case_images: PMC10624162_01
case_images: Preoperative examination showing suprapatellar gap. (A) Right knee, (B) left knee.
case_images: sicotj-9-31-fig1_small.jpg
case_images: PMC10624162_01_sicotj-9-31-fig1_small.jpg
case_images: F1
case_images: Upon conducting a clinical examination, we identified a palpable gap in the suprapatellar region and bilateral loss of knee extension, as depicted in Figure 1.
case_images: Pre-operative X-ray. (A) Right lateral view and (B) left lateral view.
case_images: sicotj-9-31-fig2_small.jpg
case_images: PMC10624162_01_sicotj-9-31-fig2_small.jpg
case_images: F2
case_images: An X-ray of the patient's knee was obtained, which shows bilateral patella infera, as depicted in Figure 2.
case_images: MRI knee showing bilateral rupture of the quadriceps tendon, as there is a noticeable increase in signal intensity on both sides along with loss of fiber continuation. (A) Right knee MRI; (B) left knee MRI.
case_images: sicotj-9-31-fig3_small.jpg
case_images: PMC10624162_01_sicotj-9-31-fig3_small.jpg
case_images: F3
case_images: However, a magnetic resonance imaging (MRI) study revealed bilateral quadriceps tendon rupture, as shown in Figure 3.
case_images: Intraoperative imaging showing complete tear of degenerative right quadriceps tendon edges (A), an approximation of the tendon to the patella following repair using suture anchor and Krackow suture technique (B), near complete tear of the left quadriceps tendon (B), and repair of the quadriceps tendon using anchor sutures (D). Following the surgery, the patient was put on a comprehensive rehabilitation program, which included immobilization in a hinge knee brace locked in extension for 1 month, along with non-weight-bearing exercises. The patient's rehabilitation program progressed to involve a gradual increase in passive flexion for the second month until he reached 90  of flexion.
case_images: sicotj-9-31-fig4_small.jpg
case_images: PMC10624162_01_sicotj-9-31-fig4_small.jpg
case_images: F4
case_images: Subsequently, the proximal stump of the tendon was reattached to the superior pole of the patella using two anchor sutures, each 4.75 mm the size, as depicted in the accompanying Figure 4.
case_images: Knee range of motion at 4 month follow-up. (A) Left knee extension, (B) flexion, (C) right knee extension, (D) flexion.
case_images: sicotj-9-31-fig5_small.jpg
case_images: PMC10624162_01_sicotj-9-31-fig5_small.jpg
case_images: F5
case_images: He was able to stand and walk and return to his normal daily activities, albeit with minor limitations in certain activities requiring more knee strength and stability (Figure 5).