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The Dubai Hip and Knee Institute (DHKI) - Dr Hervé Ouanezar

Extensor Mechanism of the Knee: Structure, Trauma, and Treatment

The extensor mechanism of the knee is essential for knee mobility and is made up of three main components that work together to enable active knee extension: the patella (kneecap), the quadriceps tendon, and the patellar tendon.

 

Structure and Function

  • Patella (Kneecap): A small bone that acts as a pulley between the quadriceps tendon and patellar tendon, increasing the efficiency of the knee’s extensor mechanism.

  • Quadriceps Tendon: Connects the quadriceps muscle to the patella and helps transmit force during knee extension.

  • Patellar Tendon: Links the patella to the tibia and is crucial for transferring the force generated by the quadriceps to extend the knee. ​

TREATMENT

​01. NON-SURGICAL MANAGEMENT

  • Rest and Activity Modification: Avoiding weight-bearing activities that strain the knee.

  • Bracing or Immobilization: To provide support and limit movement, allowing healing of minor injuries.

  • Physical Therapy: To maintain muscle strength and knee function while preventing stiffness.

  • Medications: NSAIDs for pain and inflammation control. 

 
02. SURGICAL TREATMENT 

  • Repair or Reconstruction: Surgical intervention is often required for significant tears or ruptures of the patellar tendon, quadriceps tendon, or other components of the extensor mechanism.

    • Patellar Tendon Repair: In cases of complete tears or avulsion fractures.

    • Quadriceps Tendon Repair: In cases of ruptures or tears of the quadriceps tendon, often in older patients.

  • Tendon Grafting: In severe cases, tendon grafts may be used to reconstruct the damaged extensor mechanism. ​

 

03. POST-SURGICAL REHABILITATION

  • Focus on restoring knee strength, mobility, and function through a gradual rehabilitation program.

  • Full recovery can take 3-6 months, depending on the severity of the injury and the type of surgery performed.  

​

04. KEY POINT

  • Early intervention is critical, with non-surgical treatment suitable for minor injuries and surgery necessary for more severe or complete ruptures. Rehabilitation is crucial for restoring function and strength to the knee.​

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