Patellar tendon rupture: Difference between revisions

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*Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
*Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
*Typically occur 2cm from insertion on patella
*Typically occur 2cm from insertion on patella
{{Patellar vs Quadriceps tendon rupture}}


==Clinical Features==
==Clinical Features==
*Sudden "pop" or tearing
*Sudden "pop" or tearing
*Diffuse swelling
*Diffuse swelling
*Defect may be palpable above or below the patella
*Defect may be palpable below the patella
*Partial tears lead to difficulty extending the knee
*Partial tears lead to difficulty extending the knee
*Complete tears lead to absent straight leg raise while supine or extension of the knee again
*Complete tears lead to absent straight leg raise while supine or extension of the knee again
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==Evaluation==
==Evaluation==
[[File:Patellar_Tendon_Rupture.gif|thumbnail|Patellar tendon rupture<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]]
*[[Ultrasound: Tendons|Ultrasound]]
*[[Ultrasound: Tendons|Ultrasound]]
**Separation of the tendon can be visualized
**Separation of the tendon can be visualized
*X-ray
*X-ray
**Patella alta (or high-riding patella) is consistent with patella tendon rupture
**Patella alta (high-riding patella)
**Patella baja/infera (or low-riding patella) is consistent with quadriceps tendon rupture
 
{{Patellar vs Quadriceps tendon rupture}}


==Management==
==Management==
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==Disposition==
==Disposition==
*Outpatient


==See Also==
==See Also==

Revision as of 20:24, 10 January 2018

Background

  • Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
  • Typically occur 2cm from insertion on patella

Clinical Features

  • Sudden "pop" or tearing
  • Diffuse swelling
  • Defect may be palpable 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

Differential Diagnosis

Knee diagnoses

Acute knee injury

Nontraumatic/Subacute

Evaluation

Patellar tendon rupture[1]
  • Ultrasound
    • Separation of the tendon can be visualized
  • X-ray
    • Patella alta (high-riding patella)

Patellar vs Quadriceps tendon rupture

Finding Patellar tendon rupture Quadriceps tendon rupture
Location Distal to patella Proximal to patella
Typical group Patients <40yr with history of tendinitis or steroid injections Patients >40yr
X-ray Patella alta (high-riding patella) Patella baja/infera (low-riding patella)

Management

  • Ortho consult in the ED
  • Knee immobilizer, can be weight bearing
  • Operative repair advised within 7 days

Disposition

  • Outpatient

See Also

References

  • Uptodate
  • Wheeless' Textbook of Orthopaedics