Patellar and quadriceps tendon ruptures--jumper's knee

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Analysis

Background:

• Jumper's knee, or patellar tendinopathy, can progress to tendon rupture.
• Athletes are susceptible to patellar and quadriceps tendon ruptures due to repetitive microtrauma.
• These ruptures often represent the end stage of chronic tendinopathy.

Purpose of the Study:

• To evaluate long-term outcomes of treating patellar and quadriceps tendon ruptures in athletes.
• To analyze the natural history, return to sport time, and functional level post-injury.
• To identify factors influencing prognosis after surgical repair.

Main Methods:

• Review of 13 patients with end-stage jumper's knee, including 10 patellar and 3 quadriceps tendon ruptures.
• Long-term follow-up averaging 4.5 years.
• Functional, clinical, Cybex strength testing, and radiographic evaluations.

Main Results:

• Complete patellar tendon ruptures showed a more favorable prognosis than incomplete quadriceps tendon ruptures.
• All patients with quadriceps tendon ruptures experienced persistent tendinitis post-repair.
• Chondromalacia and patella alta were associated with poor outcomes in both groups.
• Cybex testing revealed superior strength (>100%) in some patellar rupture patients, not seen in quadriceps ruptures.

Conclusions:

• Early surgical repair with attention to restoring normal tendon length is crucial for excellent outcomes in patellar tendon ruptures.
• Quadriceps tendon ruptures, often incomplete, yield less satisfactory results due to challenges in complete degenerative tissue removal.
• Repetitive microtrauma from sports activities can lead to these severe tendon injuries in athletes.