Functional Outcomes and Quality of Life in Patients over 50 Years Old Treated with Quadriceps Tendon Repair: A Retrospective Study

Objective: Quadriceps tendon rupture (QTR) is a rare but highly debilitating event, leading to a marked loss of knee extension and a significant reduction in joint function. While early surgical repair represents the treatment of choice, medium-term functional outcomes and the impact on quality of life are not yet fully defined. The aim of this study is to evaluate the clinical–functional outcomes and quality of life at a minimum of six months post-surgery in patients over 50 years of age who underwent quadriceps tendon repair. Methods: A retrospective study was conducted on patients of both sexes, aged between 50 and 80 years, who underwent surgical treatment for complete QTR at the CTO Hospital in Turin between 2018 and 2024. Demographic data and details regarding the type of surgical procedure were collected. All patients were re-evaluated at a minimum of 6 months post-surgery from a clinical perspective and using three validated questionnaires: the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, the Lysholm score, and the Short Form-36 (SF-36), to analyze joint function and quality of life, respectively. Additionally, the range of motion (ROM) of the operated knee, any extension deficit, and postoperative complications were assessed. Results: Of 61 patients who met the eligibility criteria, 29 (47.5%) completed all required questionnaires and were included in the final analysis (mean age 62 years; 27 males, 2 females). The mean BMI recorded at the time of injury was 28.6. The mean follow-up was 9.17 months. Two patients were treated with suture anchor repair, while 27 patients underwent reinsertion using transosseous tunnels. The mean post-operative flexion ROM was 102.4°. No tendon re-ruptures occurred. Two patients presented a residual extension lag. The mean IKDC score was 63.2 points. The SF-36 questionnaire revealed scores indicative of a good level of general well-being and a low psychological impact. The Lysholm questionnaire yielded a mean score of 83.15, indicating a good functional recovery of the operated limb. Conclusions: The obtained results suggest that quadriceps tendon repair in patients over 50 can achieve good functional outcomes and a low re-rupture rate, with a substantially preserved medium-term quality of life; however, given the retrospective, uncontrolled design and the exclusion of more than half of the eligible cohort, these findings should be interpreted with caution and confirmed by larger, prospective studies.