A Rare Form of Soccer Injury - Rectus Femoris Tendon Rupture

Rectus Femoris Tendon Rupture

A rectus femoris rupture is the full or partial rupture of the upper part of the the thin muscle that goes from the front side of the hip to the knee. The main causes of rectus femoris ruptures are explosive kicking techniques.

The rectus femoris muscle is composed of fibers appropriate for rapid, forceful activity and crosses two joints (the hip and the knee). These characteristics may explain why this muscle is particularly vulnerable to eccentric stress forces, such as those resulting from the powerful contractions associated with sprinting and jumping. Soccer and rugby are the sports most commonly associated with injury to this muscle.

Rectus Femoris Muscle

Symptoms include:

  1. A sudden sharp pain at the front of the hip / in the groin usually whilst doing some explosive activity e.g. shooting practice.
  2. Swelling and bruising may occur.
  3. Pain in lifting the knee up against resistance.
  4. Pain when pressing in at the point of injury.
  5. If it is a total rupture then it will be impossible to contract the muscle. A lump may be felt due to recoil and bundling up of the proximal muscle.

Case Study

This is a 17-year old boy who is a football player.  He was doing shooting practice when he felt a sudden acute pain in the front of his left thigh together with a pop sound.

Note the dimple seen due to tendon tear with muscle proximal retraction.

Rectus Femoris Rupture
Rectus Femoris Rupture | HC Chang Orthopaedic Surgery

There is an obvious deformity in the thigh when he is asked to contract the muscle.

Rectus Femoris Rupture

Rectus Femoris Rupture | HC Chang Orthopaedic Surgery

MRI scan of the left thigh was done.

It showed  a complete rupture of the rectus femoris tendon with proximal retraction.

Rectus Femoris Rupture MRI
Rectus Femoris Rupture MRI | HC Chang Orthopaedic Surgery
Rectus Femoris Rupture MRI Transverse
Rectus Femoris Rupture MRI Transverse

As this was a complete tear, surgery was deemed necessary in order to reattach the torn tendon.

Intra-operatively the torn tendon and muscle can be seen.

Rectus Femoris Rupture Intra-op
Rectus Femoris Rupture Intra-op

The tendon was reattached distally to the quadriceps tendon.

Repair of Rectus Femoris Rupture
Repair of Rectus Femoris Rupture

The patient’s left knee was kept in full extension using a knee brace and he was not allowed to place weight on his left leg when walking using crutches for the next 6 weeks.

He was subsequently sent for physiotherapy after 6 weeks of protection of the repaired tendon.

He will need at least 4 to 6 months of rehabilitation before he can return to football training.

For more information on rectus femoris tendon ruptures or musculoskeletal problems, please email us at hcchang@ortho.com.sg or call us at +65-683 666 36.

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