Quadriceps tendon tear
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Tendons are powerful tissue bands that connect muscles to bones. The most crucial tendon in the process of straightening a knee from a bent position is the quadriceps tendon. It may be difficult to walk or undergo any activities from these small tears in the tendon. Complete tear of the quadriceps tendon is a serious injury that may lead to disability. Surgery is nearly always necessary, then physical treatment is necessary to regain complete knee motion and function.
Tears in the quadriceps tendon are uncommon. They most frequently affect middle-aged athletes who engage in jumping or sprinting sports.
Types of Quadriceps tendon tears
There are two types of quadriceps tendon tears: partial and complete.
Partial tears. Even numerous tears do not totally destroy the tendon. This is comparable to a rope that has been stretched to the point where part of the fibers have frayed but the rope is still intact.
Complete tears. Either the tendon will totally separate from the bone or a complete rip will cause the soft tissue to split in two.
The quadriceps muscle is no longer attached to the kneecap when the tendon totally breaks. When the quadriceps muscles flex, the knee cannot straighten without this connection. Patients might notice a divot or gap if they feel the region above the kneecap, or they might experience severe swelling or bruising.
Cause
Injury
When there is a strong load on the leg with the foot planted and the knee slightly bent, a quadriceps tear frequently happens. Imagine landing awkwardly after making a leap in a game of basketball. The tendon tears as a result of the landing’s excessive force.
Falls, direct pressure on the front of the knee, and lacerations can also result in tears (cuts).
Weak Tendon
The quadriceps tendon is more prone to rupturing if it is weak. Tendon weakness can be caused by a number of factors.
Tendinitis. Quadriceps tendinitis, an inflammation of the tendon, weakens the tendon. Small tears could result as well. Persons who run and play sports that require hopping are more likely to get quadriceps tendinitis than other people.
Chronic illness. Diseases that affect blood flow can also lead to weakened tendons. Chronic conditions that might weaken the tendon include:
- Chronic renal failure or other conditions requiring kidney dialysis
- Gout
- Rheumatoid arthritis
- Infection
- Leukemia
- Metabolic disease
- Diabetes mellitus
- Hyperparathyroidism
- Systemic Lupus Erythematosus (SLE)
Steroid use. Increased muscular and tendon weakening has been associated to the use of corticosteroids.
Fluoroquinolones. Quadriceps tendon tears have been linked to this antibiotic.
Immobilization. The muscles and tendons that support your knees deteriorate in strength and flexibility while you are off your feet for an extended length of time.
Symptoms
There is frequently a tearing or popping sensation when a quadriceps tendon tears. Typically, pain and swelling come next, and you might be unable to straighten your knee. Additional signs comprise:
- Bruises
- Cramps
- Tenderness
- A tear in the tendon that left an indentation on the top of your kneecap
- Difficulty walking as a result of the knee giving way or buckling
- If your tendon tears, your kneecap may drop or droop
Diagnosis
Medical history and physical examination
Your general health and the symptoms you’re having will be discussed with your doctor. Inquiries concerning your medical background will also be made. You could be required to give details such as a history of quadriceps or anterior knee ligament damage, previous quadriceps tendinitis, or any medical issues that could make a quadriceps injury more likely.
Your doctor will examine your knee carefully after going over your symptoms and medical background. Your doctor will do a test to see how well you can extend, or straighten, your knee in order to pinpoint the precise reason of your problems. Although this aspect of the examination can hurt, it is crucial to find a quadriceps tendon tear.
Imaging tests
Your doctor could request imaging exams like an X-ray or Magnetic Resonance Imaging (MRI) scan to help them make the diagnosis.
X-rays. When the quadriceps tendon tears, the kneecap shifts out of position. An X-ray of the knee taken from the side usually makes this quite clear. These X-rays alone are frequently able to detect complete rips.
An MRI scan creates better images of soft tissues, like the quadriceps tendon, than an X-ray. An MRI can show the amount of tendon torn and the location. Sometimes, an MRI is required to rule out a different injury that has similar symptoms or to distinguish a partial tear from a complete tear.
Treatment
When determining your course of therapy, your doctor will take into account your age, level of activity, and the type and size of your tear, among other factors.
Nonsurgical Treatment
Wearing a brace and engaging in physical therapy are the most frequent nonsurgical treatments. The majority of minor, partial tears heal well without surgery.
Immobilization. Your physician could advise you to use a brace or knee immobilizer. Your knee will stay straight as a result, promoting healing. Crutches will probably be necessary to prevent you from placing all of your weight on your injured leg. For three to six weeks, you can anticipate wearing a knee immobilizer or brace.
Physical therapy. After the initial pain and swelling have subsided, you can begin physical rehabilitation. You can regain your leg’s strength and range of motion by performing specific exercises.
Quadriceps strengthening exercises such as straight leg lifts are frequently the focus of physical therapy programs.
Your brace will progressively be taken off over time, allowing you to move more freely and with a wider range of motion. When it is safe to resume playing sports or engaging in other physical activity, your doctor will talk about it with you.
Surgical Treatment. If you have a large partial tear or tear associated with tendon degeneration, you may need surgery to repair the torn tendon. 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.
Alternate technique. As an alternative, surgeons may repair the tendon to the bone using suture anchors. Using this method, the surgeon uses tiny metal implants known as suture anchors to secure the tendon to the bone. The surgeon can avoid drilling holes in the kneecap by using these anchors.
