Quadriceps Tendon Rupture Flashcards
What is QTR?
Loss of congruency either partial or complete of quad tendon.
Epidemiology
Quite rare 1.5 cases per 100000 per year.
More common in males and occur almsot always unilaterally
Where does the rupture typically happen?
At site of insertion at the superior pole of the patella
Risk factors
Increasing age
CKD
DM
RA
Medication (corticosteroids and fluoroquinolones)
Clinical features
Hear a pop
Feeling a tearing sensation
Pain in the anterior knee or thigh + difficulty in weight bearing
Mechanism of injury
Suden and excessive loading of quadriceps muscles (like landing from a jump)
Examination findings
Localised swelling
Tender palpable defect above the superior pole of the patella
Assymmetry with the other knee
Features of complete tears
Inability to straight leg raise and no ability to extend the knee.
In partial tears this might only be weakened or even absent
Dx
Patella tendon rupture
Patella fracture
Femoral shaft fracture
Ix
Diagnosed on clinical suspicion alone
X-ray might be done to exclude any underlying fractures
USS will give a definitive diagnoses and can be good to do to measure the degree of rupture.
MRI can be useful if uncertainty.
X-ray findings
Caudally displaced patella in complete tears
What does management depend on?
Degree of rupture
Tx of partial tears
Conservative if the extensor mechanism is intact
Immobilisation of knee joint in a brace + intensive rehab
Tx of complete tear (or if extensor mechanism is compromised)
Surgical intervention with a technique that is dependent on the position of the tear.
Tx of complete tear at point of insertion
Longitudinal drill holes or suture anchors
