Quadriceps tendon rupture

Quadriceps tendon rupture
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.

Overview

Quadriceps tendon rupture is one of the major injuries. When it occurs the patella loses its anchoring support in the thigh. Without this anchoring effect of the intact quadriceps tendon, the patella tends to move inferiorly (towards the foot). Without the intact quadriceps tendon, the patient is unable to straighten the knee. If a rupture of the quadriceps tendon occurs, and the patient tries to stand up, the knee will usually buckle and give way because the body is no longer able to hold the knee in a position of extension (straight).

Causes of Quadriceps Tendon Degeneration

• Chronic renal failure
• Diabetes mellitus
• Gout
• Hyperparathyroidism
• Long term immobilization
• Infection
• Leukemia
• Metabolic disease
• Obesity
• Rheumatoid arthritis
• Steroid abuse
• Systemic lupus erythematosus (SLE)
• Tumors

Diagnosis

The examination consists of palpating the quadriceps tendon and the patella. Usually, when the tendon ruptures, the patella moves downwards towards the knee. At the same time, the hole between the ends of the ruptured tendon is palpable on the front of the thigh, just above the knee. X-rays of the knee reveal the abnormal position of the patella, indicating a rupture of the quadriceps tendon.

Diagnostic Findings

Images courtesy of RadsWiki

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  Proton density

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  Proton density Fat sat

Additional Reading

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• Benecke P, Krug F, Wohlschlager C. A rare cause of rupture of the quadriceps tendon. Lancet. Oct 7 2000;356(9237):1236.
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• Blasier RB, Ciullo JV. Rupture of the quadriceps tendon after arthroscopic lateral release. Arthroscopy. 1986;2(4):262-3.
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• Liow RY, Tavares S. Bilateral rupture of the quadriceps tendon associated with anabolic steroids. Br J Sports Med. Jun 1995;29(2):77-9.
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• Ramseier LE, Werner CM, Heinzelmann M. Quadriceps and patellar tendon rupture. Injury. Jun 2006;37(6):516-9.
• Ramsey RH, Muller GE. Quadriceps tendon rupture: a diagnostic trap. Clin Orthop Relat Res. May-Jun 1970;70:161-4.
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• Rust PA, Tanna N, Spicer DD. Repair of ruptured quadriceps tendon with Leeds-Keio ligament following revision knee surgery. Knee Surg Sports Traumatol Arthrosc. Jan 12 2008;
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• Walczak BE, McCulloch PC, Kang RW, et al. Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players. J Knee Surg. Jan 2008;21(1):27-33.
• Walker LG, Glick H. Bilateral spontaneous quadriceps tendon ruptures. A case report and review of the literature. Orthop Rev. Aug 1989;18(8):867-71.
• West JL, Keene JS, Kaplan LD. Early motion after quadriceps and patellar tendon repairs: outcomes with single-suture augmentation. Am J Sports Med. Feb 2008;36(2):316-23.
• Zeiss J, Saddemi SR, Ebraheim NA. MR imaging of the quadriceps tendon: normal layered configuration and its importance in cases of tendon rupture. AJR Am J Roentgenol. Nov 1992;159(5):1031-4.

External Links

• [http://goldminer.arrs.org/search.php?query=Quadriceps%20tendon%20rupture Goldminer: Quadriceps tendon rupt

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