Background: There is relatively little information about quadriceps
tendon tears after total knee arthroplasty. The purpose of this study was to
determine the prevalence of this condition and the outcomes of patients who
had a tear of the quadriceps tendon after a total knee arthroplasty.
Methods: From a cohort of 23,800 primary total knee arthroplasties,
we identified twenty-four patients who had a rupture of the quadriceps tendon
postoperatively. Ten additional patients had the total knee arthroplasty done
elsewhere and were referred for care after sustaining a tear of the quadriceps
tendon. Thus, the study group consisted of thirty-four patients, and all had
at least two years of follow-up. Eleven patients had a complete tear, and
twenty-three had a partial tear.
Results: The prevalence of a quadriceps tendon tear after total knee
arthroplasty was 0.1% (twenty-four of 23,800). Seven patients with a partial
tear were treated nonoperatively, and all had a satisfactory outcome. One
patient with a complete tear was treated nonoperatively and had an
unsatisfactory result. Of the ten patients treated operatively after a
complete tear, four subsequently had rerupture of the repaired tendon and four
had a satisfactory outcome. Of the sixteen patients with a partial tear
treated operatively, only one had rerupture and twelve had a satisfactory
outcome. Complications occurred in eleven of the twenty-six patients managed
Conclusions: The prevalence of complications was high, and the
outcomes were poor for seven of the eleven patients who had a complete
quadriceps tendon tear after total knee arthroplasty. Patients who sustained a
partial tear and were treated nonoperatively had no complications and had
uniformly good outcomes.
Level of Evidence: Prognostic study, Level IV. See
Instructions to Authors for a complete description of levels of evidence.