Patellar & Quadriceps Tendon Tear / Rupture


  • Mechanism is usually one of substantially loading the quadriceps mechanism
    • Landing from jumping
    • Weight training (heavy squats)


  • Swelling around the quadriceps mechanism
  • Inability to straight leg raise or initiate the quadriceps mechanism
  • Tenderness and / or palpable defect at the level of the quadriceps tendon or patellar tendon
  • X-ray findings:
    • Patellar Tendon Rupture
      • Patella Alta (high riding patella)
      • Vertical distance between the inferior pole of the patella and the tibial tubercle is greater than 1.1* vertical patellar height
      • On a true lateral x-ray, the inferior pole of the patella will not be at the level of Blumensaat’s line
      • It may be possible to see the discontinuity of the patellar tendon fibres on plain x-ray


    • Quadriceps Tendon Rupture
      • There may be Patella Baha (low riding patella) with the normally straight patellar tendon fibres appearing waving (without tension)
      • The vertical distance between the inferior pole of the patella and the tibial tubercle may be significantly less than the normal 1.1* vertical patellar height
    • For incomplete tears of the quadriceps or patellar tendons, there may not be any significant changes on x-ray. If a significant tendon injury cannot be ruled out clinically, then Ultrasound may be of benefit.


  • The management of ruptures (and high grade tears) of either the quadriceps or patellar tendon is surgery
  • Lower grade injuries may be managed in a knee extension (Zimmer) splint and activity restriction until healing has occured