Understanding A Quadriceps Tendon Rupture
The quadriceps muscles are a group of four muscles that are located in the front of the upper leg and are usually referred to as the thigh muscles. The muscles come together to form one large tendon as they travel to the knee, called the quadriceps tendon. The quadriceps tendon connects to the upper part of the knee cap and is the primary extensor of the knee. Injury to the tendon can be problematic for athletes in a variety of sports. Due to significant stresses with sprinting sports as well as with lower body exercises such as squats, the quadriceps tendon is susceptible to several injuries such as tendonitis, tendon strain or tendon rupture. If the injury is acute and sudden, such as during a slide or jumping movement, the tendon can be strained or even completely torn as in this case.
Evaluation of Quadriceps Tendon
The most obvious sign in a quadriceps rupture will be that the knee cap is dropped out of place and the athlete will not get much movement when they try to flex the knee. They may get some slight movement due to other muscles that flex the knee that aren't including in the quadriceps muscle. The athlete likely will not be able to walk. Athletes will usually have notable swelling over the front of the upper knee as well as a palpable defect where the rupture occurred. Keep in mind, the swelling is usually concentrated over the tendon rather than throughout the entire knee such as in an ACL tear or Meniscus tear. Generally, the diagnosis is pretty clear on exam but MRI and Ultrasound are two options for diagnostic imaging.
MRI Evaluation of Ruptured Quadriceps
Treatment and Return to Play
In general, a complete quadriceps tendon rupture is likely going to require a surgical repair. The repair usually involves suturing the torn tendon back to the knee cap. Most athletes can return to sports but slightly over half of people have thigh weakness and soreness at the site of the tear. People who require surgery do better if the repair is performed early after the injury. Return to play is varies widely and is usually in the 4-6 months range, however it depends upon the sport.