case_images: PMC10400002_01
case_images: Preoperative image. Severe swelling in both knees with areas of ecchymosis over the patella in the right knee and in the peripatellar region in the left knee. The arrows show the location of the 'gaps' palpated during physical examination.
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case_images: PMC10400002_01_1809-4406-aob-31-04-e267719-gf1.jpg
case_images: f1
case_images: During palpation, we found a gap in the suprapatellar region on the right and an infrapatellar gap on the left, with patella alta (Figure 1).
case_images: Ultrasound examination of the knees. Left: signs of total quadriceps tendon rupture with a gap measuring approximately 20 mm and signs of associated hematoma. Right: rupture of the proximal insertion of the patellar tendon with an associated patellar bone fragment, a large hematoma on the left, and a large cranial deviation of the patella.
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case_images: PMC10400002_01_1809-4406-aob-31-04-e267719-gf2.jpg
case_images: f2
case_images: Radiological examination of the knees showed no fractures, but patella alta on the left side and patella baja on the right side (Figure 2).
case_images: Radiographs showing patella baja on the right knee, with a Caton-Deschamps index of 2.1, and patella alta on the left knee, with a Caton-Deschamps index of 0.5.
case_images: 1809-4406-aob-31-04-e267719-gf3.jpg
case_images: PMC10400002_01_1809-4406-aob-31-04-e267719-gf3.jpg
case_images: f3
case_images: Ultrasound examination confirmed quadriceps tendon rupture in the right upper pole and patellar tendon rupture in the left knee (Figure 3).
case_images: Intraoperative images. Transosseous tunnels and raffia performed using the Krackow technique with nonabsorbable sutures. The semitendinosus tendon was removed and used to reinforce the left patellar tendon.
case_images: 1809-4406-aob-31-04-e267719-gf4.jpg
case_images: PMC10400002_01_1809-4406-aob-31-04-e267719-gf4.jpg
case_images: f4
case_images: As a synthesis method, we performed transosseous tunnels and raffia using the Krackow technique with nonabsorbable sutures. ),(  Moreover, the semitendinosus tendon was removed and used to reinforce the left patellar tendon. (Figure 4) Postoperative imaging studies showed a bilateral return of patellar height to normal parameters (Figure 5).
case_images: Postoperative radiographs showing the return of patellar height to normal parameters, with a Caton-Deschamps index of 1.0 on the right side and 0.9 on the left side.
case_images: 1809-4406-aob-31-04-e267719-gf5.jpg
case_images: PMC10400002_01_1809-4406-aob-31-04-e267719-gf5.jpg
case_images: f5
case_images: As a synthesis method, we performed transosseous tunnels and raffia using the Krackow technique with nonabsorbable sutures. ),(  Moreover, the semitendinosus tendon was removed and used to reinforce the left patellar tendon. (Figure 4) Postoperative imaging studies showed a bilateral return of patellar height to normal parameters (Figure 5).