Document Type : Case Report

Authors

1 Department of Orthopedics and Traumatology, Hospital Cristo Redentor de Porto Alegre, Porto Alegre, Brazil

2 Department of Pediatrics, Santa Casa de Porto Alegre, Porto Alegre, Brazil

3 Research Group, Tulane University School of Medicine, New Orleans, LA, USA

4 4Department of Orthopedics and Traumatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil 5Research Group, Instituto Brasil de Tecnologias da Saúde, Rio de Janeiro, RJ, Brazil

Abstract

Objective: Quadriceps tendon ruptures are rare injuries affecting the knee extensor mechanism, typically occurring in middle-aged patients with underlying pathologies. Bilateral simultaneous quadriceps tendon ruptures are even more uncommon, and almost all reported cases in the literature are associated with an underlying disease.
Case Presentation: A 62-year-old Caucasian male presented complaining of pain in the anterior-superior aspect of both knees following a fall while walking that same day, during which his knees were in a semi-flexed position. Physical examination revealed a loss of active knee extension in both limbs and a palpable gap between the superior pole of the patella and the quadriceps tendon. MRI of both knees was performed two days after the injury, confirming bilateral quadriceps tendon ruptures. Twelve days after the initial injury, the patient underwent surgical intervention, and both injuries were addressed simultaneously using a transosseous tunnel technique. The transosseous technique consisted of three longitudinal and parallel tunnels drilled into the patella, and a modified Kessler suture was used to secure and reattach the quadriceps tendon back to the superior pole of the patella. At the patient’s eight-month follow-up, the patient was asymptomatic, ambulating normally, and had full knee extension with 120° flexion bilaterally. However, hypotrophy of the quadriceps muscle was noted bilaterally.
Conclusion: Proper evaluation and treatment of these injuries are crucial to achieving good outcomes, as they can lead to significant knee pain and disabilities.

Keywords

Main Subjects

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