Quadriceps / Patella Tendon Rupture

The quadriceps tendon connects the large muscle at the front of the thigh to the top of the kneecap (patella), and the patellar tendon connects the bottom of the kneecap to the tibia (shinbone). Together, these form the knee's extensor mechanism — the structure that allows you to actively straighten your knee and take weight through a bent leg. A rupture occurs when one of these tendons tears completely, usually from a sudden, forceful contraction of the thigh muscle — for example, stumbling and catching yourself, or landing awkwardly from a jump.

Quadriceps tendon rupture is more common in patients over 40, and is often associated with underlying tendon degeneration from factors such as chronic steroid use, diabetes, kidney disease, or prior tendon problems. Patellar tendon rupture tends to occur in younger, more active patients, often during jumping or cutting sports.

Complete ruptures of either tendon are always treated surgically — without repair, the knee cannot reliably extend or support weight, and the torn tendon ends tend to scar and retract further apart over time, making later repair more difficult.

The torn tendon is repaired back to the patella using heavy, strong sutures passed through drill tunnels in the bone, or secured with suture anchors. Where tendon quality is poor or the repair needs extra protection, this may be reinforced with a cerclage suture or wire looped around the kneecap and tibia, protecting the repair while it heals, particularly during the early stages of bending the knee.

This procedure is performed under general anaesthetic, with local anaesthetic infiltration at the time of surgery for good pain control in the first 12–24 hours afterward. It is usually done as day surgery or with a single overnight stay.