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Quadriceps Tendon Tear Treatment
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is a Quadriceps Tendon Tear
A quadriceps tendon tear involves damage to the tendon that connects the quadriceps muscles to the patella, or kneecap. This tendon plays a role in enabling the extension of the leg from a bent position. While the quadriceps tendon is usually robust, it can sustain a partial or complete tear under certain conditions. Although these injuries are relatively rare, they can have a notable impact on mobility.
In the event of a tear, the ability to straighten the knee or maintain stability while walking may be compromised. Small tears can affect movement and daily activities. Complete tears of the quadriceps tendon may necessitate surgical repair due to their potentially debilitating nature.
Causes of Quadriceps Tendon Tears
Quadriceps tendon tears can arise from two primary sources: traumatic injury and tendon weakness.
Traumatic Injury
The tendon, despite its strength, can tear when subjected to extreme forces. This is more common in activities involving high impact, such as sports that require jumping or running. Situations like an awkward landing from a jump, direct force to the knee, or a sudden, forceful contraction of the quadriceps muscle can all precipitate a tear.
Tendon Weakness
Tendons weakened by underlying conditions are more susceptible to tears. Factors contributing to this weakness include:
- Tendinitis: Inflammation within the tendon can lead to weakening and even minor strains.
- Certain Chronic Diseases: Conditions such as systemic lupus erythematosus (SLE), diabetes mellitus, rheumatoid arthritis, and gout can negatively affect tendon strength.
- Certain Medication: The use of certain medications, like corticosteroids, has been linked to increased muscle and tendon weakness.
- Surgical History and Immobilisation: Previous knee surgeries and periods of immobilisation can lead to a decrease in muscle and tendon strength.
Symptoms and Signs
The onset of a quadriceps tendon tear is often marked by several symptoms:
- Tearing Sensation and Audible Pop: Many individuals experience a sensation of tearing and may hear a pop at the time of the injury.
- Pain and Swelling: Sudden and intense pain at the front of the knee or upper part of the leg is common, accompanied by swelling and bruising in the area.
- Mobility Issues and Weakness: Some may experience difficulty in walking or straightening the leg, along with a feeling of weakness in the affected leg.
- Indentation at the Top of the Kneecap: In certain cases, there may be an indentation at the top of the kneecap where the tendon has torn.
Diagnosis
Diagnosing a quadriceps tendon tear typically involves a combination of physical examination and imaging tests.
- Physical Examination: Initially, a thorough examination of the knee is conducted. This includes assessing the range of motion, strength, and the presence of any visible gaps or indentations where the tendon has torn. A knee extension test can also be performed to help evaluate the capability to straighten the knee.
- Imaging Tests: An X-ray can help rule out other knee injuries and may show changes in the position of the kneecap in case of a complete tear. An MRI is useful in determining the extent of the tear and the exact location, providing detailed images of both bone and soft tissues.
Non-Surgical Treatment Options
Non-surgical treatments are often effective for partial tears or quadriceps tendon tears with minimal functional limitations.
Immobilisation |
For small partial tears, the knee specialist may suggest utilising a knee brace or immobiliser. This helps keep the knee in a straight position, aiding the healing process. The duration of immobilisation typically ranges from 3 to 6 weeks. |
Physical Therapy |
After the initial phase of healing, the knee specialist may recommend engaging in physical therapy. It involves specific exercises designed to restore strength and range of motion in the leg. The therapy plan is gradually intensified, starting with simple exercises like straight leg raises and progressively incorporating more demanding exercises as healing advances. |
Surgical Treatment Options
In cases of complete quadriceps tendon tears or large partial tears, surgical intervention is often necessary.
Surgical Procedure
The primary goal of surgery is to reattach the torn tendon to the top of the kneecap. This is typically achieved using sutures or anchors. The surgery aims to restore the normal anatomy and function of the knee.
Prevention Strategies
While it may not be possible to completely prevent a quadriceps tendon tear, especially those resulting from sudden injuries, certain strategies can help reduce its risk.
- Prevent Injury with Proper Warm-Up Routines - Engaging in adequate warm-up exercises before participating in sports or physical activities helps prepare the tendons for the strain.
- Strengthen the Knee Muscles - Maintaining a strong and flexible musculature through regular exercise contributes to overall tendon health and reduces the risk of injuries.
- Reduce Stress on the Knee by Using Proper Techniques - Utilising proper techniques during sports and physical activities can help mitigate undue stress on the tendon.
- Avoiding High-Risk Movements - Avoid high-risk movements that involve explosive or overly strenuous actions, as these can place excessive stress on the quadriceps tendon.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
How Long Does It Take to Recover from a Quadriceps Tendon Tear?
Recovery time from a quadriceps tendon tear varies, depending on the severity of the tear and the treatment approach. Minor tears treated conservatively may take several weeks or months to heal. Surgical repairs for more severe tears typically require a minimum of four months for recovery, with a full return to previous activity levels taking up to a year.
What Happens If a Quadriceps Tendon Tear Is Left Untreated?
Leaving a quadriceps tendon tear untreated can lead to prolonged discomfort, decreased mobility, and potential long-term damage. Untreated tears, especially severe ones, may result in chronic knee instability and weakness, making it challenging to perform everyday activities. Individuals suspecting a quadriceps tendon tear should consult with a knee specialist for a proper diagnosis and treatment plan.
Can You Walk with a Quadriceps Tendon Tear?
The ability to walk following a quadriceps tendon tear depends on the tear’s severity. While some individuals with minor tears may be able to walk, those with complete tears typically find it difficult to walk or straighten the leg.
What Exercises Can Help Strengthen Your Quadriceps Tendons?
Strengthening exercises can help in the recovery and prevention of quadriceps tendon tears. Exercises may include straight leg raises, knee extensions and gradual weight-bearing activities. Start any exercise regime under the supervision of a knee specialist to ensure safety and appropriateness for the individual’s specific condition.