Patellar Tendon & Quadriceps
Tendon Tear

The quadriceps tendon is the attachment of the quadriceps muscles to the patella (kneecap). The patellar tendon attaches the tibia (shinbone) to the patella (kneecap). Together quadriceps muscles, quadriceps tendon and patellar tendon straighten the knee.

Patellar and quadriceps tendon tears often occur from a resistive load with the foot planted or the knee partially bent. A tear can also occur due to a fall, direct trauma, or a direct cut of the tendon. Injuries are most common in middle-aged people during sports. Occasionally tears can occur in older people due to inflammation, chronic disease, and steroid use that may affect the tendon blood flow.

Symptoms of a tendon tear include bruising, swelling, gap formation about the patella (knee cap), cramping, and inability to walk or straighten the leg.

Initial evaluation includes a medical history, physical examination, and x-rays to evaluate for associated injuries. Specialized examination maneuvers are done to determine the extent and location of the tear. MRI may be ordered to evaluate the tendon quality and to distinguish a partial from a full tear.

Treatment is based on the size and type of tear, age, and activity level. Partial tears and those in older patients may be treated with nonsurgical treatment including immobilization in a knee brace for 3-6 weeks followed by physical therapy.

More commonly, those with high-grade partial tears, an inability to raise their leg, instability with walking, or complete tears surgical treatment is considered. Surgical treatment is an outpatient procedure and involves reattachment of the torn tendon with suture. The knee will be immobilized with limited weight bearing for the first 4-6 weeks followed by strengthening and range of motion. Recovery typically takes 3-6 months.