Surgical treatment of rectus femoris injury in soccer playing athletes: report of two cases

Abstract

Muscle injury is the most common injury during sport practice. It represents 31% of all lesions in soccer, 16% in track and field, 10.4% in rugby, 17.7% in basketball, and between 22% and 46% in American football. The cicatrization with the formation of fibrotic tissue can compromise the muscle function, resulting in a challenging problem for orthopedics. Although conservative treatment presents adequate functional results in the majority of the athletes who have muscle injury, the consequences of treatment failure can be dramatic, possibly compromising the return to sport practice.The biarticular muscles with prevalence of type II muscle fibers, which are submitted to excentric contraction, present higher lesion risk. The quadriceps femoris is one example. The femoris rectus is the quadriceps femoris muscle most frequently involved in stretching injuries. The rupture occurs in the acceleration phase of running, jump, ball kicking, or in contraction against resistance. Although the conservative treatment shows good results, it is common that the patient has lower muscle strength, difficulty in return to sports, and a permanent and visible gap. Surgical treatment can be an option for a more efficient return to sports.

Chronic and Recurrent Rectus Femoris Central Tendon Ruptures in Athletes: Clinical Picture, MRI Findings, and Results of Surgical Treatment

“…Shimba et al 14 also reported good results from the surgical treatment of rectus femoris central tendon injuries in 2 cases. These 2 athletes returned to normal sports activity after 4 and 5 months, respectively.…”

The management of proximal rectus femoris avulsion injuries

“…This may be accompanied by an overlying swelling and ecchymoses, with reduced range of motion in the ipsilateral hip joint. 8 , 14 The mechanism of injury is often consistent with sudden, forceful contraction of the quadriceps muscle, such as an abrupt sprint or kicking motion, or a fall with hyperextension of the hip joint. 12 , 13 Patients may describe an audible ‘pop’ at the time of injury.…”

“…Clinical evaluation may reveal significant thigh swelling, focal tenderness over the anterior inferior iliac spine, generalized anterior thigh tenderness and an antalgic or stiff-legged gait. 8 , 15 , 16 A palpable gap may be felt in the proximal aspect of the anterior thigh, although this may not always be pronounced. In some patients, a sizeable mass in the anterior thigh may be seen with muscle retraction, representing the reflected head of the rectus femoris.…”

“…In some patients, a sizeable mass in the anterior thigh may be seen with muscle retraction, representing the reflected head of the rectus femoris. 3 , 8 Active muscle examination may reveal reduced power with knee extension and hip flexion in the injured limb. Careful clinical examination for additional muscular injuries and neurological compromise is important for early identification and diagnosis of any concurrent injuries.…”

Complete midsubstance rectus femoris ruptures: a series of 27 athletes treated operatively

“…Interestingly, the clinical entity considering midsubstance rectus femoris muscle ruptures is mainly lacking in the literature. Only few case reports of rectus femoris repair have been published [11][12][13] . Our aim was to evaluate the outcomes from a retrospective series of 27 cases grade 4 midsubstance ruptures of rectus femoris muscle treated operatively in athletes.…”