Q: Do I need surgery for a grade 2 tear of quadriceps tendon? I can lift my leg against gravity but walking is very difficult. The injury is eight months old. How many days do I have to be in the cast? What sort of surgery will be done?

A:How are you sure that it is grade II tear of quadriceps? If it is already 8 months old and it is indeed a grade II tear then you need physiotherapy and not plaster. As you mentioned, the key point is your ability to straighten the bent leg against gravity. Merely able to move is not sufficient. You should be able to straighten it completely. If you cannot straighten completely then you do have what is called an extension lag. An extension lag indicates a significant rupture of the quadriceps and you may require a surgical intervention. The intervention will depend on the nature and the extent of tear. Essentially it involves reconstruction of the muscle/tendon. If you are able to fully straighten your leg you do not need any intervention other than exercises.