Patellar and quadriceps tendon rupture

The quadriceps and patellar tendon are important components of the knee extensor mechanism, which is constituted by the quadriceps muscles, quadriceps tendon, the patella, the patellar tendon and inserts on the tibia through the tibial tubercle. Once the knee extensor mechanism is extremely challenged during a high-impact functional activity (e.g.: fall from the high or abrupt stop from sprinting) or is already weakened in certain specific areas due to progressive degenerative conditions (e.g.: long-standing tendinopathy), injury can occur at different location within the chain, including the patella, the quadriceps tendon (above the patella), and the patellar tendon (below the patella). Ruptures of these tendons are typically the result of high-level quadriceps contraction in knee flexion position with high loads involved during the task. Depending on the specifics of the injury, the rupture can be classified as complete when a full transversal tear crosses the tendon, and partial if some fibres show continuity. Patients will often present a palpable defect at the point of the injury, localised tenderness, swelling, decreased ability to move the knee and weight-bearing, leading to a drop in the general functioning.

Management

The treatment plan strongly depends on the type of injury reported, if complete, surgical intervention will be necessary while, if partial, depending on a series of other factors including the functioning of the knee extensor mechanisms, a non-surgical option could be plausible. Time from injury to the diagnosis is a critical factor as a delay in the treatment or a missed diagnosis can significantly affect the outcomes. In Isokinetic Medical Group you will be promptly visited and immediately after the diagnosis, you will be directed towards the most suitable route for you, either surgical or non-surgical based on your condition. When surgical management is required, tendon repair or reconstruction are the most implemented techniques and are selected depending on several factors that are commonly discussed with the surgeon (time from injury, rupture location, extent of the injury, etc.).

rehabilitation

Rehabilitation after quadriceps or patellar tendon injury and surgery is critical, and it is paramount that a specialised medical team supports you throughout the whole recovery process. A safe and effective progression in the first few weeks post-surgery is necessary and requires rigorous attention to the surgical protocols to allow the biological healing of the tissue, coupled with an adequate stimulus to gradually improve knee mobility to avoid complications. Guided by our Medical Group you will advance throughout the different stages of rehabilitation, recovering your mobility in the pool and the gym, restoring your strength in the gym, optimising your movement quality in our movement analysis room and you will finally return to your activity of daily living and sport after completing our on-field rehabilitation plan where we will minimise your risk of injury and restore performance.