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Quadriceps Tendon Rupture: Treatment, Recovery, Surgery, Diagnosis

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Tests to Diagnose Quadriceps Tendon Rupture (QTR)

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An immediate treatment and quick diagnosis is required to undergo a correct treatment of quadriceps tendon rupture (QTR) and early recovery. The treatment procedure may be long and more complicated due to delayed initiation of treatment.

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Tests to Diagnose Quadriceps Tendon Rupture (QTR)
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Medical History Test for Quadriceps Tendon Rupture (QTR)

Your doctor may ask you about the following questions to confirm quadriceps tendon rupture (QTR):

  • Your injury history
  • Any prior injury to the quadriceps muscle
  • Presence of quadriceps tendonitis
  • Medical conditions due to quadriceps injury[1]

Knee Extension Test to Diagnose Quadriceps Tendon Rupture (QTR)

Doctors usually ask the patients to extent their knees in front of him/her to determine the condition of knee. Though painful, but knee extension test is required for the correct diagnosis of quadriceps tendon rupture (QTR)

The doctor will find out any swelling or softness in your knees. The presence of gaps in the knees hence can be figured out. Doctors ask patients to lie down on the examination table and then squeeze the quad muscle to check the reflex. Quadriceps tendon rupture (QTR) is determined in people who do not automatically have a reflex.

Imaging Tests to Diagnose Quadriceps Tendon Rupture (QTR)

Apart from the physical diagnosis, imaging tests are also prescribed for quadriceps tendon rupture (QTR). This includes the following:

  • X ray-The sideway image is essential to determine the quadriceps tendon rupture (QTR).
  • Ultrasonography is conducted to test the condition of quadriceps tendon rupture (QTR).
  • An MRI is conducted to determine other injuries to the knee cap, if any.

Treatment for Quadriceps Tendon Rupture (QTR)

Conservative Treatment Steps for Quadriceps Tendon Rupture (QTR)

  • RICE (Rest, Ice, Compression, Elevation) technique should be applied immediately on sustaining quadriceps tendon rupture.
  • Elasticized compression bandage around the injury can be used.
  • Patient who has sustained a quadriceps tendon rupture should see a sports injury professional immediately for its treatment.
  • Usage of ultrasound and TENS electrotherapy helps in the treatment of quadriceps tendon rupture.
  • Rehabilitation program for quadriceps tendon rupture including quadriceps strengthening and proprioception exercises should be undertaken.
  • Massage techniques can be done to treat the ruptured quadriceps tendon.
  • Heat and ice therapy for quadriceps tendon rupture helps in pain and swelling.

Medical Therapy for Quadriceps Tendon Rupture (QTR)

Conservative ways of treatment is prescribed for partial tears in the knees. This results in immobilization of the knees for 21 to 42 days. The straight extension of the leg is challenged for the first few days. This is practiced for a minimum period of 10 days. If there are no complaints in these 10 days, the mobilization is extended. Ranges of motion (ROM) workouts are given to the patient to gather strength in the leg.[2]

Physical Therapy (PT) for Quadriceps Tendon Rupture (QTR)

Physical therapy for quadriceps tendon rupture is started only once the pain and swelling is gone. A physiotherapist can be consulted for categorized recommendation of work outs and exercises to recover faster from quadriceps tendon rupture (QTR).

Proper exercise helps to bring in the strength to the quadriceps muscles. The brace will gradually be removed by the physiotherapist. Thus, you can move your leg freely. The healing process of quadriceps tendon rupture will be fast and improved.

Talk to your doctor and physiotherapist on when to return to active sports following quadriceps tendon rupture.

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Doctors prescribe the range of motion physical practices depending on the age and healing capacity of the patient. Tendon degeneration or partially teared tendon is differently treated. The treatment process in different in different process due to the varied capacity of people to accept the treatment. If required a surgery your surgeon must customize a unique plan for you for better recovery.[3]

Surgery for Quadriceps Tendon Rupture (QTR)

Surgical treatment is required in case of severe or complete quadriceps tendon rupture (QTR). If the tendon is completely pulled off the patella, it is sutured back in place.

  • The knee must remain immobilized in a knee brace after the surgery.
  • Patient should rest and avoid weight bearing for a multiple number of weeks.
  • Rehabilitative exercises should be followed once the healing of the rupture is complete.

Surgical repairs are best if they are carried out in the initial stage of quadriceps tendon rupture (QTR). Following are the surgical techniques used to repair and augmentation of neglected and acute tears:

  • Kangaroo tendon is used to repair quadriceps tendon rupture (QTR)
  • Free fascial grafts
  • Vastus lateralis flaps
  • Autograft of the central third of the patellar tendon
  • Polyester graft
  • Traction sutures
  • Carbon fiber
  • Dacron graft
  • Merilee sutures
  • Polyester graft.

Suture anchors and bridge technique is gaining popularity in quadriceps tendon rupture (QTR). Amongst them these three are most noted:

  • Immediate treatment of the tendon attached to the patella
  • Scuderi technique for extreme cases of quadriceps tendon rupture (QTR)
  • Lengthening of codivilla tendon and chronic ruptures repair[4]

Recovery Period Following Surgery for Quadriceps Tendon Rupture (QTR)

The sutures or staples are usually detached after a period of 14 to 21 days. The pull-out wires are abandoned after a period of minimum 21 days. Cylinder casting is more popular, which goes for 30-45 days. The initial weight of post operation is managed with a walker or crutches. In case of cast, isometric quadriceps exercises are initially prescribed by physiotherapists. Once the cast is over, ROM (Range of motion) exercises are prescribed for continued quadriceps strengthening.

If you are an athlete and have been treated for partial or complete rupture of the quadriceps tendon, you should follow the below mentioned guidelines to continue with the recovery:

  • You have to be used to of ROM (range of motion) and have to be completely free from quadriceps tendon rupture (QTR) pain.
  • The knee strength has to be gained till 85 to 90 percent.
  • Any sort of sport-specific agility program can be good for athletes, like football, soccer, basketball, or tennis.

References:

Also Read:

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:September 7, 2020

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