Quadriceps Tendon Ruptures: A Clinical Review.

Abstract

Quadriceps tendon ruptures (QTRs) are uncommon lower limb injuries that lead to pain, loss of active knee extension, and a prolonged rehabilitation course. They typically affect middle-aged or older adults, particularly in patients with comorbidities or degenerative tendon changes, and they most often occur during eccentric contraction when the knee suddenly flexes against an active quadriceps muscle. QTR is a clinical diagnosis. Although history and examination are the cornerstones of diagnosis, imaging is commonly used to confirm the diagnosis and to stage injury severity, with magnetic resonance imaging (MRI) functioning in many centres as the modality of choice to define site, severity, and tissue quality. Management is individualised and depends on injury-related factors such as tear extent, chronicity, tissue quality, and patient-related factors such as age, comorbidities, and functional demands. Selected partial-thickness tears in low-demand patients may be treated non-operatively, whereas operative repair is generally the mainstay for complete ruptures, high-grade partial tears with functional deficit, and chronic presentations. Evidence indicates broadly similar outcomes with transosseous tunnel and suture anchor repair. Current research into biological allograft augmentation and minimally invasive approaches is ongoing and may influence future practice.