests your physician may order.
will likely ask you when your quadriceps tendon rupture
occurred, how it has been feeling since the pain began,
and if your knee has been previously injured. Physicians
also typically ask about other conditions, such as diabetes
and allergies, and medications currently being taken.
The doctor may also ask about your physical and athletic
goals information that will help to decide what
treatment might be best for you in achieving those goals.
A physician usually can make an early
assessment of an injury by feeling around the area.
Because the kneecap is easily visible, physicians can
easily test for pain and tenderness. He probably will
move your kneecap up and down. A ruptured quadriceps
tendon usually causes your kneecap to move abnormally,
downward toward your shin. The doctor sometimes can
feel a defect where your quadriceps tendon has split
in two. By moving your kneecap around to check how well
it tracks as your leg bends up and down, physicians
can often determine any underlying damage caused by
a quadriceps tendon rupture.
Should your physician require a closer look, the following
tests may be conducted:
taken from different angles can occasionally show when
your kneecap is out of place, signaling that the connection
to the thigh muscles has been ruptured. Physicians usually
take X-rays of both knees so they can see the position
of the healthy kneecap and sew the ruptured tendon at
a matching length.
(magnetic resonance imaging) may be used to see if the
rupture has caused any bone, cartilage, or muscle problems.
in which a tiny camera is inserted into your knee, may
be used to determine the diagnosis in more detail. It
is rarely needed to diagnose a tendon rupture but it
may help your physician determine if any other injuries
are present. Arthroscopy is usually done on an outpatient
basis, and does not require a hospital stay.