Chronic and Recurrent Rectus Femoris Central Tendon Ruptures in Athletes: Clinical Picture, MRI Findings, and Results of Surgical Treatment

Abstract

Background: Severe rectus femoris central tendon rupture is an uncommon sports-related injury. Most rectus femoris central tendon injuries can be treated by nonoperative means, but some tend to reinjure, resulting in chronic symptoms. Physicians treating athletes with rectus femoris injuries should be aware of this clinical condition and know that surgical treatment could be beneficial to the athlete if the rectus femoris central tendon rupture becomes chronic. Purpose: To describe the clinical picture, magnetic resonance imaging (MRI) findings, and surgical treatment results of rectus femoris central tendon injuries. Study Design: Case series; Level of evidence, 4. Methods: This study included 12 patients who underwent successful repair of recurrent rectus femoris central tendon rupture. Presurgical MRI scans were obtained and compared with the surgical findings. The time of return to play was recorded, and the outcome of surgical treatment was evaluated with validated Subjective Patient Outcome for Return to Sports (SPORTS) criteria: good = full return to preinjury level of sports without any symptoms; moderate = return to preinjury level of sports with some residual symptoms (mild discomfort during sports); and poor = did not return to preinjury level of sports. Results: Overall, 10 patients had a good outcome (83%), and 2 had a moderate outcome (17%). All athletes included in the study were able to return to sport at their preinjury levels 2.5 to 4 months postoperatively. Presurgical MRI scans correlated well with the surgical findings. Conclusion: The surgical treatment of rectus femoris central tendon rupture seems to be a good option in chronic and recurrent cases. After surgery and successful rehabilitation, the athlete is expected to continue sports at the preinjury level.

Efficacy of Surgical Tenodesis for Treatment of Distal Semitendinosus Hamstring Tendon Injuries

“…Outcomes of the surgical treatment were evaluated using the validated Subjective Patient Outcome for Return to Sports (SPORTS) criteria ( Table 2 ). 8 , 25 Patient satisfaction was recorded using the Musculoskeletal Outcomes Data Evaluation and Management System and the Surgical Satisfaction Questionnaire, which scores satisfaction on a 5-point scale (1 = very unsatisfied, 2 = unsatisfied, 3 = neutral, 4 = satisfied, and 5 = very satisfied). 15 …”

Management of anterior thigh injuries in soccer players: practical guide

“…The injury may be solely muscular, or it may primarily be associated with a tendon, such as the central tendon structure of the rectus femoris (Fig. 4 ) [ 4 , 5 ]. This tendinous anatomy with aponeurosis structures runs throughout the length of rectus femoris [ 25 ].…”

“…Rectus femoris central tendon rupture may sometimes also require operative treatment, especially in recurrent and chronic cases (Fig. 4 ) [ 5 ]. Without exception, total ruptures of the lower part of the quadriceps tendon and patellar tendon, as well as significant partial tendon ruptures, require operative treatment (Figs.…”

“…The most common pitfall in treating anterior thigh injuries is overlook them as simple muscle belly injuries and categorically misdiagnose these injuries as simple strains [ 4 ]. In recent years, research have shown that tendon related injuries possess high rate of prolonged rehabilitation, and structures such as central tendon has been discovered [ 5 ]. Physician treating these injuries are recommended to create their own regional pathway, where early diagnosis—using modern imaging such as MRI—is available together with musculoskeletal injury—oriented physiotherapist.…”

“…As in other muscle groups, when the athlete describes a combination of pain and audible noise or sometimes the feeling that something just displaced in the hip during the trauma, a tendon structure injury should be suspected [ 2 , 3 ]. Often, this type of injury has a different prognosis and even different therapeutic approaches [ 3 – 5 ]. The key to successful and optimal treatment is the correct and early diagnosis.…”