Association between patella spurs and quadriceps tendon ruptures

Ellanti, Prasad; Moriarity, Andrew; Wainberg, N.; Fhoghlu, Cliodhna Ní; McCarthy, Tom

doi:10.32098/mltj.02.2015.06

Cited by 11 publications

(5 citation statements)

References 12 publications

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“…5,12,23,29 Interestingly, it appears that the rate of patellar tendon injuries was significantly higher in male athletes (1.30 vs 0.48 injuries per 100,000 AEs), whereas female athletes were over twice as likely to sustain quadriceps tendon injuries (20.14 vs 9.96 injuries per 100,000 AEs). The observed predilection for patellar tendon injuries in male athletes is relatively consistent with the prior literature 5,9 ; however, this is the first study the authors are aware of in which the female study cohort was more prone to quadriceps tendon injuries than the male cohort. Recently, ACL injury prevention strategies consisting primarily of focused, aggressive hamstring strengthening have become commonplace in competitive female athletics.…”

Section: Discussionsupporting

confidence: 89%

Epidemiology of Acute Extensor Mechanism Injuries in Collegiate-Level Athletes in the United States

Chen

Chan

Ranson

et al. 2021

Sports Health: A Multidisciplinary Approach

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Background: Extensor mechanism injuries involving the quadriceps tendon, patella, or patellar tendon can be a devastating setback for athletes. Despite the potential severity and relative frequency with which these injuries occur, large-scale epidemiological data on collegiate-level athletes are lacking. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Knee extensor mechanism injuries across 16 sports among National Collegiate Athletic Association (NCAA) men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Extensor mechanism injuries per 100,000 athlete-exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre-/regular/postseason), and time lost were compiled and calculated. Results: A total of 11,778,265 AEs were identified and included in the study. Overall, 1,748 extensor mechanism injuries were identified, with an injury rate (IR) of 14.84 (per 100,000 AEs). N = 114 (6.5%) injuries were classified as severe injuries with a relatively higher median time loss (44 days) and operative risk (18.42%). Male athletes had higher risk of season-ending injuries in both all (3.20% vs 0.89%, P < 0.01) and severe (41.54% vs 16.33%, P < 0.01) extensor mechanism injuries. Similarly, contact injuries were more frequently season-ending injuries (4.44% vs 1.69%, P = 0.01). Women’s soccer (IR = 2.59), women’s field hockey (IR = 2.15), and women’s cross country (IR = 2.14) were the sports with the highest rate of severe extensor mechanism injuries. Conclusion: Extensor mechanism injuries in collegiate athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries. Injuries defined as severe had a higher risk of operative intervention and greater amount of missed playing time. Clinical Relevance: Knowledge of the epidemiology of extensor mechanism injuries may help clinicians guide their athlete patients in sports-related injury prevention and management.

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Section: Discussionsupporting

confidence: 89%

Epidemiology of Acute Extensor Mechanism Injuries in Collegiate-Level Athletes in the United States

Chen

Chan

Ranson

et al. 2021

Sports Health: A Multidisciplinary Approach

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“…4 ). Spurs and calcifications in the bone-tendon junction indicating antecedent tendinopathy may be observed in two-thirds of these patients ( 35 ). Patella infera may not always be seen, only 39% of the cases had a Caton–Deschamps index <0.8 in one series ( 32 ).…”

Section: Quadriceps Tendon Tearsmentioning

confidence: 99%

Extensor mechanism ruptures

et al. 2022

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Native patellar tendon injuries are seen in younger patients compared to quadriceps tendon ruptures. Up to a third of the patients may have local (antecedent tendinopathy and cortisone injections) or systemic risk factors (obesity, diabetes, hyperparathyroidism, chronic renal failure, fluoroquinolone or statin use) of injury, these are more frequent in bilateral disruptions. Complete extensor mechanism disruptions should be repaired surgically. Although isolated primary repair has been reported to have good outcomes in younger patients with acute tears and good tendon quality, augmentation of the repair with autograft, allograft or synthetic material should be considered in patients with poor tendon quality, chronic tears or tendon defects. High rates of return to work/sports have been reported in native patellar and quadriceps tendon tears, with re-rupture rates <5%. Extensor mechanism disruptions in patients with a total knee arthroplasty are challenging due to older age, systemic co-morbidities and poor local conditions, resulting in inferior outcomes compared to native extensor mechanism injuries. Some form of augmentation with autograft, allograft or synthetics is advisable in all cases. Salvage procedures such as whole extensor mechanism allografts provide acceptable outcomes in multiply operated knees with extensive bone and soft tissue deficits.

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“…While the present case did not have previous medical conditions or any knee-related complaints, it is worth mentioning the insertional enthesophytes at the superior poles of his patellas. The incidence of such spurs at the quadriceps-patella junction ranges from 62% to 79% in patients presenting a quadriceps rupture versus 19% in the general population [12,13]. Although a clear causative relationship is not clearly established, such findings on knee x-rays of patients with knee trauma should raise the suspicion of a QTR and warrant further investigations.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Quadriceps Tendon Rupture in a Healthy Individual Following a Motor Vehicle Accident: A Case Report

Ghanimeh¹,

Alam²,

Otayek³

et al. 2023

Cureus

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Bilateral quadriceps tendon rupture (QTR) is a rare injury that typically affects middle-aged men presenting underlying medical conditions, while only a few cases have been reported in healthy individuals. The gold standard treatment of such injuries is prompt surgical repair, followed by postoperative immobilization and physiotherapy.We present the case of a 51-year-old previously healthy man who experienced bilateral, simultaneous, and complete QTR following a high-velocity motor vehicle accident. Physical examination revealed bilateral extensor mechanism disruption and palpable defects at the superior poles of the patellae. MRI confirmed the diagnosis, and the patient underwent surgical repair using three anchor sutures on each side. Postoperative management involved a brief period of immobilization followed by progressive passive motion exercises and protected weight bearing. At a six-month follow-up, the patient had excellent functional outcomes and was satisfied with the treatment.

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Association between patella spurs and quadriceps tendon ruptures

Cited by 11 publications

References 12 publications

Epidemiology of Acute Extensor Mechanism Injuries in Collegiate-Level Athletes in the United States

Epidemiology of Acute Extensor Mechanism Injuries in Collegiate-Level Athletes in the United States

Extensor mechanism ruptures

Bilateral Quadriceps Tendon Rupture in a Healthy Individual Following a Motor Vehicle Accident: A Case Report

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