Abstract
The quadriceps tendon is the largest tendon and a fulcrum for function of the most powerful muscles in the human body and has great influence on knee function and independent walking ability. A complete rupture of quadriceps tendon is rarely reported in patients without known co morbidities. In the present case was a 65-year-old male presented with severe pain and inability to extend his right knee after missing a step while walking in his compound. His physical examination revealed the presence of a suprapatellar gap and inability to extending his right knee. Knee X rays revealed a small avulsion fracture of the medial femoral condyle. The magnetic resonance imaging (MRI) also confirmed a diagnosis of complete rupture of his right quadriceps tendon at the insertion point. He denied having systemic disease or being on chronic steroid use. The patient underwent a successful operative repair of the tendon using two arthrex suture anchors. Intraoperatively we found that the right quadriceps had ruptured transversely at the tendon insertion. During the two-month follow-up after the surgery, the patient received a full rehabilitation with a satisfactorily outcome.
Highlights
Quadriceps is one of the largest and most powerful muscles in the human body[1]
A complete rupture of quadriceps tendon is rarely reported in patients without known co morbidities
His physical examination revealed the presence of a suprapatellar gap and inability to extending his right knee
Summary
Quadriceps is one of the largest and most powerful muscles in the human body[1]. The rupture of Quadriceps tendons is often associated with systemic disease such as chronic renal failure, hyperparathyroidism, rheumatoid arthritis, systemic lupus erythematosus, and connective tissue diseases[2,3,4,5,6,7]. The initial assessment at the casualty missed the quadriceps rupture and he was discharged home on analgesics He didn’t improve and was seen again 4 days later and this time both physical examination and MRI revealed the presence of quadriceps tendon rupture. He was managed by surgical repair of the tendon and protected range of motion in a locking knee brace. MRI (Figures 1 and 2) and Ultrasound of the knee revealed a complete rupture of the quadriceps tendon at the insertion point He was admitted and operated on the first January 2019 under spinal anaesthesia. After a 6-week immobilization period for knee in a locked knee brace, the patient received passive knee joint movement at 0°-30°, the passive flexion movement achieved 60° until 8th week and 90° by tenth week
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