Spontaneous Rupture of Tendons

Lotem, M; Bernheim, Jacques; Conforty, B

doi:10.1159/000181394

Cited by 58 publications

(3 citation statements)

References 5 publications

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“…When fibrinoid degeneration occurs in the ligamentous or tendinous structure with inflammatory cells, some vessels are thrombosed. This ischemic change can be a predisposing factor for spontaneous rupture [9]. Additionally, the urate crystals themselves may cause a reduction in tensile strength of the tendon.…”

Section: Discussionmentioning

confidence: 99%

Anterior cruciate ligament rupture in gouty arthritis

Hwang

Lee

Han

et al. 2011

Knee Surg Sports Traumatol Arthrosc

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A 34-year-old male presented with right knee instability without any trauma. He had been diagnosed with right knee gouty arthritis 2 years prior. An arthroscopic examination revealed abundant calcific material deposited around the knee joint, including in the ACL tissue, and that the ACL was torn at the femoral attachment site. Treatment involved a synovectomy to remove calcific material, followed by an ACL reconstruction. Histology evaluation revealed gouty arthritis with the presence of tophi in the synovium, soft tissue, and ACL tissue. The case presented here indicates the possibility of pathologic rupture of the ACL associated with gouty tophus infiltration of that ligament. Level of evidence IV.

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Section: Discussionmentioning

confidence: 99%

Anterior cruciate ligament rupture in gouty arthritis

Hwang

Lee

Han

et al. 2011

Knee Surg Sports Traumatol Arthrosc

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“…Chronic renal failure is considered to be the most frequently encountered risk factor in simultaneous QTR with a reported rate of more than 40% [28]. In renal patients incidence of QTR seems to be correlated to the duration of the disease, which contributes to the weakening of the tendon's ultrastructure by connective tissue elastosis and disturbance of the ground substance; primary or secondary hyperparathyroidism additionally may yield in weakening at the osteotendineous junction [16, 22, 23]. The fact that in our review obesity was found most frequently among risk factors (21.4%), might be explained by the selected group of patients.…”

Section: Discussionmentioning

confidence: 99%

Bilateral, simultaneous rupture of the quadriceps tendon: a diagnostic pitfall?

Neubauer

Wagner

Potschka

et al. 2006

Knee Surg Sports Traumatol Arthr

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Bilateral, simultaneous quadriceps tendon rupture (QTR) represents a rare entity and delay in establishing the correct diagnosis is not uncommon. Another three cases are reported here and in all the correct diagnosis was missed initially. A review of the English and German literature retrieved 105 cases of bilateral, simultaneous QTR and in 32 patients (30.5%) the correct diagnosis was established with delay. In 28 cases--representing 25 men (89.3%) and 3 women (10.7%)--sufficient data was available for further analysis. In the majority of patients (n = 19/28; 67.9%) rupture was associated with trauma, while no trauma was reported in 9/28 cases (32.1%). No direct correlation between age and the kind of rupture form (traumatic/spontaneous) could be detected (P = 0.35). Most partients (n = 18/28; 64.3%) presented risk factors associated with QTR and obesity (n = 6/28; 21.4%) was most frequently encountered. A direct association between the rate of risk factors and the rupture form was not seen (P = 0.5). Overall diagnostic delay lasted 64.7 days on an average (traumatic ruptures 67.7 days/spontaneous ruptures 58.7 days) with this period being longer than 2 weeks in 51.9% and longer than 3 months in 33.3% of patients. Delay varied distinctly in different medical institutions as this period lasted in hospital departments 93.9 days, in ambulances 24 days and in General Practitioners 7.6 days on an average. Initially 25 incorrect diagnoses were established in 21/28 (75%) patients, while 7/28 cases (25%) were discharged initially without any diagnosis. Clinical examination revealed most often palpable suprapatellar gaps (n = 17/24) and effusions (n = 13/24), while the classic trias of painful swelling, suprapatellar gap and loss of knee extension was found in only 58.3% of reported patients (n = 14/24). The correct diagnosis of bilateral QTR was established in 60.7% (n = 17/28) by history and clinical examination alone. In 10.7% (n = 3/28) clinical suspect was supported by sonography and in 14.3% (n = 4/28) by MRT; in 14.3% (n = 4/28) the correct diagnosis represented a by chance finding during diagnostic or operative procedures of other indication. In 52 tendons detailed information about repair was provided and most often transosseous fixation (n = 30/52; 57.7%) and direct repair (n = 14/52; 26.9%) were used, while a tenoplasty was performed in only 15.4% (n = 8/52). Only 34.6% of patients (n = 9/26) with follow-up data (n = 26/28) reported a full recovery with a trend that early surgical repair (limit 2 weeks) improves the final outcome.

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“…Mont et al published a case of hypocalcemic tetany resulting in bilateral QTR and unilateral TTR, but this is considered a spontaneous and not a traumatic tendon rupture [ 7 ]. A combination of QTR and TTR was described by Lotem et al, but they did not adequately document whether the lesions were complete or incomplete and whether they were simultaneous or sequential [ 11 ]. Despite the fact that many cases of single, bilateral, or even sequential tendon ruptures have already been described in the literature, we consider our case a novel presentation of traumatic quadriceps and triceps tendon rupture associated with end-stage renal disease.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Ipsilateral Quadriceps and Triceps Tendon Rupture in a Patient with End-Stage Renal Failure

Moerenhout

Gkagkalis

Benoit

et al. 2018

Case Reports in Orthopedics

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Introduction Quadriceps tendon ruptures (QTR) frequently occur in patients with end-stage renal failure, while triceps brachii tendon ruptures (TTR) are less common. This is the first properly documented report of a simultaneous ipsilateral traumatic rupture of both of these tendons. Case Report A 50-year-old patient, on hemodialysis for end-stage renal failure, fell on his right side. He presented with sudden right knee and elbow pain, with functional impairment of both joints. X-rays showed avulsion-like osseous lesions on the olecranon and patella with a low-riding patella. Ultrasound confirmed complete quadriceps and triceps avulsion ruptures. Both lesions were treated surgically. Fixation was performed with anchors using the Krackow suture technique for both tendons. Postoperative clinical and radiological results were satisfactory, and follow-up was uneventful. The patient regained his preinjury functional level with a complete range of motion of both his knee and elbow. Discussion Isolated QTR and TTR are frequent lesions in chronic renal failure patients treated with hemodialysis. Simultaneous ipsilateral rupture of both tendons however is extremely rare and should therefore not be overlooked. Surgical treatment is recommended for complete ruptures.

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Spontaneous Rupture of Tendons

Cited by 58 publications

References 5 publications

Anterior cruciate ligament rupture in gouty arthritis

Anterior cruciate ligament rupture in gouty arthritis

Bilateral, simultaneous rupture of the quadriceps tendon: a diagnostic pitfall?

Simultaneous Ipsilateral Quadriceps and Triceps Tendon Rupture in a Patient with End-Stage Renal Failure

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