The quadriceps tendon is the combined tendon of all four quadriceps heads, inserting on the superior patellar pole in three layers reflecting their muscle origins. It is the proximal link of the extensor mechanism, transmitting the powerful quadriceps force to the knee. Rupture occurs predominantly in older patients with systemic risk factors, distinguishing it from patellar ligament rupture which affects younger patients.
Transmits quadriceps force to extend the knee through the patella and patellar ligament
Quadriceps tendon rupture presents with a palpable suprapatellar gap, patella baja on lateral radiograph, and inability to extend the knee against gravity. Risk factors include renal failure, diabetes, hyperparathyroidism, fluoroquinolone use, and corticosteroid injection. Surgical repair within 72 hours produces the best outcomes, with delayed repair requiring tendon advancement or augmentation procedures.
Complete rupture from eccentric overload in older patients producing inability to extend the knee, palpable suprapatellar gap, and patella baja, requiring urgent surgical repair within 72 hours for best outcomes.
Suprapatellar tendon degeneration producing anterior knee pain above the patella in jumping athletes and runners, managed with progressive load rehabilitation and shockwave therapy.
