Spontaneous bilateral quadriceps tendon rupture treated with polyethylene terephthalate tape augmentation: Report of two consecutive cases

Abstract

The quadriceps femoris muscles (QMFs) form the largest human muscle and it transmits a high amount of forces. Quadriceps tendon (QT), therefore, is the terminal for transmitting high intensity forces and its structure is severely tested during daily, work and sport activities. Spontaneous rupture of QT is rare and it is commonly associated with systemic comorbidities, leading to tendon degeneration such as connective tissue disorders, chronic renal failure, rheumatoid arthritis, diabetes, hyperparathyroidism, gout and pharmacological treatments with fluoroquinolones and steroids. [1] While unilateral rupture is a Spontaneous rupture of quadriceps tendon (QT) is a rare condition and it is commonly associated with systemic comorbidities and medical products assumption, which may lead to tendon degeneration. While unilateral rupture is a quite common injury, spontaneous bilateral ruptures are very rare. Herein, we report two consecutive cases of spontaneous bilateral QT rupture in two patients with a positive history of chronic statin use, successfully treated with bilateral single-stage reconstruction with polyethylene-terephthalate tape augmentation. At 12 months of follow-up, both patients recovered the full extension, a 120° pain-free flexion and knee scores improvement. Magnetic resonance imaging at one year showed a complete, bilateral, bio-integration of the augmentation for each knee. In conclusion, polyethylene terephthalate tape augmentation provides a good structural support with a good grade of bio-integration, allowing a fast recovery.