Patellar and quadriceps tendon ru p tures— jumper's knee

Abstract

We reviewed 13 patients with end stage jumper's knee, 10 with patellar tendon ruptures, and 3 with ruptures of the quadriceps tendon to evaluate our long-term results in treating these tendon ruptures in an athletic population. The focus was on the natural history, the time until return, and the level of return, to athletic activity. Jumper's knee affected all patients to a varying degree prior to rupture. Basketball was the most common sport involved. At followup, averaging 4 1/2 years, patients underwent functional and clinical, as well as Cybex and roentgenographic, evaluations. Results indicated patellar tendon ruptures, where the ruptures are complete, have a more favorable prognosis than those of the quadriceps tendon which are incomplete. All of the latter patients continued to have quadriceps tendinitis following repair. In both groups, the poor results were obtained in patients with chondromalacia and/or patella alta. Cybex testing yielded results of greater than 100% strength in three patients with patellar tendon ruptures, but no patient with quadriceps rupture had comparable test results. There was no apparent relationship between ruptures and cortisone injections. Patellar and quadriceps tendon ruptures from indirect injury in athletes represent the end stage of jumper's knee and result from repetitive microtrauma. Excellent function usually follows repair of patellar tendon ruptures when surgery is performed early and care is taken to restore normal patellar tendon length. Results of quadriceps ruptures are less satisfactory since these ruptures are usually incomplete and all degenerative tissue may not be involved in the healing response.

Clinical Case of Bilateral Rupture of the Patellar Tendon of the Late Diagnosis

“…Then some authors 8, 9 [6] [7] suggest that when they occur after 40 years The taking of fluoroquinolones or a repeated corticoid infiltration, or anabolisant steroid abuse are also reported as promoting factors [9]. Those pathologies are sources of reshuffle (amyloid deposit, collagen synthesis alteration, tendons vascularisation alteration) linked to a chronic inflammation which weakens tendon.…”

Repair of partial quadriceps tendon rupture Observations in 28 cases

“…Plain radiographs were not usually informative. Kelly et al (1984) repaired the partial quadriceps tendon ruptures with nonabsorbable sutures passed through patellar drill holes. Although the number of cases was small in their study, their results of surgical treatment of partial rupture of the quadriceps tendon were inferior to those of the patellar tendon.…”

“…It is most commonly seen at the inferior pole of the patella at the origin of the patellar tendon, hut i n about one fourth of the cases it may be locnted at the insertion of the quadriceps tendon (Perugia et al 1977). Conservative treatment is usually successful, but some cases progress to a chronic stage, with a partial or even complete rupture of the tendon, and operative treatment is required (Kelly et al 1984). We report here the results of 28 cases, in which jumper's knee in the quadriceps tendon was treated surgically.…”

Bilateral Simultaneous Infrapatellar Tendon Ruptures: A Case Study

“…Kelly et al (9) also reported a variety of disrup tions: midsubstance, distal pole avulsion, tibial tubercle avulsion, and combined inferior/superior avulsion. T w o ruptures were in the patellar midsubstance; one avulsed medially from the distal pole of the patella and laterally from the tibial tubercle, and one case was an inverted U , where the medial and lateral portions of the tendon ruptured from the tibia1 tubercle and the midportion from the distal pole of the patella (9).…”