The combined tendon of all four quadriceps heads inserting on the superior pole of the patella, continuing as the patellar tendon below — the final pathway for all knee extension force.
Quadriceps tendon ruptures are more common in older patients than patellar tendon ruptures and carry a high re-rupture rate. Surgical repair is required for active individuals. Tender superior patellar pole distinguishes quadriceps tendinopathy from patellar tendinopathy.
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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