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La rotura traumática, simultánea y bilateral del tendón cuadricipital es una lesión infrecuente, generalmente asociada a otras enfermedades sistémicas tales como insuficiencia renal o trastornos endocrinos. Presentamos el caso de un varón sano y atleta de 38 años que sufrió esta lesión mientras realizaba una sentadilla en el gimnasio. (AU)
The traumatic bilateral and simultaneous quadriceps tendon rupture is a rare injury, usually associated with other systemic diseases such as renal insufficiency or endocrine disorders. We present the case of a 38-year-old healthy male athlete who sustained this injury while performing a squat at the gym. (AU)
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Humanos , Masculino , Adulto , Ruptura/diagnóstico por imagem , Traumatismos dos Tendões/diagnóstico por imagem , Músculo Quadríceps/lesões , Músculo Quadríceps/diagnóstico por imagem , Ruptura/cirurgia , Traumatismos dos Tendões/cirurgia , Espectroscopia de Ressonância Magnética , Radiografia , Ultrassonografia , Músculo Quadríceps/cirurgia , Joelho/cirurgia , Joelho/diagnóstico por imagemRESUMO
@#Recurrent bilateral quadriceps tendon rupture in a young patient is a very rare incident. The underlying medical condition is always present and may have contributed to this injury. We report a recurrent bilateral quadricep tendon rupture in a 28-year-old man with underlying end-stage renal failure that occurred 10 months after the first repair. Injuries were indirect and trivial during the first and second events. Surgical repair was performed with similar technique for both incidents and he was advised to exercise extreme cautions after the second repair. He could return to his daily activities with no further recurrence at 30 months follow-up.
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OBJECTIVE@#To observe the effects of acupotomy intervention on the behavior, morphology and tensile mechanics of knee osteoarthritis (KOA) rabbits, and to explore the biomechanical effects of acupotomy on KOA.@*METHODS@#Twenty-four New Zealand male rabbits were randomly divided into four groups: normal group, model group, electroacupuncture group and needle-knife group, with 6 rabbits in each group. In each model group, rabbit KOA model was established by fixing Videman's left hind limb in straight position for 6 weeks. In the electroacupuncture group, rats were treated left on Liang Qiu, Xue Hai, Nei Xi Yan and Wai Xi Yan 3 times a week for 3 weeks. In the acupotomology group, the left quadriceps femoris tendon was released with acupotomology, and the treatment was once a week for 3 weeks. Behavioral tests were performed using Lequesne MG knee joint evaluation method one week after the end of modeling and one week after the end of treatment, and HE staining and mechanical tests were performed one week after the end of treatment.@*RESULTS@#Behavioral observation before treatment showed that there were significant differences in local pain, gait response, joint activity and joint swelling between the normal group and the model group(0.05). After treatment, the results showed that there were significant differences in local pain, gait response, joint activity and joint swelling among model group, electro-acupuncture group and needle-knife group compared with normal group(0.05); there was significant difference between needle knife group and model group(0.05). In gait change, there was significant difference between model group and electro-acupuncture group(0.05). In joint activity, there was significant difference between electro-acupuncture group and model group(0.05). Mechanics: Compared with the blank group, the ultimate load of the model group decreased significantly(0.05), and the ultimate load of the needle-knife group increased(>0.05). Compared with the model group, the ultimate load of the electro-acupuncture group increased significantly(0.05). Compared with the blank group, the maximum displacement of the model group decreased significantly(0.05). Compared with the model group, the maximum displacement of the electro-acupuncture group increased(>0.05), and the maximum displacement of the needle-knife group increased significantly(0.05). There was no significant difference in stiffness among groups(>0.05).@*CONCLUSIONS@#Acupotomy intervention can significantly change the behavior and morphology, significantly improve the mechanical properties of quadriceps femoris tendon stretch, and exert its biomechanical effects to achieve the purpose of treating KOA.
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Animais , Humanos , Masculino , Coelhos , Ratos , Eletroacupuntura , Articulação do Joelho , Osteoartrite do Joelho , Músculo Quadríceps , TendõesRESUMO
Introducción A nivel mundial el uso del injerto del tendón cuadricipital libre sin taco óseo, no es la primera elección para reconstrucción primaria de ligamento cruzado anterior. Se presenta una serie de pacientes con un seguimiento mínimo de dos años en la que se evaluará la elección del injerto cuadricipital sin taco óseo como una alternativa confiable y segura para la reconstrucción primaria del ligamento cruzado anterior. Materiales y Métodos Fueron incluidos en este estudio pacientes intervenidos durante un período de 24 meses (2013-2015). Se realizó un seguimiento por un mínimo de 2 años. Se efectuaron controles a los 8 y 15 días, fecha en que se retiraron los puntos, luego se valoraron cada 3 semanas los primeros 2 meses, cada 6 semanas hasta los 6 meses y al año,18 meses y dos años registrando los valores obtenidos por cada paciente en las escalas de Lysholm, Tegner e IKDC (International Knee Documentation Committee). Resultados Se seleccionaron 92 pacientes que cumplieron los criterios de inclusión. La puntuación subjetiva media IKDC en el seguimiento al año era 80.44 puntos, y la media de reducción de índice de actividad de Tegner fue 0,82 puntos de índice. La puntuación media de Lysholm y Gillquist al año fue de 89 puntos, con el 89,1%. Discusión el injerto del tendón del cuádriceps central sin taco óseo, es un procedimiento técnicamente reproducible sin mayor morbilidad en sitio donante, que ha reflejado un excelente resultado en las escalas funcionales y en la satisfacción expresada por los pacientes intervenidos hasta con dos años de seguimiento.
Background The use of a free quadriceps tendon graft without the use of a bone plug is not the first choice for primary anterior cruciate ligament reconstruction. A series of patients, with a minimum follow-up of two years, is presented in which the choice of free quadricipital tendon graft without a bone plug will be evaluated as a reliable and safe alternative for primary reconstruction of the anterior cruciate ligament. Methods Patients undergoing surgery for a period of 24 months (2013-2015) were included in this study. A follow-up was carried out for a minimum of 2 years. Controls were carried out at 8 and 15 days, when the sutures were removed. The first 2 months were then evaluated every 3 weeks and every 6 weeks for 6 months, and then at 1 year, 18 months, and two years. A record was made of the values obtained by each patient on the Lysholm, Tegner, and IKDC (International Knee Documentation Committee) scales. Results The study included 92 patients that met the inclusion criteria. The mean subjective IKDC score at one-year follow-up was 80.44 points, and the mean Tegner activity index reduction was 0.82 index points. The mean Lysholm and Gillquist score was 89 points per year, with good results being obtained in 89.1%. Discussion The central quadriceps tendon graft without a bone plug is a technically reproducible procedure with no greater morbidity in the donor site. This has been reflected in the excellent scores on functional scales and in the satisfaction expressed by the patients during two years of follow-up.
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Humanos , Ligamento Cruzado Anterior , Tendões , TransplanteRESUMO
Introducción En los últimos años ha cobrado importancia la reconstrucción del LPFM. La técnica más utilizada es con autoinjerto de tendones isquiotibiales. En algunas series los reportes de complicaciones son mayores al 26%. Este trabajo pretende demostrar la utilidad del autoinjerto del cuádriceps para la reconstrucción del LPFM, sin túneles rotulianos y sin el uso de fluoroscopia intraoperatoria. Materiales y métodos Se incluyeron pacientes con historia clínica de al menos dos episodios de luxación. Se tomaron en todas los pacientes serie radiográfica, TAC axial rótulas, TAC 3D y RNM. Se obtuvo registro de manera retrospectiva de puntuaciones en las escalas de Lysholm, Tegner y Kujala en el posoperatorio con controles a los 6,12 y 18 meses. Resultados Cumplieron con los criterios de selección 24 pacientes, 16 mujeres y 8 hombres, edad promedio de 23 años.En nuestro estudio se observó la mejoría de puntuaciones en las escalas de Lysholm, Tegner y Kujala en el posoperatorio con controles a los 6,12 y 18 meses. Sin presentarse nuevos episodios de luxación rotuliana u otras complicaciones relevantes. Hubo un retorno en todos los casos a la actividad deportiva. Discusión Este estudio reafirma que el tendón cuadricipital es un injerto que reproduciendo mejor la anatomía del LPFM, presenta cifras comparables o mejores funcionalmente con los otros injertos utilizados en la actualidad. Con el protocolo preoperatorio de TAC3D se ha conseguido identificar en forma individual y con la especificidad anatómica de cada paciente, al tubérculo aductor y epicóndilo medial, dando mayor certeza en la ubicación anatómica de la inserción femoral LPFM. Con las ventajas adicionales de disminuir el tiempo quirúrgico, y evitar radiación innecesaria en el equipo quirúrgico.
Background The reconstruction of the medial patellar-femoral ligament (MPFL) has become increasingly important in recent years. The most used technique is a hamstring tendons autograft. Complications of greater than 26% have been reported in some series. The aim of this study is to demonstrate the use of quadriceps autograft for the reconstruction of the MPFL, without patellar tunnels and without the use of intraoperative fluoroscopy. Methods A Case Series study was performed. Patients with a clinical history of at least two episodes of dislocation were included. A series of x-rays, axial Computed Tomography (CT), patellae, 3D CT, and MR image were taken in all patients. Scores on the Lysholm, Tegner, and Kujala scales were used in the postoperative period, with controls at 6, 12 and 18 months being recorded Results A total of 24 patients, 16 women and 8 men, with a mean age of 23 years, met the selection criteria. An improvement was observed in the scores on the Lysholm, Tegner, and Kujala scales in the postoperative period, with controls at 6, 12, and 18 months. No new episodes of patellar dislocation or other relevant complications were observed. There was a return to sports activity in all cases. Discussion This study reaffirms that the quadriceps tendon is a graft that reproduces the anatomy of the MPFL better, shows figures comparable or functionally better than with the other grafts used at present. Using the preoperative protocol of 3-D CT scans, the adductor and medial epicondyle tubules have been identified individually and with the anatomical specificity of each patient, giving greater certainty in the anatomical location of the MPFL femoral insert. This also has the additional advantages of decreasing surgical time, and avoiding unnecessary radiation in the surgical team.
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Humanos , Articulação Patelofemoral , Transplante Autólogo , Tomografia Computadorizada por Raios X , LigamentosRESUMO
Introducción La artrofibrosis de rodilla es una complicación importante que se puede presentar en cirugía de reconstrucción primaria del ligamento cruzado anterior (LCA) y afecta negativamente a los resultados por pérdida de flexoextensión de la rodilla. El objetivo del estudio es establecer la existencia de artrofibrosis en reconstrucción primaria del LCA en pacientes en los cuales se utilizó técnica de autoinjerto de tendón del cuádriceps. Materiales y métodos Se realizó un estudio retrospectivo, una serie de casos, en que se incluyó a todos los pacientes con lesión del LCA a quienes se practicó cirugía durante un período de observación de 4 años, en los cuales se utilizó autoinjerto de tendón del cuádriceps sin taco óseo rotuliano. Resultados Se encontró a 127 pacientes con cirugía primaria del LCA con autoinjerto de tendón del cuádriceps sin bloqueo óseo rotuliano durante el período de observación. Cinco pacientes (3,9%) presentaron artrofibrosis que se clasificaron, de acuerdo con la clasificación de Shelbourne, como un paciente de tipo I, tres pacientes de tipo II y un paciente de tipo III. A todos los pacientes se les realizó artrólisis artroscópica total y un plan agresivo de rehabilitación. Todos recuperaron los rangos de movilidad y retornaron a su actividad deportiva. Discusión Mejoras en la técnica quirúrgica, en instrumental quirúrgico, en los protocolos de rehabilitación acelerada y en minimizar los factores de riegos asociados han disminuido considerablemente esta complicación. Nivel de evidencia clínica Nivel IV.
Background Knee arthrofibrosis is a significant complication that can occur in primary reconstruction surgery of the anterior cruciate ligament (ACL), and adversely affects the results due to loss of flexion-extension of the knee. The aim of this study is to establish the presence of arthrofibrosis in primary ACL reconstruction in patients in whom a quadriceps tendon autograft reconstruction technique was performed. Materials and methods A retrospective case series study was conducted over a four-year observation period on all patients with ACL lesion who were subjected to surgery, in which autograft of the tendon quadriceps without patellar bone block was used. Results A total of 127 patients underwent primary ACL surgery with quadriceps tendon autograft without patellar bone block during the observation period. The five (3.9%) patients that presented with arthrofibrosis were classified according to the Shelbourne classification as one type I patient, three type II patients, and one type III patient. All patients underwent total arthroscopic arthroscopy and aggressive rehabilitation. They all regained mobility ranges and returned to their sporting activity. Discussion Improvements in surgical technique, surgical instruments, accelerated rehabilitation protocols, and minimisation of associated risk factors have significantly reduced the incidence of arthrofibrosis. Evidence level Level IV.
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Humanos , Ligamento Cruzado Anterior , Tendões , Transplante Autólogo , Músculo QuadrícepsRESUMO
Fundamento: La ruptura traumática aguda del tendón del cuádriceps es una entidad poco frecuente con una incidencia de 1,37/100 000 pacientes por año. Los hombres son los más afectados y la edad media de aparición ronda los 50 años. La cirugía ofrece los mejores resultados. Objetivo: Presentar un paciente con ruptura traumática aguda del tendón del cuádriceps derecho, con evolución favorable luego de una reparación primaria precoz con sutura transpatelar de alambre. Reporte de caso: Paciente masculino de 58 años de edad, con antecedentes de diabetes mellitus tipo II, que sufrió caída de sus pies. Acudió al servicio de urgencias con dolor intenso a nivel de la rodilla derecha, e imposibilidad para la marcha. A la exploración física se encontró impotencia absoluta para la extensión de la pierna derecha y signo del surco en la zona del tendón del cuádriceps. En la ultrasonografía de la rodilla derecha se apreció una solución de continuidad total del tendón del cuádriceps, a nivel del polo superior de la rótula lo que corroboró el diagnóstico de una ruptura traumática aguda del tendón del cuádriceps derecho. Se decidió tratamiento quirúrgico que consistió en perforaciones en la rótula y reinserción del tendón mediante alambres de acero, con buena evolución clínica Conclusiones: La reparación primaria precoz con sutura transpatelar de alambre en la ruptura traumática aguda del tendón del cuádriceps es un proceder quirúrgico efectivo cuando se realiza en los primeros diez días de la lesión.
Background: The acute traumatic rupture of the quadriceps tendon is a rare diseases with an incidence of 1.37 / 100 000 patients per year. Men are the most affected and the average age of appearance is around 50 years old. Surgery offers the best results. Objective: to present a patient with acute traumatic rupture of the right quadriceps tendon, with a favorable evolution after an early primary repair with transpatellar wire suture. Case report: a 58-year-old male patient with a personal history of type II diabetes mellitus, who suffered a fall in his feet. He arrived to the emergency room with severe pain in the right knee and impossibility to walk. At physical examination showed an absolute impotence for the extension of the right leg and a depression sign in the area of the quadriceps tendon. In the right knee ultrasonography, a complete continuity solution of the quadriceps tendon was observed at the level of the superior pole of the patella, which corroborated the diagnosis of an acute traumatic rupture of the right quadriceps tendon. Surgical treatment consisted of perforations in the patella and reinsertion of the tendon through steel wires, with good clinical evolution Conclusions: early primary repair with transpatellar wire suture in acute traumatic rupture of the quadriceps tendon is an effective surgical procedure when it is done in the first ten days of the lesion.
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Enxertos Osso-Tendão Patelar-Osso/cirurgia , Músculo Quadríceps/cirurgia , Fios Ortopédicos , Diabetes Mellitus Tipo 2 , Tendinopatia/cirurgiaRESUMO
OBJECTIVE: The objective of this study was to evaluate the efficacy of the surgical technique using the quadriceps tendon as a graft in static reconstruction of the medial patellofemoral ligament. METHODS: This was a prospective case series study in which the participants were 22 patients with a diagnosis of recurrent patellar dislocation without any other anatomical alterations that required surgical treatment. The functional results from the technique were evaluated using clinical data and the Lysholm questionnaire, one year after the operation. RESULTS: It was observed that the patients were predominantly female (86%) and under 21 years of age (73%), just like in the literature. At the first annual return after the surgery, there was no significant pain on medium efforts, no loss of range of motion and a positive apprehension test. According to the questionnaire used, the results were graded as good. The patients who reported having severe pain on greater effort were involved in employment-related legal disputes. CONCLUSION: This technique showed low morbidity and good functional results over the short term.
OBJETIVO: Avaliar a eficácia de técnica cirúrgica que usa o tendão do quadríceps como enxerto na reconstrução estática do LPFM. MÉTODOS: Estudo de série de casos, prospectivo, do qual participaram 22 pacientes com o diagnóstico de luxação recidivante da patela, que não apresentavam outras alterações anatômicas que necessitassem de tratamento cirúrgico. Os resultados funcionais da técnica foram avaliados por meio de dados clínicos e do questionário de Lysholm, com um ano de pós-operatório. RESULTADOS: Observou-se predomínio de pacientes do sexo feminino (86%) e menores de 21 anos (73%), a exemplo do observado na literatura. No primeiro retorno anual após a cirurgia, não houve dor significativa aos médios esforços, perda de amplitude de movimento e positividade dos testes de apreensão. Segundo o questionário empregado, os resultados foram graduados como bons. Aqueles que informaram dor intensa aos maiores esforços apresentavam pendências trabalhistas. CONCLUSÃO: A técnica apresentada mostrou, em curto prazo, baixa morbidade e bons resultados funcionais.
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Humanos , Masculino , Feminino , Luxação Patelar , Ligamento Patelar , Transplante AutólogoRESUMO
Objective To discuss the clinical effect of using autologous quadriceps tendon fixed by a patellar block as the graft to reconstruct posterior cruciate ligament (PCL ) under arthroscopy on a single-bundle way .Methods We treated 21 patients with damaged PCL using autologous quadriceps tendon fixed by a patellar block as the graft and absorbable interference screw fixation to reconstruct PCL under arthroscopy on a single-bundle way .Their functional recovery was evaluated by Lysholm scoring ,Tegner scoring and International Knee Documentation Committee (IKDC) criteria .Results All 21 patients got successful surgery on PCL reconstruction and multiple trauma ,no patients lost to follow-up .The subjective symptoms were improved after operation ,the post-operative Lysholm score and Tegner score were both significantly enhanced and showed statistical significance compared with the preoperative scores(P<0 .01) .Conclusion Using autologous quadriceps tendon fixed by a patellar block as the graft to reconstruct PCL on a single-bundle way leads to satisfactory short term clinical effects ,however ,the long term clinical effects remain to be eval-uated .
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A rare case of ganglion cyst of quadriceps tendon is described here. A 19-year-old male presented with left anterior knee pain of two weeks duration . The patient gave a history of trauma to the left knee joint while a wrestling match six months ago. Physical examination revealed focal tenderness just above the superior pole of patella without any obvious swelling. Magnetic resonance imaging showed a small cystic lesion within the quadriceps tendon just proximal to the superior pole of patella. Intraoperatively, the excised cystic lesion was found to be filled with gelatinous and viscous fluid. The lesion was confirmed as a ganglion cyst on histopathologic examination.
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Bilateral quadriceps tendon rupture is an unusual injury, but may be encountered in patients with various chronic diseases after minor trauma. This article presents a case of bilateral quadriceps tendon rupture of a 38-year-old woman with chronic renal failure. Surgical repair was performed using a bone tunnel technique with a nonabsorbable suture and a suture anchor. Postoperative magnetic resonance imaging confirmed complete healing of the repair site, and clinically active extension with 120 degrees of range of motion was achieved.
Assuntos
Adulto , Feminino , Humanos , Doença Crônica , Falência Renal Crônica , Imageamento por Ressonância Magnética , Amplitude de Movimento Articular , Ruptura , Âncoras de Sutura , Suturas , TendõesRESUMO
Simultaneous bilateral spontaneous rupture of the quadriceps tendon is a very rare condition and only a few cases have been reported in the literature. The etiology is not clear yet. But it occurs infrequently in patients with chronic metabolic disorders. A 30-year-old female patient with simultaneous bilateral spontaneous quadriceps tendon rupture visited our hospital. She had chronic renal failure and her parathyroid hormone level was elevated due to parathyroid adenoma. We report a surgical repair of both quadriceps tendons of a patient with chronic renal failure as well as management of hyperparathyroidism.
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Adulto , Feminino , Humanos , Hiperparatireoidismo , Falência Renal Crônica , Hormônio Paratireóideo , Neoplasias das Paratireoides , Ruptura , Ruptura Espontânea , TendõesRESUMO
[Objective]To describe a new way of arthroscopic posterior cruciate ligament reconstruction and evaluate the early stage of follow up results.[Method]Twenty four consecutive cases of isolated and combined posterior cruciate ligament deficiency were studied.Quadriceps tendon patellar bone was used for preparation of "Y" shaped autograft.Double-tunnel of femur were drilled and tibia was inlayed at their anatomical footprint.[Result]All cases were followed up for 24 months to 30months,averaging 24.5 months.Lysholm rating scales were used to make clinical subjective evaluations.Lysholm scores raised from 49.20?1.44 before operation to 87.91?1.52 after operation.Finial Lysholm evaluation showed 7 patients were excellent,16 good,and 1 poor.The good to excellent rate was 95.8%.Anteroposterior translation as clinical objective evaluations was measured with KT-1000.KT1000 arthrometer measurement showed that the average posterior translation improved from 12.85?1.10mm preoperatively to 3.98?1.99mm postoperatively.One patient was graded as failure.[Conclusion]Arthrosopy assisted prodedure of double bundle posterior cruciate ligament reconsruction using quadriceps tendon patellar bone autograft by double-tunnel of femur and inlaying of tibia is effective and reproducible.The short follow up clinical results are encouraging.
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PURPOSES: We analyzed the comparative results of arthroscopic anterior cruciate ligament reconstruction using the autologous quadriceps tendon-bone versus the bone-patellar tendon-bone. MATERIALS AND METHODS: Thirty-three patients with ACL reconstruction using the autologous quadriceps tendon-patellar bone were evaluated (group 1). Control group were 33 patients underwent ACL reconstruction with autologous bone-patellar tendon-bone in similar period (group 2). The mean age was 29.7 years in group 1 and 23.5 years in group 2. The mean follow-up period was 20.8 months in group 1, and 21.8 months in group 2. We selected the patient with the similar age, conditions and operation methods. But group 1 with bone-to-tendon graft healing at one side was delayed rehabilitation program than group 2 (bone-to-bone healing). The final evaluation were range of motion, anterior knee pain, Lachman test, KT-2000 arthrometer, Lysholm score, IKDC evaluation, one-leg hop muscle function test. Student ttest was used for statistical analysis (p 0.05). According to the International Knee Documentation Committee (IKDC) rating system, normal were 30.3%, nearly normal 57.6%, abnormal 12.1% in group 1, and in group 2 normal was 24.3%, nearly normal was 63.6%, abnormal 12.1%. There were no statistical differences in normal and nearly normal rate between two groups (p> 0.05). Recovery of quadriceps strength by one-leg hop test was 78% of the normal knee in group 1, and 80% in group 2 (p> 0.05). CONCLUSION: There were no significant differences of clinical results in ACL reconstruction using between quadriceps tendon-bone and bone-patellar tendon-bone, but anterior knee pain. We consider that autologous quadriceps tendon-bone is a good alternative substitute in ACL reconstruction together with the bone-patellar tendon-bone.
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PURPOSE: We report upon our experience of ACL reconstruction using autologous central quadriceps tendon. MATERIALS AND METHODS: Twenty-six patients with ACL reconstruction using autologous central quadriceps tendon, who were followed up at least one year, were included in the present study. The clinical results including, anterior laxity, range of motion, anterior knee pain, and quadriceps power were evaluated using, the Lachman test, anterior drawer test, pivot shift test, Lysholm score, KT-2000 study and Cybex II dynamometer. RESULTS: The results of the Lachman, anterior drawer and pivot shift tests were markedly improved. The side to side difference of maximal manual translation measured by KT-2000 reduced from an average 7.5 mm preoperatively to 2.5 mm postoperatively and the Lysholm score improved significantly from 69.4 preoperatively to 86.2 postoperatively. No patient complained of a newly developed anterior knee pain. CONCLUSION: ACL reconstruction using autologous central quadriceps tendon showed satisfactory clinical results without anterior knee pain or donor site morbidity. Autologous central quadriceps tendon may be a resonable source of graft in ACL reconstruction.
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Humanos , Joelho , Amplitude de Movimento Articular , Tendões , Doadores de Tecidos , TransplantesRESUMO
Bilateral rupture of quadriceps tendon is a rare but well known disease entity. It can be happened in the patient with underlying systemic disease or condition, like diabetes mellitus, hemodialysis for renal failure, long-term steroid therapy for systemic lupus erythematosus and rheumatoid arthritis etc. The surgical repair is the treatment of choice for this condition in spite of' underlying pathology. This is a report on one case of 6 months interval staged bilateral rupture of quadriceps tendons following moderate trauma.