According to Aceto, the main reason he didn't to the Olympia Europe was because he picked up a case of dysentery in India. Probably not a good idea to mess with water when you're shitting your brains out.
Apparently, he pulled his vastus lateralis, but he was still walking about afterwards, so it probably wasn't that serious. Most likely not a tear, and the rumors about surgery are just rumors. I doubt it's really that bad. I'm sure people just saw him limping around and freaked out. And even if it's bad, Big Ramy would be fine with a little less vastus lateralis.