The incidence of quadriceps tendon rupture is estimated to be 1.37 cases per 100,000 people/year, with a predilection for these injuries in patients who are ≥40 years of age.Quadriceps tendon ruptures are more likely to occur in the presence of preexisting comorbidities such as rheumatoid arthritis, systemic lupus erythematosus, gout, chronic kidney disease, secondary hyperparathyroidism, diabetes mellitus, and peripheral vascular disease. The most common mechanism of injury is a simple fall.Magnetic resonance imaging is the gold-standard test for diagnosing quadriceps tendon ruptures, with a reported sensitivity, specificity, and positive predictive value of 1.0.Complete tears require prompt surgical intervention; the most common technique is transosseous sutures passed through longitudinal patellar drill holes. Suture anchors have been proposed as an alternative method; they have shown superior biomechanical results in cadaveric models.Early functional mobilization with full weight-bearing and progressive range-of-motion exercises is recommended for rehabilitation following injury.

PurposeThe aim of this study was to investigate the effects of different recumbent sleeping positions of the head and body on intraocular pressure (IOP) in secondary open-angle glaucoma and glaucoma suspect patients, specifically pigmentary dispersion (PD) as measured using the ICare rebound tonometer.Patients and methodsA total of 44 eyes of 24 patients with PD were selected in this study. The IOP of 44 eyes was measured in the initial seated position, in the 4 recumbent positions, and again in the sitting position between each of the recumbent positions.ResultsThe IOP of the right eyes and left eyes was higher in each of the 4 recumbent positions compared to its initial sitting position (all P<0.001). Dependent (D) vs nondependent (ND) comparisons failed to show a significant difference. All lateral vs prone comparisons showed a higher average IOP in the prone position than in the lateral position regardless of D vs ND status. The range of recumbent IOP changes was −4 to +17 mmHg or −17% to +142%. A total of 64% had at least a ≥33% IOP increase with 43% having a ≥50% increase.ConclusionLateral and prone sleeping positions usually do result in significant elevations of IOP in PD patients. Dependency status did not make a difference. A significantly larger IOP increase was seen in the prone position than in the lateral position. The presence of 3 clinical variables (disk hemorrhage [DH], notches, and BV changes) might increase the chances of developing a large recumbent increase in IOP. These patients and possibly all PD syndrome (PDS) or PD glaucoma (PDG) patients should consider sleeping in a bed that allows a head elevation of 30°.

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