Quadriceps and Patellar Tendon Tear

If you are an athlete, especially when it comes to playing basketball or tennis, you rely on complex components of the knee to aid you in jumping, cutting, and sudden rapid movements. That is when the patellar tendons and quadriceps tendons serve a vital function. If you suffer a patellar tendon tear or a quadriceps tendon tear, you’ll likely need to pause your athletic activities until you receive knee treatment and fully recover.

The extensor mechanism is made up of the quadriceps muscle, quadriceps tendon, patella, patellar tendon, and tibia. The main function of the patellar tendon and the quadriceps tendon is to straighten the knee, which is essential for walking. The quadriceps tendon is the attachment of the quadriceps muscles to the patella (knee cap), and the patellar tendon is the attachment from the patella (knee cap) to the tibia (shin bone) (Figure 1).

At Hoag Orthopedic Institute, our knee doctors and surgeons specialize in repairing patellar tendon tears and quadriceps tendon tears so that you can get back in the game.

What is a Patellar Tendon Tear?

A patellar tendon tear may occur due to a forceful contraction of the quadriceps while running, kicking or jumping. It can also be torn by falling directly on the kneecap. In both cases, the tear can be partial or completely ruptured (torn fully). A small patellar tendon tear can make it difficult to walk and perform other daily activities. A larger patellar tendon tear, however, can be quite disabling and usually requires surgery and physical therapy to regain full knee function.

What is a Quadriceps Tendon Tear?

The quadriceps tendon most often tears due to a sports injury, joint weakness or an underlying chronic knee condition. Injury typically arises when the knee is bent and under heavy load. Besides pain, a popping sensation usually accompanies a quadriceps tendon tear.

Even a small quadriceps tendon tear can make walking difficult. If the tendon ruptures, the muscle is no longer connected to the kneecap. Already weakened quadriceps tendons are more likely to tear or rupture.

Quadriceps and Patellar Tendon Tear Symptoms

Patellar tendon tears and quadriceps tendon tears occur when the quadriceps tendon contracts suddenly, with force exceeding the capacity of the tendons, often as a result of jumping during sport or falling on a flexed knee. A patellar tendon rupture or quadriceps tendon rupture consisting of a full tear is commonly found in patients with pre-existing tendon degeneration/tendinosis.

Patellar tendon tear symptoms may include acute pain around the knee cap, often with an associated popping noise. The knee typically has significant swelling after rupture. Patients will have difficulty extending the knee and walking after the injury.

Quadriceps and Patellar Tendon Rupture Diagnosis

A clinical exam is central to the diagnosis of the patellar tendon and quadriceps tendon tear or rupture. A palpable gap is often felt at the respective tendon site. The surgeon will test the competence of the extensor mechanism by asking the patient to perform a straight leg raise against gravity; if the patient cannot extend the knee, a significant quadriceps or patellar tendon tear is likely.

When the patellar tendon ruptures, the knee cap will be significantly elevated (patella alta) compared to the normal knee (Figure 2). In a quadriceps tendon rupture, the knee cap will be slightly lower (patella baja).

Additional imaging studies are used to help confirm the diagnosis:

• X-rays can be helpful in determining the location of the extensor mechanism disruption.
• MRI is often used to confirm diagnosis and can help characterize tear patterns, underlying tendon disease, and any associated injuries (Figure 3).

Treatment Options for Quadriceps and Patellar Tendon Tears

Options for treating a patellar tendon tear or a quadriceps tendon tear depend on whether a tear or actual rupture occurred.

Nonsurgical Treatment for Patellar Tendon Tears and Quadriceps Tendon Tears

Partial patellar and quadriceps tendon tears may be treated conservatively if patients continue to have the ability to extend the leg. Conservative treatment for a patellar tendon tear or a quadriceps tendon tear may include the following:

• Rest and modification/avoidance of activities that will aggravate your knee pain
• Applying ice to the affected area
• Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) for pain and swelling reduction (such as ibuprofen)
• Physical therapy to improve mobility flexibility and decrease pain
• Knee brace to rest the affected muscles and tendons
• Corticosteroid injections to relieve symptoms

Surgical Treatment for Patellar Tendon Rupture and Quadriceps Tendon Ruptures

Complete patellar tendon ruptures and complete quadriceps tendon ruptures require surgical intervention because, without repair, patients will be unable to extend the leg or support themselves when walking.

When to See a Doctor for Knee Tendon Tear

Because a knee tendon tear can often cause pause and may make walking difficult, it is crucial to see a doctor as soon as possible. You need a patellar tear diagnosis before proper treatment can start. If you have a patellar tendon tear or a quadriceps tendon tear or rupture, our board-certified, fellowship-trained knee surgeons will build a custom treatment plan to help you get back to doing the things you love doing.

Hoag Orthopedic Institute is ranked as one of the top Orthopedic Hospitals by U.S. News & World Report in 2024-2025. Contact Hoag Orthopedic Institute today to schedule a consultation with one of our knee doctors.

Figure 1: The Extensor Mechanism of the Knee

Figure 2: X-ray demonstrating patella alta due to patellar tendon rupture

Figure 3: MRI of a quadriceps tendon rupture

Find a knee surgeon that treats patellar tendon tears and quadriceps tendon tears. ​Call us at (949) 705-6493 to make an appointment.