The quadriceps tendon is a composite structure formed by the aponeuroses of all four quadriceps components (rectus femoris, vastus intermedius, vastus medialis, vastus lateralis), converging in three layers to insert onto the superior patellar pole. The rectus femoris layer is superficial, the vasti form the middle and deep layers. The tendon continues as the patellar retinaculae on either side.
| Muscle |
|
|---|---|
| Attachment | Base (superior border) of the patella |
Transmits quadriceps force to the patella for knee extension
Quadriceps tendon rupture is more common than patellar tendon rupture, predominantly affecting patients over 40 with predisposing conditions (diabetes, chronic renal failure, steroid use, fluoroquinolone use). Complete rupture produces loss of active knee extension, a palpable suprapatellar gap, and a low-riding patella (patella baja). Because the tendon is layered, partial tears can occur without complete extensor failure; ultrasound and MRI confirm the tear location and depth. Partial tears with a preserved straight-leg raise are often managed with bracing in extension and progressive loading, whereas complete ruptures require surgical transosseous or anchor repair into the superior patellar pole, with augmentation in chronic cases. Full return to sport after repair commonly takes around 6 months.
Superior patellar pole tendon degeneration from repetitive loading, producing pain on stairs and squatting distinct from patellar tendinopathy by its location above rather than below the patella.
Complete tear above the patella from sudden eccentric overload, more common in middle-aged men, producing inability to extend the knee against gravity and a low-riding, distal patella.
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