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
. 2022 Jul 6;30(spe1):e245692.
doi: 10.1590/1413-785220223001e245692. eCollection 2022.

TREATMENT OF QUADRICEPS TENDON RUPTURE IN HEMODIALYSIS PATIENTS: A 2020 UPDATE

Luis Marcelo de Azevedo Malta  1 , Alair Augusto Sarmet Moreira Damas Dos Santos  2 , Marcio Carpi Malta  1 , Leonardo Martins Machado  1 , Jocemir Ronaldo Lugon  3
Affiliations

TREATMENT OF QUADRICEPS TENDON RUPTURE IN HEMODIALYSIS PATIENTS: A 2020 UPDATE

Luis Marcelo de Azevedo Malta et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Quadriceps tendon tears are uncommon injuries often associated with chronic diseases, including end-stage renal disease (ESRD). The role of secondary hyperparathyroidism as a predisposing factor for tendon tears in this group of patients is well documented, and the weakening of the tendon-bone junction is part of this context. The treatment of choice for quadriceps tendon ruptures in patients with ESRD is surgery, which should be performed as soon as possible. There are several surgical techniques to be used, but the lack of comparative studies does not allow us to conclude which one is the best option. More recent publications have preferred the association of techniques, with emphasis on the use of autologous tendon grafts as a reinforcement tool, which is the author's procedure of choice. Recent studies reported the use of biological agents to stimulate healing and allografts, but the information seems preliminary to be routinely recommended. Level of evidence II; Obsevation of therapeutic studies.

As rupturas do tendão do quadríceps são lesões incomuns, frequentemente associadas a doenças crônicas, incluindo a doença renal em estágio de falência funcional. O papel do hiperparatireoidismo secundário como fator predisponente para rupturas tendinosas nesse grupo de pacientes está bem documentado, e o enfraquecimento da junção tendão-osso faz parte desse contexto. O tratamento de escolha para rupturas do tendão do quadríceps em pacientes com falência renal é a cirurgia, e deve ser realizado o mais rápido possível. Existem várias técnicas cirúrgicas a serem utilizadas, mas a falta de estudos comparativos não nos permite concluir qual é a melhor opção. Publicações mais recentes têm preferido a associação de técnicas, com destaque para o uso de enxerto tendíneo autólogo como ferramenta de reforço, procedimento de escolha do autor. Estudos recentes relatam o uso de agentes biológicos para estimular a cicatrização e aloenxertos, mas as informações parecem preliminares para serem rotineiramente recomendadas. Nível de Evidência II; Observação de estudos terapêuticos.

Keywords: Hemodialysis; Hyperparathyroidism; Quadriceps muscle.

PubMed Disclaimer

Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Palpable gap above superior pole of patella.
Figure 2
Figure 2. Intraoperative aspect of rupture.
Figure 3
Figure 3. Transosseous suture and autologous semitendinosus graft augmentation.
Figure 4
Figure 4. Final construction.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ciriello V, Gudipati S, Tosounidis T, Soucacos PN, Giannoudis PV. Clinical outcomes after repair of quadriceps tendon rupture: A systematic review. Injury. 2012;43:1931–1938. - PubMed
    1. Lim CH, Landon KJ, Chan GM. Bilateral quadriceps femoris tendon rupture in a patient with chronic renal insufficiency: A case report. J Emerg Med. 2016;51:e85–e87. - PubMed
    1. Reito A, Paloneva J, Mattila VM, Launonen AP. The increasing incidence of surgically treated quadriceps tendon ruptures. Knee Surg Sports Traumatol Arthrosc. 2019;27:3644–3649. - PMC - PubMed
    1. Chang ES, Dodson CC, Tjoumakaris F, Cohen SB, Chang ES, Dodson CC, Tjoumakaris F, Cohen SB. Functional results following surgical repair of simultaneous bilateral quadriceps tendon ruptures. Phys Sportsmed. 2014;42:114–118. - PubMed
    1. Gao MF, Yang HL, Shi WD. Simultaneous bilateral quadriceps tendon rupture in a patient with hyperparathyroidism undergoing long-term hemodialysis: A case report and literature review. J Int Med Res. 2013;41:1378–1383. - PubMed

LinkOut - more resources