Complete midsubstance rectus femoris ruptures: a series of 27 athletes treated operatively

Abstract

Introduction: Rectus femoris muscle injuries are common in sports. Although majority of these injuries are treated conservatively, some tend to present significant disability which could compromise the returning to pre-activity level of competition in athletes. The purpose of this study is to evaluate possible benefits of operative treatment in acute and recurrent rectus femoris ruptures. Methods: Retrospectively, a total of 27 patients (23 men, 4 women) with grade 4 rectus femoris muscle rupture which located at the diaphyseal area between proximal and distal myotendinous junctions. Operative treatment was carried out in the acute (8 cases, < 4 weeks after injury) or recurrent rectus femoris ruptures (19 cases). Results: 20 (74%) patients had excellent or good results, moderate results in 6 (26 %) and poor (required re-operation after re-injury) in 1 (4%) patients. The return to pre-activity level of competition was 5 months on average. Adverse events were haematoma (n=4, percutaneously drained), superficial infection (n=1, healed with cephalexin antibiotics), partial dehiscence of the wound (n=1, no intervention). Conclusion:Based on these cases, excellent or good results may often be expected after surgical repair of grade 4 rectus femoris midsubstance ruptures. Level of evidence: IV, Case series.

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

“…Good results after surgery have been reported for rectus femoris proximal avulsions and midsubstance complete ruptures, mainly among high-performance athletes. 7,10,12,15 More research should be performed to clarify the central tendon injury treatment methods. It is still not clear which central tendon injuries benefit from more aggressive therapy, including surgery.…”

“…Most rectus femoris injuries are strains or contusions and treated through nonoperative means with good results. 10 , 13 However, there are also surgical indications for severe rectus femoris injuries. According to recently published studies, complete proximal rectus femoris avulsions and complete midsubstance muscle ruptures often need surgical treatment, especially when they occur in high-performance athletes.…”

“…According to recently published studies, complete proximal rectus femoris avulsions and complete midsubstance muscle ruptures often need surgical treatment, especially when they occur in high-performance athletes. 10 , 12 , 15 …”

“…According to recently published studies, complete proximal rectus femoris avulsions and complete midsubstance muscle ruptures often need surgical treatment, especially when they occur in highperformance athletes. 10,12,15 Muscle tissue injuries usually heal well and without complications. 13 If the injury also affects tendon tissue, the healing process can be more demanding and require more time.…”

Midterm outcome and strength assessment after proximal rectus femoris refixation in athletes

“…Within quadriceps injuries, the rectus femoris (RF) muscle is known to be the most commonly affected muscle [ 8 , 29 ]. Proximal RF injuries mainly occur during sprints and kicking movements [ 19 ], and present as myofascial injuries, small to complete ruptures at the myotendinous junction, midsubstance ruptures, or avulsion injuries from its anatomic origin [ 4 , 9 , 15 , 19 , 21 – 23 , 25 , 26 , 33 ]. For proximal rectus femoris avulsions (PRFA), operative treatment options include suture anchor repair and tenodesis with excision of the proximal tendon in which both alternatives yield satisfactory results primarily in small case series [ 23 , 26 , 28 , 32 ].…”