Simultaneous bilateral quadriceps tendon rupture in a patient with chronic renal failure

Abstract

Bilateral quadriceps tendon rupture is an unusual injury, but may be encountered in patients with various chronic diseases after minor trauma. This article presents a case of bilateral quadriceps tendon rupture of a 38-year-old woman with chronic renal failure. Surgical repair was performed using a bone tunnel technique with a nonabsorbable suture and a suture anchor. Postoperative magnetic resonance imaging confirmed complete healing of the repair site, and clinically active extension with 120 degrees of range of motion was achieved.

Keywords: Bilateral rupture; Chronic renal failure; Primary repair; Quadriceps tendon.

Fig. 1

Lateral radiographs of right (A) and left (B) knees showing patella baja and calcification of quadriceps tendons (arrows).

Fig. 2

Preoperative sagittal T2-weighted magnetic resonance images of the right (A) and left (B) knees showing complete disruption at the distal quadriceps tendo-osseous junctions (arrow).

Fig. 3

Smooth and round surface of a ruptured quadriceps tendon at the tendo-osseus junction.

Fig. 4

Bleeding bony surface at the proximal pole of a patella after rasping.

Fig. 5

(A) Ruptured quadriceps tendons were sutured using a Krackow technique and nonabsorbable suture materials. (B) Schematic illustration of the operative technique.

Fig. 6

Sagittal T2-weighted magnetic resonance image of the right knee (A) and left knee (B) at 6 months after surgery showing a quadriceps tendon well attached to the patella proximal pole. A high signal intensity cystic lesion (2×2 cm sized) was found incidentally at the left distal femur (arrow).