Bilateral Quadriceps Rupture: Results With and Without Platelet-rich Plasma

Abstract

This article presents a 46-year-old man with bilateral atraumatic quadriceps rupture that occurred while he was descending stairs. The patient underwent surgery the day after the accident. In the left knee, quadriceps reinsertion was performed using a conventional technique. In the right knee, platelet-rich plasma (PRP), both in its liquid and semisolid patterns, was added intraoperatively. Ultrasonography and magnetic resonance imaging evaluations were performed 1, 6, and 24 months postoperatively. At 6 and 24 months postoperatively, clinical and functional evaluations also were performed. Clinical examination showed no differences between the knees, and functional scores were the same for both knees. Ultrasonographic evaluation showed bilateral persistent tendon thickening and gross echotexture abnormalities, with no side-to-side differences. Magnetic resonance imaging showed signals of vascularized granulation tissue in both knees, which was more evident in the right (PRP) knee at 1 month postoperatively, along with a better signal of scar tissue in the right knee at 6 and 24 months postoperatively. The use of PRP yielded no better clinical or functional results than the lack of its use. However, a more intense and significant reparative healing process occurred where the PRP was used, thus suggesting a more rapid completion of the healing process, although this effect seems to remain only a radiographic finding with no clinical correlation.