The quadriceps tendon is a large tendon that attaches the quadriceps femoris to the patella at the knee. Since the quadriceps femoris is such a large muscle group, large amounts of stress may be placed on the quadriceps tendon, making it vulnerable to rupture. This is especially true for athletes in sports that require sudden, explosive movements such as football. Surgery is often required to repair the damaged tendon. In order to regain muscle strength and function after surgery, physical therapy is recommended.
Surgery
Rupture of the quadriceps tendon requires surgery. Due to the nature of this injury and the location of the tendon, surgery is not typically repaired arthroscopically. Instead, the surgery requires an incision to be made vertically across the top of the knee. If the tendon has pulled away from the kneecap, it will be sewn back on. Some ruptures will require pins to be placed in the patella to hold the tendon in place. The incision will then be stapled back together.
Surgery Recovery
Immediately following surgery, you may be required to stay in the hospital overnight. A cast or brace is often placed on the leg post-surgery. You will also require some form of pain management, including medications and ice. Your leg will be largely immobilized until localized swelling subsides. About two weeks after surgery, your doctor will remove the staples from your leg.
Short-Term Physical Therapy
Your surgeon may prescribe an immediate motion protocol, although this may not be appropriate for all patients. A continuous passive motion machine may be attached to your leg. This machine will gently force your leg to bend at the knee. It can be set to varying degrees of flexion, beginning with a very small bend in the knee and progressing to a much greater bend in the knee as recovery progresses. Most surgeons will recommend your leg be placed in this machine for 20 to 23 hours a day for the first seven days following surgery.
Long-Term Physical Therapy And Recovery
Return to normal daily activity takes at least four months. After six months, the knee should be almost fully healed, although a recovery lasting a full year is not uncommon for this type of surgery. As soon as you are able, more dynamic physical therapy will be prescribed. This may include the addiction of load-bearing exercises to strengthen the quadriceps. The exercises should be completed while wearing a lockable brace, with your physical therapist gradually unlocking the brace to allow for greater range of motion as your therapy progresses. More challenging exercises will be given to you as you continue to heal. Your surgeon will discuss with you when it is appropriate to return to normal daily activity, and when you can return to sports activity as well.
References
- American Adademy Of Orthopaedic Surgeons: Quadriceps Tendon Tear; 2009.
- "Essentials Of Athletic Training"; Daniel D. Arnheim and William E. Prentice; 2002.
