Bilateral Simultaneous Quadriceps Tendon Rupture in a 92-Year-Old independently mobile patient: A Case Report and Review of the Literature.

Volume 7, Issue 1, February 2023     |     PP. 78-82      |     PDF (127 K)    |     Pub. Date: February 8, 2023
DOI: 10.54647/sociology840990    87 Downloads     4468 Views  

Author(s)

UKPONG-DAN EDET, Orthopaedic Department, Hinchingbrook Hospital, Huntingdon, PE29 6NT. United Kingdom
DOSANI ANIS, Orthopaedic Department, Hinchingbrook Hospital, Huntingdon, PE29 6NT. United Kingdom

Abstract
Introduction: Simultaneous bilateral quadriceps tendon ruptures are uncommon knee injuries, though reported to frequently occur in males over 50 years of age. Bilateral simultaneous ruptures are rarely associated with minor trauma (1), but often associated with certain predisposing factors like obesity, diffuse idiopathic skeletal hyperostosis, steroids use, use of anabolic steroids, chronic tendonitis, chronic renal failure, rheumatoid arthritis, systemic lupus, gout and hyperthyroidism (2)(3).
Objective: The objective of our presentation is to present a rare case of simultaneous bilateral quadriceps tendon rupture in an independently mobile elderly patient with well controlled mild hypertension and heart murmur (not on any medications for heart murmur), and the absent of known predisposing factors.
Case Report: A 92 year old, otherwise fit and healthy gentleman, apart from well controlled hypertension and heart murmur (not on any medications for heart murmur), presented at the emergency department with bilateral suprapatellar knee pain and swelling after a trivial trauma. The patient missed a step at home while descending stair and leaned onto the wall to steady himself. The day after his presentation, 24 hours following the injury, the patient underwent a successful surgery for the repair of bilateral quadriceps tendon rupture. Following the repair, both legs were immobilised in plaster cylinder casts.
Conclusion: Minor trauma resulted in the simultaneous bilateral quadriceps tendon ruptures in an active elderly male with no commonly associated risk factors.

Keywords
Bilateral Quadriceps rupture ; Patellar tendon rupture; Female Hormones; controlled hypertension, Predisposing factors.

Cite this paper
UKPONG-DAN EDET, DOSANI ANIS, Bilateral Simultaneous Quadriceps Tendon Rupture in a 92-Year-Old independently mobile patient: A Case Report and Review of the Literature. , SCIREA Journal of Sociology. Volume 7, Issue 1, February 2023 | PP. 78-82. 10.54647/sociology840990

References

[ 1 ] Chiu M., Forman E. S. Bilateral quadriceps tendon rupture: a rare finding in a healthy man after minimal trauma. Orthopedics. 2010;33(3) doi: 10.3928/01477447-20100129-32. [PubMed] [Cross Ref]
[ 2 ] Rougraff B. T., Reeck C. C., Essenmacher J. Complete quadriceps tendon ruptures. Orthopedics. 1996;19(6):509–514. [PubMed]
[ 3 ] Fahad H. Abduljabbar, et al, Bilateral Simultaneous quadriceps tendon rupture in a 24-year old obese patient: a case report and review of literature, Case Rep Orthop: 2016;2016:4713137. Epub 2016 Oct 20.
[ 4 ] Varaprasad N Vemuri et al, Spontaneous bilateral quadriceps tendon rupture in a patient with renal failure; BMJ Case Report 2018; doi:10.1136/bcr-2017-223191
[ 5 ] Wearing SC, Hooper SL, Purdam C, Cook J. (2013) The Acute transverse strain response of the Patellar tendon to quadriceps exercise, Am. J Sports Med. 45(4): 772 – 777.
[ 6 ] Hansen M, Miller BF, Holm L, Doessing S, Petersen SG, Skovgaard D, Frystyk J, Flyvbjerg A, Koskinen S, Pingel J, Kjaer M and Langberg H (2009) Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissues in young women, J Appl Physiol 106(4);1434-43.
[ 7 ] Hansen M, Koskinen SO, Petersen SG, Doessing S, Frystyk J, Flyvbjerg A, Westh E, Magnusson SP, Kjaer M and Langberg H (2008) Ethynil oestradiol administration in women suppresses synthesis of collagen in tendon in response to exercise, J Physiol 15;586(Pt12):3005-16.
[ 8 ] Camarda et all (2017), Bilateral ruptures of the extensor mechanism of the knee: a systematic review, J of Ortho. 14(4):445 – 453
[ 9 ] Wren TAL, Beaupre GS, Carter D (2000) Tendon and ligament adaptation to exercise, immobilization and remobilization; J Rehab Research and Dev. 37(2): 217-24.
[ 10 ] Andarawis-Puri, N. and Flatow, EL (2011) Tendon fatigue in response to mechanical loading: J Musculoskelet Neuronal Interact; 11(2):106-114.
[ 11 ] Heinemeier KM, Kjaer M (2011) In vivo investigation of tendon responses to mechanical loading, J Musculoskeletal neuronal Interact, 11(2):115 – 123.
[ 12 ] Wearing SC, Hooper SL, Purdam C, Cook J. (2013) The Acute transverse strain response of the Patellar tendon to quadriceps exercise, Am. J Sports Med. 45(4): 772 – 777.
[ 13 ] Fredberg U, Bolvig L, Lauridsen A, Stengaard-Pederesn K (2007) Influence of acute physical activity immediately before ultrasonographic measurement of Achilles tendon thickness, Scand J Rheumatol,36;488-9.
[ 14 ] Pearson SJ, Ritchings T, Mohammed ASA (2014) Regional Strain variations in the Human Patellar Tendon; Am. J Sports Med. 46(7): 1343 – 1351.