Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 2;17(10):e93717.
doi: 10.7759/cureus.93717. eCollection 2025 Oct.

The Fixed Patella Test: A Reliable and Accurate Test for Detecting Quadriceps Tendon Rupture

Arifur Rahman  1 , Ahmed Ashour  2 , Ahmed Hamed  2 , Anastasios P Nikolaides  2 , Tarek Boutefnouchet  2
Affiliations

The Fixed Patella Test: A Reliable and Accurate Test for Detecting Quadriceps Tendon Rupture

Arifur Rahman et al. Cureus. .

Abstract

Purpose: Delayed diagnosis of quadriceps tendon rupture can compromise outcomes, particularly when standard clinical tests are limited by pain, swelling, or compensatory muscle activation. The fixed patella test is a novel, non-invasive clinical manoeuvre designed to assess tendon continuity. This service evaluation aimed to assess its diagnostic performance in routine clinical practice.

Methods: A prospective service evaluation was conducted at a major UK trauma centre across multiple sites. Patients presenting with suspected extensor mechanism injury underwent routine clinical evaluation, including the fixed patella test. During the test, patients performed an isometric quadriceps contraction while the examiner assessed mediolateral patellar mobility. A mobile patella indicated a ruptured tendon. All participants underwent confirmatory imaging with ultrasound and/or MRI. Surgical findings were used where available.

Results: Thirty patients (31 knees) were included. The fixed patella test demonstrated a sensitivity of 100%, a specificity of 50%, a positive predictive value of 93.1%, a negative predictive value of 100%, and an overall accuracy of 93.5%. All patients with a positive test were confirmed to have a complete or high-grade partial rupture on imaging or at surgery.

Conclusion: The fixed patella test is a simple, highly sensitive, and well-tolerated clinical tool for detecting quadriceps tendon rupture. It requires no additional equipment and may expedite diagnostic confirmation and surgical intervention. Ongoing data collection will help further validate its use in larger cohorts.

Keywords: diagnostic; fixed patella test; patella; quadriceps tendon; tendon rupture.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

References

    1. Pope JD, El Bitar Y, Mabrouk A, Plexousakis MP. StatPearls [Internet] Treasure Island (FL): StatPearls Publishing; 2025. Quadriceps tendon rupture. - PubMed
    1. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Clayton RA, Court-Brown CM. Injury. 2008;39:1338–1344. - PubMed
    1. Acute quadriceps tendon rupture: presentation, diagnosis, and management. Arnold EP, Sedgewick JA, Wortman RJ, Stamm MA, Mulcahey MK. JBJS Rev. 2022;10 - PubMed
    1. A new clinical test in diagnosing quadriceps tendon rupture. Jolles BM, Garofalo R, Gillain L, Schizas C. Ann R Coll Surg Engl. 2007;89:259–261. - PMC - PubMed
    1. Outcomes after repair of quadriceps tendon rupture in patients aged 40 years and younger. Rao S, Johnson EE, D'Amore T, Szeto S, Otlans P, Cohen SB. Orthop J Sports Med. 2022;10:23259671221097107. - PMC - PubMed

LinkOut - more resources