Acute Quadriceps Tendon Rupture: Presentation, Diagnosis, and Management

The incidence of quadriceps tendon rupture is estimated to be 1.37 cases per 100,000 people/year, with a predilection for these injuries in patients who are ≥40 years of age.

Quadriceps tendon ruptures are more likely to occur in the presence of preexisting comorbidities such as rheumatoid arthritis, systemic lupus erythematosus, gout, chronic kidney disease, secondary hyperparathyroidism, diabetes mellitus, and peripheral vascular disease. The most common mechanism of injury is a simple fall.

Magnetic resonance imaging is the gold-standard test for diagnosing quadriceps tendon ruptures, with a reported sensitivity, specificity, and positive predictive value of 1.0.

Complete tears require prompt surgical intervention; the most common technique is transosseous sutures passed through longitudinal patellar drill holes. Suture anchors have been proposed as an alternative method; they have shown superior biomechanical results in cadaveric models.

Early functional mobilization with full weight-bearing and progressive range-of-motion exercises is recommended for rehabilitation following injury.