Quadriceps tendinopathy: a review, part 2—classification, prognosis, and treatment

King, Dominic; Yakubek, George; Chughtai, Morad; Khlopas, Anton; Saluan, Paul; Mont, Michael A.; Genin, Jason

doi:10.21037/atm.2019.01.63

Cited by 15 publications

(7 citation statements)

References 37 publications

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“…The findings of this case series are of interest since the pain mechanisms related to quadriceps tendinopathy are unknown, and treatment is known to be difficult. 1 , 4 , 6 When conservative management fails, surgical treatment focuses on revision of the tendon inside. Via open surgery, and a longitudinal tenotomy, macroscopically abnormal tissue is excised.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Non-operative treatment using different types of loading regimens is first-line treatment, and when surgery is needed intra-tendinous revision surgery is commonly used. 1 , 4 , 6 Compared to the more common patellar tendinopathy, there is sparse scientific knowledge about the pain mechanisms related to this condition. Quadriceps tendinopathy is therefore often misdiagnosed as patellar tendinopathy.…”

Section: Introductionmentioning

confidence: 99%

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Is There a Relationship Between Quadriceps Tendinopathy and Suprapatellar Plica? An Observational Case Series

Alfredson¹,

Masci²,

Spang³

2022

IMCRJ

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Purpose Chronic painful quadriceps tendinopathy is a relatively rare condition known to be difficult to manage. Conservative management is first-line treatment and if that fails open intra-tendinous revision surgery followed by a long rehabilitation period is used. There is sparse research on etiology and new treatment methods. This observational study aimed to evaluate the intra-articular findings in patients with chronic painful quadriceps tendinopathy resistant to conservative management. Patients and Methods Seven male athletes (mean age 33 years, range 22–40) suffering from chronic painful quadriceps tendinopathy in altogether 10 tendons, not responding to conservative management including heavy strength training, were included. Clinical examination and ultrasound scanning were used for diagnosis. Arthroscopy was used for evaluation of the inside of the knee. Results In all 10 knees, there were obliterating major plica formations in the suprapatellar pouch. Conclusion Obliterating plica formations in the suprapatellar pouch may be involved in the aetiology and pathology in quadriceps tendinopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is There a Relationship Between Quadriceps Tendinopathy and Suprapatellar Plica? An Observational Case Series

Alfredson¹,

Masci²,

Spang³

2022

IMCRJ

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“…Quadriceps tendon rupture is most commonly caused by trauma and most frequently occurs in young males. The mechanism includes instantaneous contraction of the quadriceps and passive stretching of the tendon beyond its limits, resulting in rupture [6]; older adults often have chronic diseases and tendinopathy, and therefore might be affected bilaterally.…”

Section: Discussionmentioning

confidence: 99%

Open tibia plateau fracture with intra-osseous dislocation of the patella and quadriceps tendon rupture: a case report

Zhao

Liu

et al. 2020

BMC Surg

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Background: Both tibial plateau fractures and extensor apparatus injuries are serious injuries to the knee joint that generally do not occur in the same patient. We report a rare case of open tibial plateau fracture combined with quadriceps tendon rupture and complete displacement of the patella into the tibial plateau fracture. Case presentation: The case involved a male who was 19 years old who had been in a motorcycle accident. The patient was admitted to our department with an open tibial plateau fracture 3 h post-injury. X-ray showed a tibial plateau fracture and complete displacement of the patella into the tibial plateau. CT showed an avulsion fracture in the patella and tibial intercondylar eminence. Concomitant quadriceps tendon injury and both anterior and posterior cruciate ligament tibial insertion avulsion fractures were considered. The operative findings of emergency surgery confirmed our preoperative diagnosis. Single-stage quadriceps tendon repair and ORIF for the tibial plateau fracture were performed. Satisfactory restoration of function was acquired at the last follow up. Conclusion: The most difficult aspect of this case was the determination of the cause of the intra-osseous dislocation of the patella into the tibial plateau. The most likely mechanism of the injury may be that the patient experienced transient posterior dislocation of the knee during the injury. Rupture of the quadriceps tendon should be considered with posterior dislocation of the knee, and the patella was pushed into the tibial plateau fracture by force after the rupture of the quadriceps tendon.

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“…Подошвенная фасциопатия относится к большой группе тендинопатий и фасциопатий различных локализаций, клинически проявляющихся хроническим упорным болевым синдромом [1][2][3][4]. Несмотря на длительную историю изучения этой патологии, причины и морфогенез клинических проявлений до сих пор остаются не вполне понятными [3,[5][6][7].…”

Section: Traumatology травматология введениеunclassified

Morphofunctional reorganization of plantar aponeurosis in experimental modeling of fasciopathy by synthetic analogue of prostaglandin E1

Silantyev

Dzyuba

Ерофеев

et al. 2022

Acta biomedica scientifica

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Foundation. Chronic plantar fasciopathic pain syndrome is a pathology that significantly affects the quality of life of patients of all age categories. Insufficient knowledge of the etiological and pathogenetic factors in the development of fasciopathies explains the multiplicity, and sometimes inconsistency, of conservative and surgical treatment regimens. The choice of the optimal variant of therapeutic or surgical intervention may be associated with experimental modeling of fasciopathies and the study of the dynamics of the pathological process.The aim. To study the morphological changes in structures identical to the human plantar aponeurosis in experimental modeling of fasciopathy in animals.Research methods. The material for the study was fragments of the tendonaponeurotic complex of the foot of laboratory animals (control group: animals with the introduction of physiological sodium chloride solution (n = 12); main group: animals with the introduction of alprostadil (n = 12)). The methods of light microscopy (staining with alcian and toluidine blue, according to Van Gieson, Weigert – Van Gieson and Picro-Mallory) and morphometry were used.Results and discussion. As a result of the study, it was found that the four-fold administration of alprostadil had a significant effect on the structure of the dense fibrous connective tissue of the plantar foot of laboratory animals. The mechanisms of damage (edema, microhemorrhages, infiltration by lymphocytes, plasmocytes and leukocytes, dystrophy by the type of mucoid and fibrinoid swelling, delamination and rupture of collagen fibers), adaptation and regeneration (the appearance of a large number of activated fibrocytes, fibroblasts, microvessels, neoplasm of collagen fibers) were activated. All this together led to spatial focal histotopographic changes, consisting in an increase in the cellular composition of connective tissue structures against the background of a noticeable violation of their spatial orientation.Conclusion. Modeling of fasciopathy using alprostadil was accompanied by the appearance of mosaic reversible and irreversible heteromorphic and heterochronous changes in all connective tissue aponeurotic structures. Such histotopographic changes should be considered as one of the reasons for the clinical manifestations of plantar fasciopathies, causing functional insufficiency and explaining the clinical recurrent nature of the pathological process.

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Quadriceps tendinopathy: a review, part 2—classification, prognosis, and treatment

Cited by 15 publications

References 37 publications

Is There a Relationship Between Quadriceps Tendinopathy and Suprapatellar Plica? An Observational Case Series

Is There a Relationship Between Quadriceps Tendinopathy and Suprapatellar Plica? An Observational Case Series

Open tibia plateau fracture with intra-osseous dislocation of the patella and quadriceps tendon rupture: a case report

Morphofunctional reorganization of plantar aponeurosis in experimental modeling of fasciopathy by synthetic analogue of prostaglandin E1

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