Patellar tendon rupture
Background
- Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
- Quadriceps rupture proximal to the patella while patellar tendon ruptures are distal
- Typically occur 2cm from insertion on patella
- Patellar tendon rupture
- Pts <40yr w/ history of tendinitis or steroid injections
- Quadriceps tendon rupture
- Pts >40yr
Clinical Features
- Sudden "pop" or tearing
- Diffuse swelling
- Defect may be palpable above or below the patella
- Partial tears lead to difficulty extending the knee
- Complete tears lead to absent straight leg raise while supine or extension of the knee again
Associated Conditions
Work Up
- Ultrasound
- Separation of the tendon can be visualized
- X-ray
- Patella alta (or high-riding patella) is consistent with patella tendon rupture
- Patella baja/infera (or low-riding patella) is consistent with quadriceps tendon rupture
Management
- Ortho consult in the ED
- Operative repair advised within 7 days
Source
- Tintinalli
- Uptodate
- Wheeless' Textbook of Orthopaedics