Quadriceps Tendon Tear
Tendons are strong cords of fibrous tissue that attach muscles to bones. The quadriceps tendon works with the muscles in the front of your thigh to straighten your leg.
Small tears of the tendon can make it difficult to walk and participate in other daily activities. A large tear of the quadriceps tendon is a disabling injury. It usually requires surgery and physical therapy to regain full knee function.
Quadriceps tendon tears are not common. They most often occur among middle-aged people who play running or jumping sports.
Cause
A quadriceps tear often occurs when there is a heavy load on the leg with the foot planted and the knee partially bent. Think of an awkward landing from a jump while playing basketball. The force of the landing is too much for the tendon and it tears.
Tears can also be caused by falls, direct force to the front of the knee, and lacerations (cuts).
Symptoms
When a quadriceps tendon tears, there is often a tearing or popping sensation. Pain and swelling typically follow, and you may not be able to straighten your knee. Additional symptoms include:
- An indentation at the top of your kneecap where the tendon tore
- Bruising
- Tenderness
- Cramping
- Your kneecap may sag or droop because the tendon is torn
- Difficulty walking due to the knee buckling or giving way
Diagnosis
Physical Examination & Patient History
During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy. Most injuries can be diagnosed with a thorough physical examination.
Imaging Tests
Imaging Tests Other tests which may help your doctor confirm your diagnosis include:
X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.
Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.
Treatment Options
Non-Surgical
Most small, partial tears respond well to nonsurgical treatment.
Nonsurgical treatment most often includes wearing a brace and physical therapy.
Immobilization. Your doctor may recommend you wear a knee immobilizer or brace. This will keep your knee straight to help it heal. You will most likely need crutches to help you avoid putting all of your weight on your leg. You can expect to be in a knee immobilizer or brace for 3 to 6 weeks.
Physical therapy. Once the initial pain and swelling has settled down, physical therapy can begin. Specific exercises can restore strength and range of motion.
Exercises will gradually be added to your program. Straight leg raises to strengthen your quadriceps are often central to a physical therapy plan. As time goes on, your doctor or therapist will unlock your brace. This will allow you to move more freely with a greater range of motion. You will be prescribed more strengthening exercises as you heal.
Your Peninsula Bone and Joint Clinic physician will discuss with you when it is safe to return to sports activity.
Surgical
Most people with complete tears will require surgery to repair the torn tendon. If you have a large partial tear or a partial tear associated with tendon degeneration, your doctor may also recommend surgery. This will likely depend upon your age, your activities, and your previous level of function.
Surgical repair reattaches the torn tendon to the top of the kneecap. People who require surgery do better if the repair is performed soon after the injury. Early repair may prevent the tendon from scarring and tightening into a shortened position.
