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01-12-2013 | Case Report

Bilateral simultaneous quadriceps tendon rupture in a patient with diabetes and gout: a case report and review of the literature

Authors: K. Moens, S. Harth, Y. Depaepe, A. Harth, G. Vandendriessche, C. Van Vynckt

Published in: European Orthopaedics and Traumatology | Issue 4/2013

Excerpt

A quadriceps tendon rupture (QTR) is a well-known condition in orthopedic practice, requiring adequate surgical treatment to avoid residual deformity and loss of knee function [23]. Bilateral spontaneous rupture of the quadriceps tendon is rather rare [4]. It is usually associated with concomitant underlying conditions such as advanced age, chronic renal failure, obesity, diabetes mellitus, gout, hyperparathyroidism, pseudogout, steroid usage, and autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus [4]. Chronic renal failure is considered to be the most frequently encountered risk factor in simultaneous QTR with a reported rate of more than 40 % [23]. In Table 1, case reports of bilateral quadriceps tendon ruptures that were found in literature are listed.

Table 1

Reported cases of simultaneous bilateral quadriceps tendon rupture

Author name	Reference number	Year	Age/sex	Rupture mechanism	Location of tear	Associated lesions	Chronic disease	Method of repair
Levy et al.	[17]	1971	54/M	Spontaneous	Not specified	None	Gout; chronic renal failure (CRF)	Scuderi technique
MacEachern and Plewes	[20]	1984	68/M	Fall	Not specified	None	None	Trans-osseous sutures through patella
			84/M	Fall	Not specified	None	None	Mattress sutures
			54/M	Fall	Not specified	None	Obesity	Sutures around patella and through quadriceps tendon
			80/M	Fall	Not specified	None	None	Mattress sutures
			74/M	Fall	Not specified	None	Diabetes mellitus	Trans-osseous sutures through patella
Bhole and Johnson	[3]	1985	71/M	Fall	Musculotendinous	None	Diabetes mellitus	End-to-end suture and figure-of-8 gauge wire
Keogh et al.	[15]	1988	70/M	Fall	Not specified	None	Possible gout (hyperuricemia)	Mattress sutures
			71/F	Fall	Not specified	None	None	Mattress sutures
			72/M	Fall	Not specified	None	None	Steel wire loops through patella
			74/M	Spontaneous	Osseotendinous	Avulsion fractures patella bilateral	Diabetes mellitus	Trans-osseous sutures through patella (nylon)
Zimmermann et al.	[33]	1993	64/M	Fall	Osseotendinous	None	None	Trans-osseous sutures through patella (PDS)
David et al.	[6]	1994	32/M	Spontaneous	Osseotendinous	None	Steroid use	STATAK soft-tissue attachment device
Liow and Tavares	[18]	1995	29/M	Fall	Osseotendinous	Quadriceps tendon calcifications	Steroid use	Trans-osseous sutures through patella
Stein et al.	[30]	1999	58/M	Spontaneous	Not specified	None	Wilson's disease	Tenosuture
Tedd et al.	[31]	2000	58/M	Spontaneous	Not specified	Synovitis of both knees	Pseudogout	Trans-osseous sutures through patella
Alpantaki et al.	[1]	2004	85/M	Spontaneous	Osseotendinous	Meniscal tear bilateral	Spinal stenosis; instability of the knee	Trans-osseous sutures through patella
Figueroa et al.	[7]	2005	28/M	Fall	Osseotendinous	None	Osteogenesis imperfecta type I	Trans-osseous sutures through patella
Johnson and Rose	[5]	2006	46/M	Fall	Osseotendinous	Enthesopathy of the proximal patella pole	None	Surgery (not specified)
Chua and Chang	[4]	2006	45/M	Fall	Osseotendinous	Osteoarthritis	Alkaptonuria	Trans-osseous sutures through patella
Kim et al.	[16]	2006	38/F	Spontaneous	Osseotendinous	Avulsion fracture patella unilateral	CRF with hemodialysis; secondary hyperparathyroidism	Trans-osseous sutures through patella
Katz et al.	[12]	2006	46/M	Fall during sports	Osseotendinous	None	None	Trans-osseous sutures through patella
Neubauer et al.	[23]	2007	55/M	Spontaneous	Osseotendinous	None	Diabetes mellitus; obesity	Trans-osseous sutures through patella
			52/M	Fall	Osseotendinous	None	Obesity; arterial hypertension	Trans-osseous sutures through patella
			30/M	Fall	Osseotendinous	None	Obesity	Trans-osseous sutures through patella
Kazimoğlu et al.	[14]	2007	37/F	Fall	Osseotendinous	Femoral neck fracture	CRF undergoing hemodialysis	Tycron transpatellar suture anchors
Haasper et al.	[9]	2007	60/M	Spontaneous	Not specified	None	None	Surgery (not specified)
Vigneswaran et al.	[32]	2007	30/M	Spontaneous	Osseotendinous	Meniscal tear and chondral defects	CRF	Mitek suture anchors
Arumilli et al.	[2]	2008	54/M	Fall	Osseotendinous	Enthesopathy of both quadriceps tendons	Chronic enthesopathy	Tendon-to-bone repair
Kayali et al.	[13]	2008	40/M	Fall	Osseotendinous	Avulsion fractures patella bilateral	CRF undergoing hemodialysis	Transpatellar sutures with reverse quadriceps tendon flap
Salcedo-Dueñas et al.	[25]	2009	24/M	Fall	Osseotendinous	None	Type I congenital osteogenesis imperfecta	Surgery (not specified)
Matokovic et al.	[21]	2010	27/M	Fall	Osseotendinous	None	CRF undergoing hemodialysis and transplantation	End-to-end technique and cerclage at site of rupture
Longo et al.	[19]	2010	46/M	Fall	Osseotendinous	None	BstUI polymorphism of the COL5A1 gene	Not specified
Gaheer and Hawkins	[8]	2010	65/M	Spontaneous	Not specified	None	None	Surgery (not specified)
Senevirathna et al.	[26]	2011	57/M	Spontaneous	Osseotendinous	Avulsion fracture patella	Psoriasis; topical steroids	Trans-osseous sutures through patella
Rubin et al.	[24]	2011	58/M	Spontaneous	Osseotendinous	None	Statins	Trans-osseous sutures through patella
Shah and Jooma	[29]	2011	39/M	Fall	Osseotendinous	None	None	Trans-osseous sutures through patella
Celik et al.	[5]	2012	56/M	Spontaneous	Osseotendinous	None	Statins	Trans-osseous sutures through patella

…

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Kim YH, Shafi M, Lee YS, Kim JY, Kim WY, Han CW (2006) Spontaneous and simultaneous rupture of both quadriceps tendons in a patient with chronic renal failure. A case studied by MRI both preoperatively and postoperatively. Knee Surg Sports Traumatol Arthrosc 14(1):55–59PubMedCrossRef

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Levy M, Seelenfreund M, Maor P, Fried A, Lurie M (1971) Bilateral spontaneous and simultaneous rupture of the quadriceps tendons in gout. J Bone Joint Surg Br 53(3):510–513PubMed

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Liow RY, Tavares S (1995) Bilateral rupture of the quadriceps tendon associated with anabolic steroids. Br J Sports Med 29(2):77–79PubMedCrossRef

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Longo UG, Fazio V, Poeta ML, Rabitti C, Franceschi F, Maffulli N, Denaro V (2010) Bilateral consecutive rupture of the quadriceps tendon in a man with BstUI polymorphism of the COL5A1 gene. Knee Surg Sports Traumatol Arthrosc 18(4):514–518PubMedCrossRef

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Muratli HH, Celebi L, Hapa O, Biçimoğlu A (2005) Simultaneous rupture of the quadriceps tendon and contralateral patellar tendon in a patient with chronic renal failure. Orthop Sci 005 10(2):227–232CrossRef

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Rubin G, Haddad E, Ben-Haim T, Elmalach I, Rozen N (2011) Bilateral, simultaneous rupture of the quadriceps tendon associated with simvastatin. Isr Med Assoc J 13(3):185–186PubMed

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Salcedo-Dueñas JA, Torres Castro C, Estrada Gómez JA, Algarín Reyes JA, Bello González A (2009) Bilateral quadriceps rupture in a patient with osteogenesis imperfecta. A case report. Acta Ortop Mex 23(6):386–389PubMed

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Title: Bilateral simultaneous quadriceps tendon rupture in a patient with diabetes and gout: a case report and review of the literature
Authors: K. Moens
S. Harth
Y. Depaepe
A. Harth
G. Vandendriessche
C. Van Vynckt
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: European Orthopaedics and Traumatology / Issue 4/2013
Print ISSN: 1867-4569
Electronic ISSN: 1867-4577
DOI: https://doi.org/10.1007/s12570-013-0185-3

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