Quadriceps tendon rupture

Background

  • Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
  • Typically occur 2cm from insertion on patella

Clinical Features

  • Sudden "pop" or tearing
  • Diffuse swelling
  • Defect may be palpable above the patella
  • Partial tears lead to difficulty extending the knee
  • Complete tears lead to absent straight leg raise while supine or extension of the knee again

Differential Diagnosis

Knee diagnoses

Acute knee injury

Nontraumatic/Subacute

Evaluation

  • Ultrasound
    • Separation of the tendon can be visualized
  • X-ray
    • Patella baja/infera (low-riding patella)

Patellar vs Quadriceps tendon rupture

Finding Patellar tendon rupture Quadriceps tendon rupture
LocationDistal to patellaProximal to patella
Typical groupPatients <40yr with history of tendinitis or steroid injectionsPatients >40yr
X-rayPatella alta (high-riding patella)Patella baja/infera (low-riding patella)

Management

  • Ortho consult in the ED
  • Knee immobilizer, can be weight bearing
  • Operative repair advised within 7 days

Disposition

  • Outpatient

See Also

References

  • Wheeless' Textbook of Orthopaedics
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