Quadriceps Tendon Rupture and Periosteal Sleeve Avulsion Fracture of the Proximal Patella Pole in an Active Adolescent

Bimmel, R.; Prime, Matthew; Reddy, K. Ramkumar

doi:10.3928/01477447-20110505-32

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…6 Investigations in patients aged ≤40 years are often limited to case reports or small series. 2,15,16,33 Given the morbidity of quadriceps tendon rupture and the functional goals of younger patients, further investigation into their outcomes is warranted. The purpose of this study was to review the clinical outcomes of patients who underwent QTR at age ≤40 years.…”

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confidence: 99%

Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger

Rao

Johnson

D’Amore

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Injury to the quadriceps tendon is rare and most commonly occurs in middle-aged men. Few reports are available regarding outcomes after quadriceps tendon rupture in younger patients. Purpose/Hypothesis: To review the clinical outcomes of patients who underwent quadriceps tendon repair at age ≤40 years. We hypothesized that this cohort would experience better clinical outcomes in comparison to historical older controls. Study Design: Case series; Level of evidence, 4. Methods: Using an institutional database, we retrospectively identified patients who underwent quadriceps tendon repair between January 2009 and December 2017. Patients were included in the study if they were aged ≤40 years at the time of surgery and had sustained an isolated, complete tendon rupture. Patient and injury characteristics were recorded. Patients were contacted to complete a custom survey, the 2000 International Knee Documentation Committee (IKDC) form, the Lysholm scale, and the Tegner scale. Results: Included were 38 patients (86.8% male; mean age, 32.0 ± 6.9 years; age range, 15-40 years), with a mean follow-up of 5.9 ± 2.3 years (range, 2.4-11.3 years). At final follow-up, the mean IKDC score was 74.1 ± 22.6 (range, 26.4-100.0), and the mean Lysholm score was 85.4 ± 20.0 (range, 30-100), which were similar if not inferior to historical controls of patients >40 years. Only 16 patients (42.1%) had unchanged or higher Tegner scores after surgery, whereas 22 patients (57.9%) reported lower postoperative activity level. Overall, 91.2% (31/34) of workers returned at a mean 3.9 months after surgery, whereas 63% (12/19) of athletes were able to return to play at 8.8 months. At final follow-up, 12 patients (31.6%) reported persistent pain and stiffness in their knees. Additionally, 3 patients (7.9%) reported pain without stiffness, and 4 (10.5%) reported stiffness without pain. Patients reporting pain or stiffness had significantly lower IKDC scores, Lysholm scores, postoperative Tegner scores, and change in their Tegner score at final follow-up in comparison to those who did not report pain or stiffness. Conclusion: Although patients aged ≤40 years had satisfactory outcomes after quadriceps tendon repair, this injury resulted in significant long-term sequelae in a substantial percentage of patients, despite their youth. Further, this group did not have better outcomes compared with historical controls aged > 40 years.

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confidence: 99%

Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger

Rao

Johnson

D’Amore

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…Complete rupture/avulsion indicates prompt surgical management within 72 hours, which yields best results according to literature [15][16][17]. Most patients obtain a good range of motion but some may have persistent weakness preventing them from carrying out strenuous exercise [17].…”

Section: Discussionmentioning

confidence: 92%

“…Most patients obtain a good range of motion but some may have persistent weakness preventing them from carrying out strenuous exercise [17].…”

Section: Discussionmentioning

confidence: 99%

Bipartite patella separation with quadriceps tendon avulsion: A rare surgical case

Mohammad¹,

Bitar²,

Laughlin-Symon³

et al. 2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. The occurrence of bipartite patellar disruption simultaneously with quadriceps tendon avulsion is an extremely rare injury. A literature review found three documented cases in which only two repaired both the patella and tendon. We present a case report outlining this unusual injury and propose a method of surgical treatment. Case Report: A 45-year-old male presented following a fall directly onto his knee, with no significant medical history or previous injury. He was diagnosed with both separation of a type III bipartite patella and a clinical suspicion of a quadriceps tendon rupture. Intra-operatively, we found a complete tear of the quadriceps tendon at its insertion to the patella with disruption of the synchondrosis and significant separation of the bipartite patella. The displaced fragment was reduced and held using two cannulated screws, the quadriceps tendon was reattached to the superior pole of the patella using two anchor sutures and the retinaculum repaired. Conclusion:We could find no documented cases of using both cannulated screws and anchor sutures as a fixation method for this injury. We recommend this technique as we found that it gave a stronger fixation and was associated with a good functional outcome for our patient.

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“…The highest incidence is among middle-aged and elderly men after minor trauma or with a history of chronic illnesses, such as diabetes, obesity, and end-stage renal disease on hemodialysis 15,16 . Among adolescent and pediatric patients, QTR is considerably uncommon and is usually a result of primary external trauma or rapid deceleration 17-20 . A number of case reports have also demonstrated QTR in the weeks or months after an unrelated traumatic injury or surgery, including traumatic intramuscular hematoma of the vastus lateralis region 21 , traumatic patellar subluxation 22 , medial patellofemoral ligament reconstruction 23 , traumatic valgus-stress injury of the knee 24 , and arthroscopic meniscectomy 25 .…”

Section: Discussionmentioning

confidence: 99%

Adolescent Quadriceps Tendon Rupture, an Early Complication After ACL Reconstruction

Gawel

Kemler

Rao

et al. 2022

JBJS Case Connector

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Case: A healthy adolescent male patient initially presented with complete rupture of the anterior cruciate ligament (ACL) after a plant-twist injury during a high school football game. Four weeks after ACL reconstruction with autograft bone-patella tendonbone, the patient slipped and fell, sustaining hyperflexion of the knee, resulting in rupture of the ipsilateral quadriceps tendon. Conclusion:Although this rare complication has previously been reported in the adult population, to the best of our knowledge, this is the first known report of an adolescent patient sustaining a quadriceps tendon rupture after ACL reconstruction.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B799).

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Quadriceps Tendon Rupture and Periosteal Sleeve Avulsion Fracture of the Proximal Patella Pole in an Active Adolescent

Cited by 8 publications

References 10 publications

Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger

Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger

Bipartite patella separation with quadriceps tendon avulsion: A rare surgical case

Adolescent Quadriceps Tendon Rupture, an Early Complication After ACL Reconstruction

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