Abstract
The diagnosis of quadriceps and patellar tendon ruptures requires a high index of
suspicion and thorough history-taking to assess for medical comorbidities that may
predispose patients to tendon degeneration. Radiographic assessment with plain films
supplemented by ultrasound and magnetic resonance imaging when the work-up is equivocal
further aids diagnosis; however, advanced imaging is often unnecessary in patients
with functional extensor mechanism deficits. Acute repair is preferred, and transpatellar
bone tunnels serve as the primary form of fixation when the tendon rupture occurs
at the patellar insertion, with or without augmentation depending on surgeon preference.
Chronic tears and disruptions following total knee arthroplasty are special cases
requiring reconstructions with allograft, synthetic mesh, or autograft. Rehabilitation
protocols generally allow immediate weight-bearing with the knee locked in extension
and crutch support. Limited arc motion is started early with active flexion and passive
extension and then advanced progressively, followed by full active range of motion
and strengthening. Complications are few but include quadriceps atrophy, knee stiffness,
and rerupture. Outcomes are excellent if repair is done acutely, with poorer outcomes
associated with delayed repair.
Keywords
extensor mechanism - tendon rupture - quadriceps tendon - patellar tendon
