Total ruptures of the extensor apparatus of the knee

Abstract

ObjectiveThis was a retrospective case-control study on total ruptures of the extensor apparatus of the knee, aimed to compare patella fractures with tendinous ruptures.MethodsThe sample included 190 patients and 198 total ruptures of the knee extensor apparatus. All patients were evaluated by the same examiner after a minimum one-year follow-up.ResultsTendinous ruptures occurred most frequently in men, in younger patients, and had better clinical and functional outcomes when compared with patella fractures; however, the former presented higher levels of thigh atrophy. Patella fractures occurred most frequently in women and in older patients and caused most frequently caused residual pain, muscle weakness, and limitations in daily activities. Comminuted fractures were related to high-energy trauma, lower clinical and functional outcomes, and higher levels of residual pain and osteosynthesis failure. Early removal of osteosynthesis material was related to better outcomes. Regarding the tendinous ruptures, over half of the patients presented risk conditions for tendinous degeneration; a longer delay until surgery was related to lower Kujala scores.ConclusionThe surgical repair of bilateral ruptures of the knee extensor apparatus resulted in satisfactory clinical and functional outcomes, which were better for tendinous ruptures when compared with patella fractures. However, these lesions are associated with non-negligible levels of residual pain, muscle weakness, atrophy, and other complications.

Simultaneous Rupture of the Patellar and Contralateral Quadriceps Tendons in a Nephropathy Patient

“…On the other hand, the literature also includes few reports of this type of injury in healthy patients without systemic diseases. 1 ),( 3 …”

“…Quadriceps tendon rupture is a condition with a higher incidence in older patients, aged around the 60th and 70th decades of life, due to degenerative conditions in the tendon caused or aggravated by falls and low-impact trauma. 1,2 Patellar tendon rupture usually occurs in patients aged under 40 years due to intra-and periarticular applications of corticosteroids as a result of previous patellar tendinitis and/or sports practices that increase the risk of this type of injury. 3 Simultaneous rupture of the patellar and contralateral quadriceps tendons in patients with chronic renal failure is an extremely rare condition, with few cases described in the medical literature.…”

Long-Term Outcome After Surgical Treatment of Acute and Chronic Quadriceps Tendon Rupture

“…Disruptions of quadriceps tendon are more frequent than those of the patellar tendon, which result in a profound limitative impairment from actively extending the knee and resisting passive flexion (7,11). Early diagnosis and surgery is important, since delay in surgical repair generally affects the outcome adversely (1,12).…”