Simultaneous Bilateral Quadriceps Tendon Rupture following Long-Term Low-Dose Nasal Corticosteroid Application

Abstract

Simultaneous bilateral quadriceps tendon rupture is a very rare injury, which was previously only described in slightly more than 100 cases in the English literature. Occurrence after minor trauma is predominantly associated with certain medical conditions including chronic diseases and long-term use of certain drugs. We report the case of a 61-year-old healthy patient who sustained a simultaneous bilateral quadriceps tendon rupture following minor trauma. Medical history was completely clear except of a long-term nasal corticosteroid medication due to allergic rhinitis.

Figure 1

Plain radiographies show low riding of both patellae and signs of suprapatellar ossification of the right knee.

Figure 2

Intraoperative pictures of the ruptured quadriceps tendons. On the right side (a), the rupture is directly at the insertion site of the tendon to the suprapatellar aspect while a intratendinous rupture is apparent on the left side (b).

Figure 3

Postoperative radiographies demonstrate regular positioning of the patellae.

Figure 4

Six weeks following tendon suturing, the patient was able to extend the knee actively. However, there was an extension lag of 10° at the right side (a) and 15° at the left side (b).