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Acute Quadriceps Tendon Rupture: Presentation, Diagnosis, and Management
Evan P Arnold1, Justin A Sedgewick1, Ryan J Wortman1
1Tulane University School of Medicine, New Orleans, Louisiana.
JBJS Reviews
|February 7, 2022
Summary
Quadriceps tendon ruptures, common in those over 40 after falls, are best diagnosed with MRI. Prompt surgery and early mobilization are key for recovery from this knee injury.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Imaging
- Sports Medicine
Background:
- Quadriceps tendon ruptures occur in 1.37 per 100,000 people annually, primarily affecting individuals aged 40 and above.
- Preexisting conditions like rheumatoid arthritis, diabetes, and chronic kidney disease increase susceptibility.
- Simple falls represent the most frequent cause of quadriceps tendon rupture.
Purpose of the Study:
- To review the diagnosis, treatment, and rehabilitation of quadriceps tendon ruptures.
- To highlight the efficacy of MRI in diagnosing these injuries.
- To discuss surgical techniques and post-operative rehabilitation protocols.
Main Methods:
- Literature review focusing on quadriceps tendon rupture epidemiology, diagnosis, and management.
- Analysis of diagnostic accuracy for Magnetic Resonance Imaging (MRI).
- Evaluation of surgical techniques, including transosseous sutures and suture anchors.
- Review of rehabilitation strategies, emphasizing early functional mobilization.
Main Results:
- MRI demonstrates high diagnostic accuracy (sensitivity, specificity, positive predictive value of 1.0) for quadriceps tendon ruptures.
- Complete ruptures necessitate timely surgical repair, with transosseous sutures being a common method.
- Suture anchors offer promising biomechanical advantages in cadaveric studies.
- Early weight-bearing and progressive range-of-motion exercises are recommended for rehabilitation.
Conclusions:
- Quadriceps tendon ruptures require prompt diagnosis, often via MRI, and surgical intervention for complete tears.
- Suture anchors show potential for improved outcomes.
- A structured rehabilitation program involving early mobilization is crucial for optimal patient recovery.
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