Knee

Tendon Ruptures (Patella Quad Tendon Hamstring)

Tendons are strong bands of tissue that connect muscles to bones. The patellar, quadriceps and hamstring tendons work together. The patellar tendon attaches the shinbone bone to the kneecap. The quadriceps tendon connects the kneecap to the quadriceps muscles. The hamstring tendon attaches the hamstring muscles to the thigh bone.

Often tendonitis (inflammation) or tendinosis (degeneration) weakens the tendon and increases the risk of a tear. A rupture is also referred to a tear. Ruptures may be partial for full. Treatment options will depend on the type and size of the tear, and your activity level and age.

What is a patellar tendon rupture?

The patellar tendon allows you to straighten your leg. A complete tear disconnects the tendon from the kneecap. When this happens, you will be unable to straighten your knee. A piece of bone often breaks off during the rupture.

Small tears can lead to weakness of the quadriceps muscles, and difficulty walking and performing daily activities. A large tear is disabling and requires surgery and rehabilitation to regain knee function. Patellar tears are found in young athletes and middle-aged men who are physically active.

What is a quadriceps tendon tear?

Quadriceps tendon tears are rare, and usually affect middle-aged people who play run and jump sports. Complete tears leave the muscle unattached to the kneecap If that happens, the knee cannot be straightened. Partial tears cause the tendon to fray.

An awkward landing from a jump, falls, and direct force cause a tear. The tear may occur after knee surgery or knee dislocation. Early surgical repair is indicated for all complete tears. A trial of conservative treatment is indicated for partial tears. In both cases, physical therapy will be important to recovery.

What are hamstring tendon tears?

The hamstrings are tendons of the hamstring muscles on the back of the thigh that bend and flex the knee, and straighten the hip. Athletes frequently injure the hamstrings especially if they sprint, as in track, soccer and basketball. It is caused by explosive movements, kicking, climbing, running and jumping.

Hamstring tears may be partial or complete, and have the ability to heal themselves. Complete tears require immobilization with a plaster cast or surgery to repair the damage. Conservative treatment is often recommended for partial tears.

What causes tendon ruptures?

Aside from direct impact to the front of the knee from a fall, a blow, or a sports injury, tendon weakness increases the risk of ruptures.

What weakens tendons?

  • Steroid injections and oral steroid use increase tendon weakness and the risk of tendon rupture.
  • Chronic diseases that interrupt blood supply can weaken tendons. Some include diabetes, metabolic disease, infection, Lupus, and chronic renal failure.
  • Previous knee surgery.
  • Tendinosis is a chronic condition caused by repetitive trauma that degenerates the tendon.
  • Tendinitis is inflammation of the tendon that weakens the tendon.

Symptoms of all tendon tears:

  • Hearing a popping sound when the tendon tears
  • Pain and swelling
  • Inability to straighten the knee
  • Bruising
  • Tenderness
  • Cramping
  • Knee buckling

Diagnosis

Your consultation will include a physical exam. Dr. Stark will ask how you were injured, and check for tenderness and bruising, weakness, swelling and other symptoms of injury. Imaging tests will help to confirm the diagnosis. MRI studies may help determine the extent and degree of your injury.

Treatment

All treatments are designed to help you return to the activities you love.

Conservative management

Early treatment with PRICE- protection, rest, ice, compression and elevation. Plus, immobilization, and physical therapy. This approach can result in better function and faster return to sports.

Surgical management

Surgery will be necessary for avulsion injuries. Avulsion injuries are where the tendon is torn completely away from the bone. Surgery will reattach the tendon to the bone. If muscle is injured, Dr. Stark will repair it with stitches. Rehabilitation is essential to recovery of function.

Dr. Stark has offices in San Diego, Carlsbad and Oceanside.


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