Patellar tendon rupture: Difference between revisions

No edit summary
(7 intermediate revisions by 2 users not shown)
Line 1: Line 1:
==Background==
==Background==
*Occurs via forceful contraction of quadriceps muscle or falling on flexed knee
*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
*Typically occur 2cm from insertion on patella
*Patellar tendon rupture
**Patients <40yr with history of tendinitis or steroid injections
*Quadriceps tendon rupture
**Patients >40yr


==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
Line 18: Line 13:
{{Knee DDX}}
{{Knee DDX}}


==Work Up==
==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==
Line 29: Line 26:
*Knee immobilizer, can be weight bearing
*Knee immobilizer, can be weight bearing
*Operative repair advised within 7 days
*Operative repair advised within 7 days
==Disposition==
*Outpatient
==See Also==
*[[Quadriceps tendon rupture]]


==References==
==References==
<references/>
<references/>
*Uptodate
*Wheeless' Textbook of Orthopaedics
*Wheeless' Textbook of Orthopaedics


[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Sports Medicine]]

Revision as of 01:45, 10 May 2019

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

  • Wheeless' Textbook of Orthopaedics