Patellar Tendon Rupture Research Articles

Treatment of Patellar Fractures and Injuries to the Extensor Mechanism of the Knee: A Critical Analysis Review.

* Patellar fractures occur as a result of a direct blow to the knee and/or as a result of tension when the forces generated between the quadriceps tendon and patellar tendon overcome the strength of the bone.* Patellar fractures that include a functional disruption to the extensor mechanism should be treated with stable open reduction and internal fixation.* If necessary, partial (or, rarely, complete) excision of the patella can be performed to provide a stable extensor mechanism repair.* Acute quadriceps and patellar tendon ruptures, if complete, require primary repair.* Delayed intervention for any complete extensor mechanism disruption may result in the need for reconstruction, augmentation, or advanced techniques to facilitate early motion.

Early and Successful Reconstruction of a Traumatic Bilateral Patellar Tendon Rupture: A Case Report

Early and Successful Reconstruction of a Traumatic Bilateral Patellar Tendon Rupture: A Case Report

Is it safe? Outpatient total joint arthroplasty with discharge to home at a freestanding ambulatory surgical center.

BackgroundTotal joint arthroplasty (TJA) is trending toward shorter hospitalizations; as a result, there are many ambulatory surgical centers (ASCs) starting to perform outpatient TJA. However, there are limited studies examining the safety of outpatient TJA in the freestanding ASC setting. This study aims to evaluate 30-day and 90-day complication rates in patients who underwent outpatient TJA at a freestanding, independent ASC with direct discharge to home.MethodsA retrospective cohort review using health records was performed on the first 115 TJAs performed between August 2015 and March 2017 by one of the 4 orthopedic surgeons. Before the first TJA, the ASC had developed a multidisciplinary TJA pathway.ResultsOf the 115 TJAs, 37 (32%) were total hip arthroplasties (THAs), 53 (46%) total knee arthroplasties (TKAs), and 25 (22%) unicompartmental knee arthroplasties, with a mean age of 57 ± 7 years and body mass index of 30 ± 5 kg/m2. There were no intraoperative or direct ASC-related complications. There was 1 instance (0.9%) of a postoperative minimally displaced intertrochanteric femur fracture after THA due to a fall treated nonoperatively complication within 30 days of surgery. Of the 90-day complication events, there were 2 patients (2%) with postoperative arthrofibrosis of the knee after TKA requiring manipulation under anesthesia, 1 postoperative patellar tendon rupture during therapy after TKA requiring surgical repair and 1 delayed hematogenous infection after international travel after THA requiring 2-staged exchange.ConclusionsOutpatient TJA with discharge to home at a freestanding, independent ASC is a safe option after development of a multidisciplinary TJA pathway.

Literature review of acquired patella baja

Patella baja is one of the complications after total knee arthroplasty (TKA). It refers to an abnormal location of patella occurred secondary to shortening of the patellar tendon or distal positioning of the patella relative to the femoral trochlea. Clinically, it can be classified into congenital, acquired, and a combination of the above two types. Acquired patella baja is the most common type and usually occur as a result of trauma or surgery. Acquired patella baja is also caused by elevation of the joint line after TKA, which refers to pseudo-patella baja. Presently, its etiology is still uncertain. Some studies report the following causes of patella baja, including extending of quadriceps femoris, contracture of patella tendon or patellar fat pad, and fibrosis of joint. The diagnosis is mostly based on the lateral roentgenogram. The following parameters, including Insall-Salvati ratio, Modified Insall-Salvati ratio, Blackburne-Peel ratio, Caton-Deschamps ratio and Plateau-Patella angle, are used to assist diagnosis for patella baja. With the progress of imageology, some literatures describe several methods based on magnetic resonance imaging (MRI). However, the diagnostic methods of patella baja are not entirely precise. Patella baja can lead to decreased range of motion (ROM), a decreased lever arm, impingement of the patella against the tibial polyethylene or tibial plate, which may result in anterior knee pain, rupture of the patellar or quadriceps tendons. The treatment of patella baja depends on determining the cause and distinguishing between patella baja and pseudo-patella baja. Patients with severe symptom or failed for conservative treatment should receive surgery. The corrective measures for patella baja include lengthening of the patellar tendon and proximalize osteotomy of tibial tuberosity. In addition, the therapies for pseudo-patella baja include reestablishing the joint line by use of distal femoral augment, replacement of the patellar implant or polyethylene insert.

Management of Simultaneous Patellar Tendon and Anterior Cruciate Ligament Ruptures-A Systematic Review of Available Literature.

Combined rupture of the anterior cruciate ligament (ACL) and patellar tendon (PT) is a rare injury pattern. Currently, little evidence exists to help guide management decisions for these patients. A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE and MEDLINE) for all articles reporting on combined rupture of the ACL and PT. The characteristic injury mechanisms, common presentation findings, and outcomes of simultaneous and staged treatment strategies were determined to provide guidance for the management of this uncommon injury pattern. An additional case report from our institution is also reported. Overall, 17 studies met the inclusion criteria and were included in our qualitative review. The mean age at injury was 30 years (range, 15-50 years). A high-energy injury with a rapid deceleration event through a flexed knee on a fixed foot is commonly described as the mechanism of injury. Anterior cruciate ligament rupture was missed on initial clinical examination in 24.1% compared with 17.2% for PT rupture. Injuries to the medial collateral ligament and menisci occured in 65.5% of cases. Outcome scores were reported in 41.4% (12/22) of patients undergoing staged or simultaneous repair. The Lysholm score postoperatively was 96 ± 3.3 for the staged group compared with 85.3 ± 18.6 for simultaneous repair. There were no clear differences between range of motion, time to return to sport, and complication rates between the groups. A high index of suspicion is required to detect concomitant ACL injuries when assessing high-energy PT ruptures. Simultaneous or staged protocols to address both injuries are safe and effective management strategies for this rare combined injury pattern. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Extensor Mechanism Reconstruction with Use of Marlex Mesh: A Series Study of 77 Total Knee Arthroplasties.

Disruption of the extensor mechanism after total knee arthroplasty (TKA) is debilitating, and the reported results of numerous reconstructive options have varied. We previously reported the early results of 13 patients who underwent reconstruction of the extensor mechanism with use of Marlex mesh. The purpose of the current study was to assess results in a larger cohort of patients, with an emphasis on the survivorship of the mesh, clinical results, and complications. During the period of 2000 to 2015 at a single tertiary care academic institution, 77 patients (77 TKAs) underwent reconstruction with use of Marlex mesh for an extensor mechanism disruption (27 quadriceps tendon disruptions, 40 patellar tendon disruptions, and 10 patellar fractures). The mean patient age at the time of reconstruction was 65 years; 70% of the patients were female. The mean body mass index was 35 kg/m. The mean follow-up was 4 years. Eighteen (23%) of the patients underwent mesh reconstruction with the primary TKA in place, and 59 (77%) had mesh reconstruction at the time of revision TKA. The mean time between disruption and reconstruction was 7 months. Twenty (26%) of the patients had previously undergone attempted extensor mechanism reconstruction at outside institutions. Sixty-five of the 77 mesh reconstructions were in place at the time of the latest follow-up. Twelve patients experienced a failure that required mesh revision: 5 for patellar tendon rupture, 5 for quadriceps tendon rupture, and 2 for symptomatic lengthening. Four additional patients with mesh failure were treated nonoperatively with bracing. The 2-year survivorship free of mesh revision was 86% for patients with no prior reconstruction and 95% for patients with previous reconstructions of the extensor mechanism that did not involve Marlex mesh. Knee Society Score (KSS) results significantly improved following reconstruction (p < 0.001). Extensor lag improved by a mean of 26°, with mean postoperative extensor lag measuring 9° (p < 0.001). Reconstruction of the extensor mechanism with use of Marlex mesh is a viable option in patients with catastrophic disruption after TKA. At the time of the latest follow-up, 84% of the mesh reconstructions were in place and the functional outcomes were excellent, with mean improvement in extensor lag of 26°. Extended follow-up is required, but the results of this large series with a mean follow-up of 4 years are encouraging. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Allograft of the knee extensor in cases of patellar tendon rupture in total arthroplasty patients

ObjectiveRetrospective study to evaluate the functional results of patients with total knee arthroplasty and rupture of the patellar tendon, submitted to transplantation of the extensor knee apparatus with fresh frozen allograft. MethodNine patients, operated between 2003 and 2015, with a minimum of one year of follow-up. All patients were reviewed by performing a functional evaluation using the Knee Society score. Preoperative values were compared with those of the final evaluation. ResultsMean survival was 2.7±1.9 years (14–1). The knee score improved from 38±4.5 to 70±8.5, and functional score from 30±6.5 to 90±3.5. Mean extension deficit was 5 (1–15). Mean range of motion was 80 (60–100). ConclusionThe use of allograft is a solution for extreme cases of patellar rupture after total knee arthroplasty, providing reasonable functional results and representing an alternative to knee arthrodesis.

Trans-osseous versus Anchor Repair of Acute Patellar Tendon Ruptures

Objectives:Patellar tendon ruptures are relatively uncommon injuries. They require prompt diagnosis and surgical repair to restore the extensor mechanism of the knee. The gold standard procedure is a suture repair of the tendon, passed through trans-osseous tunnels, and tying of the sutures on the superior pole of the patella. Suture anchors have gained popularity with a recent cadaveric study demonstrating significantly less gap formation during cyclic loading and significantly higher ultimate failure loads. We present the largest series of patellar tendon repairs and compare the clinical outcomes and complications of trans-osseous (TO) and anchor (A) repair types.Methods:All patients who underwent a primary repair of a traumatic patellar tendon rupture within 45 days of injury, between 2007 and 2016, were retrospectively reviewed. Surgeries were performed at a multi-surgeon (114 surgeons), multi-center (13 centers) community-based integrated health care system. Patients with prior knee surgery, use of graft, patellar debridement for tendonitis, inferior pole avulsion fracture, concurrent knee surgery with other procedures were excluded. Patient demographic information, repair type, complications, and time from surgery to release from medical care were recorded.Results:361 patients (374 knees) met our inclusion criteria. 13 had bilateral repairs during our study period and an additional 8 had a contralateral repair prior to our study period, for a bilateral incidence at 5.8%. The average age was 39.8 years (9 to 86 years). There were 341 males (94.5%). The most common mechanism of injury was basketball (47%), fall (19.5%), football (5.0%), and soccer (4.8%). Average time from injury to surgery was 6.3 days (range: 1- 45 days). There were 321 TO and 53 A repairs. There was no significant difference in the mean age (P=0.27), gender (P=0.79), tourniquet time (P=0.93), or BMI (P=0.78) between the two groups. There was a significant difference in re-rupture between (24 of 321) TO (7.5%) and (0 of 53) A (0%) (P=0.034). Using logistic regression, we found that TO had 3.244 times the odds of re-operation as those with A (95% CI: 0.757, 13.895. p-value: 0.1129) but did not reach signficance. The infection rate was 7.5% for A and 1.6% for TO (P= 0.160). There was no difference in time to release from medical care, 18.4 weeks for and 17.1 weeks (P=0.92).Conclusion:Compared to Anchors, primary repair of patellar tendon ruptures with trans-osseous repair had a significantly higher re-rupture rate, but there was no difference in re-operation rate, infection, or release from medical care.

SURGICAL TREATMENT OF CHRONIC PATELLAR TENDON RUPTURE; A CASE SERIES STUDY

Background: Early detection and treatment of extensor mechanism rupture are essential for a long-term functional knee joint. In chronic cases, quadriceps muscle retraction and contracture make surgery difficult and results are less predictable. Objectives: The purpose of this study was to evaluate outcomes in the cases of late repaired patellar tendon rupture. Methods: This study included patients with chronic patellar tendon rupture who were operated at Shafa orthopedic hospital from 2006 to 2013. Results: A total of ten patients were evaluated, wirh 12 cases of chronic patellar tendon rupture. Patients had a mean age of 34.4 years (range 18 - 58). Seven cases were caused by a traffic accident and three by a fall. The mean length of time from injury to surgery was 23 months (range 3 - 132). The mean time of follow-up was 6.2 years (range 3 - 9). Cerclage wire reinforcements were applied in nine of the knees and three knees had fiber wire reinforcement. Tendon graft augmentation was applied in ten of the knees; six with semitendinosus and gracilis autograft, two with semitendinosus autograft, one with an Achilles tendon allograft, and one with a tibialis anterior allograft. Means for preoperative/postoperative active knee range of motion, extension lag, subjective international knee documentation committee score, and modified Cincinnati scores were 81/117, 32/2, 22.7/84.5 and 24/87, respectively. Wire breakage was seen on all nine knees but wires were removed in only two symptomatic cases. Conclusions: Good to excellent results were obtained in terms of functioning with operative treatment of chronic patellar tendon rupture. Direct repair with autogenous or allogenic graft augmentation and cerclage wire reinforcement and postoperative cast immobilization are recommended.

5-year-old child with late discovered traumatic patellar tendon rupture—a case report

A 5-year-old otherwise healthy boy was referred to our outpatient clinic with a high-riding patella in the left knee. The patient’s mother had 2 months earlier discovered a small round lump on the ...

Midlevel Constraint Without Stem Extensions in Primary Total Knee Arthroplasty Provides Stability Without Compromising Fixation

BackgroundMany total knee arthroplasty (TKA) systems allow for so-called midlevel constraint (MLC) articular bearings that can be used with primary implants. The purpose of this study is to report the early outcomes with MLC bearings in primary TKA. Materials/MethodsFrom December 2005 to June 2015, minimum 2-year follow-up was available on 96 patients (103 TKA) who underwent primary TKA with an MLC bearing using the Vanguard Total Knee System. Outcomes included pain, Knee Society clinical and functional score, range of motion, and need for revision. ResultsMean follow-up was 5 years (range, 2-11 years). Range of motion improved from 103 to 113. Knee Society clinical and function scores improved from 28 and 43 to 88 and 62, respectively. There were 10 manipulations (9.9%). There were no failures for aseptic loosening of any components; however, 10% of patients were lost to follow-up. There were 3 revisions (3%): 1 patellar tendon rupture, 1 open lysis of adhesions for stiffness, and 1 2-stage treatment of infection. ConclusionIn cases of intraoperative medial collateral ligament incompetence, severe deformity, or valgus deformity requiring release of the lateral collateral ligament, the use of MLC showed good survivorship with no cases of aseptic loosening or instability.

Long-term results of extensor mechanism reconstruction using Achilles tendon allograft after total knee arthroplasty.

Disruption of the extensor mechanism after total knee arthroplasty (TKA) is an infrequent but devastating complication. Presently, limited data exists regarding the optimal treatment and long-term outcomes. Patients who underwent reconstruction of their knee extensor mechanism using Achilles tendon allograft following TKA between January 2003 and January 2012 were identified. Sixteen patients with 17 reconstructions (10 patellar tendons, 7 quadriceps tendons) were studied. All patients underwent evaluation at an average of 45.7months. Ten of the patients were followed to an average of 65.4months. After reconstruction, the average extensor lag was 6.6° and average knee flexion was 105.1°. Of the patients with a minimum follow-up of two years and an average follow-up of 65.4months, the average extensor lag and knee flexion was 8.4° and 107.9°, respectively, with quadriceps strength maintained at an average of 4/5. The quadriceps tendon reconstructions had an average extensor lag and flexion of 2.9° and 103°, respectively. The patellar tendon reconstructions, excluding one re-rupture, had an average extensor lag and flexion of 9.6° and 105.1°, respectively. Four patients died during the follow-up period. All but one of the patients were below the mean for age-matched controls on the SF-36. Achilles tendon allograft reconstruction is a reliable and durable treatment for patients who sustain not only patellar tendon ruptures, but also quadriceps tendon ruptures following TKA. Despite the success of this technique, the injury and procedure have a profound impact on overall function.

Surgical Treatment of Chronic Patellar Tendon Rupture: A Case Series Study

Background: Early detection and treatment of extensor mechanism rupture are essential for a long-term functional knee joint. In chronic cases, quadriceps muscle retraction and contracture make surgery difficult and results are less predictable. Objectives: The purpose of this study was to evaluate outcomes in the cases of late repaired patellar tendon rupture. Methods: This study included patients with chronic patellar tendon rupture who were operated at Shafa orthopedic hospital from 2006 to 2013. Results: A total of ten patients were evaluated, wirh 12 cases of chronic patellar tendon rupture. Patients had a mean age of 34.4 years (range 18 - 58). Seven cases were caused by a traffic accident and three by a fall. The mean length of time from injury to surgery was 23 months (range 3 - 132). The mean time of follow-up was 6.2 years (range 3 - 9). Cerclage wire reinforcements were applied in nine of the knees and three knees had fiber wire reinforcement. Tendon graft augmentation was applied in ten of the knees; six with semitendinosus and gracilis autograft, two with semitendinosus autograft, one with an Achilles tendon allograft, and one with a tibialis anterior allograft. Means for preoperative/postoperative active knee range of motion, extension lag, subjective international knee documentation committee score, and modified Cincinnati scores were 81/117, 32/2, 22.7/84.5 and 24/87, respectively. Wire breakage was seen on all nine knees but wires were removed in only two symptomatic cases. Conclusions: Good to excellent results were obtained in terms of functioning with operative treatment of chronic patellar tendon rupture. Direct repair with autogenous or allogenic graft augmentation and cerclage wire reinforcement and postoperative cast immobilization are recommended.

Proximal Tibial Fracture after Bone-Patellar Tendon-Bone Autograft Harvesting in Anterior Crutiate Ligament Reconstruction: Literature Review and Report of Two Cases

ACL reconstruction surgery shows low incidence of complications (1.38%) like DVT, Infection, patellar tendon rupture and fractures whether in the proximal tibia or the distal femur. We hereby present two cases that have had the rare complication of proximal tibial fracture. The circumstances of each case are discussed together with discussion of similar cases described in the literature. We tried in the end to have an idea about the possible causes and how to prevent such a devastating event. Case presentation: Case 1 shows a 38-year-old female patient who had an ACL reconstruction surgery by BTB graft followed by iatrogenic proximal tibial fracture managed by open reduction internal fixation by T plate and screws. Case 2 shows a 28-year-old male patient who had an ACL reconstruction surgery by BTB graft also followed by Proximal tibial fracture 3 weeks later managed by open reduction internal fixation using a locked plate and screws. Discussion: Fractures are a rare complication that may follow ACL reconstruction surgery. These fractures can be femoral or tibial that may be due to the reduction of the bone strength as a result of the drill holes which behave as a stress riser. We also suggest that usage of osteotomes during grafting plays a role in these fractures. Management of these fractures is either by open reduction and internal fixation or closed reduction. What is known about the subject: Patellar fractures are a known complication of ACL reconstruction using patellar tendon graft. What this study adds to the existing knowledge: Raising the Knowledge that also the tibia can be fractured as a complication of patellar tendon harvesting not only the patella.

Clinical results of reconstruction for patellar tendon rupture after total knee arthroplasty using Telos artificial ligament

Clinical results of reconstruction for patellar tendon rupture after total knee arthroplasty using Telos artificial ligament

Surgical Management of Simultaneous Anterior Cruciate Ligament and Patellar Tendon Ruptures: A Systematic Review.

This study performs a systematic review to determine (1) if a significant difference exists in return to preinjury activity level between one- and two-stage treatment of combined anterior cruciate ligament (ACL) and patellar tendon (PT) tears; and (2) if a significant difference exists in the number of postoperative complications between the two differing surgical treatment approaches. A systematic review was performed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered on PROSPERO. MEDLINE, Cochrane Central Register of Controlled Trials, SCOPUS, and Sport Discus were searched for English language level I-IV evidence studies on either one- (simultaneous) or two-stage (sequential) surgical treatment of simultaneously sustained ipsilateral ACL and PT tears. The approach to initial evaluation, diagnosis, treatment, and outcomes were qualitatively analyzed. Methodological quality assessment of all included studies was completed using the Methodological Index for Non-randomized Studies (MINORS). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess quality of evidence and provide strength of recommendation. Statistical analyses were done using Fischer's exact test. Eleven articles (18 patients; 83% males; mean age, 31.1 ± 10.1 years; mean follow-up, 2.2 ± 1.7 years; and mean MINORS 7.8/16) were analyzed. Eight patients had a one-stage procedure (primary PT repair and ACL reconstruction), and 10 patients underwent a two-stage procedure (primary PT repair first followed by ACL reconstruction) with mean 28 ± 45.7 weeks (5 weeks-3 years) between surgeries. The rate for return to preinjury activity level after surgery was not significantly different between one- (88%) and two-stage (100%) (p = 0.444). There was a significantly higher complication rate (p = 0.023) in the one-stage (stiffness, instability, and patella baja) versus two-stage surgery (no complications). There was no significant difference in return to preinjury activity level between one- and two-stage PT repair and ACL reconstruction. However, the one-stage combined surgery had a significantly higher complication rate compared with two-stage surgery. The level of evidence is IV.

HOFFA’S FRACTURE WITH IRREDUCIBLE PATELLAR DISLOCATION: APPROACH TO AVOID COMPLICATIONS IN A RARE INJURY

Hoffa’s fracture is coronal oriented fracture of distal femur with the fracture line extending through the femoral condyles. Hoffa’s fracture is rarely associated with ipsilateral femur and tibia fractures. Proper clinical examination and radiographic evaluation is necessary to diagnose associated injuries around the knee joint with Hoffa’s fracture. Closed reduction of dislocated patella in emergency room and field triage should be avoided to prevent patellar tendon incarcenation, patellar tendon rupture and osteochondral damage. We report a rare case of Hoffa’s fracture with irreducible patellar dislocation and tibial intercondylar eminence fracture following road traffic accident.

Augmentation of Patellar Tendon Repair With Autologous Semitendinosus Graft—Porto Technique

Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height. This note describes a surgical technique to provide an additional reinforcement to the patellar tendon repair with a semitendinous autograft, without the necessity to perform any transosseous tunnels at the patella bone. First, the patellar tendon is repaired with an end-to-end technique and the semitendinous tendon is harvested. A transosseous tunnel at the tibial tubercle is drilled and 2 rents are made, both medial and lateral to the retinaculum at the level of the intermedial segment of the patella close to the patellar margin. The graft is passed through the tunnel and rents in a U-shaped form. The graft is sutured along the length of the patellar tendon on both margins in tension at 30° of knee flexion. Fluoroscopy imaging is performed to assess the patella height. This technique provides a significant augmentation of patellar tendon, avoiding the potential patella bone tunnel complications.

Patellar Tendon Repair With Ipsilateral Semitendinosus Autograft Augmentation

Patellar tendon ruptures are rare but potentially devastating injuries. Acute repair after patellar tendon rupture affords the best opportunity for tension-free restoration of the extensor mechanism. Biological augmentation of primary repair is believed to decrease strain across the repair site and reduce the risk of rerupture. We present a technique for primary patellar tendon repair with bidirectional fixation using transosseous tunnels, suture anchor fixation, and ipsilateral hamstring autograft augmentation in a distal patellar pole socket.

Ruptura bilateral total do aparelho extensor do joelho

ObjectiveBilateral extensor tendon ruptures of the knee are rare and have only been published in the form of case reports or small series. MethodsSeven patients corresponding to 14 extensor tendon ruptures of the knee were evaluated by the same examiner after a minimum one year post‐surgery. Clinical and radiographic evaluations were performed; for statistical analysis, the level of significance was set at 0.05. ResultsThe most common injury was patellar tendon rupture (n=9; 64.29%) followed by quadriceps tendon rupture (n=5, 35.71%). The intrasubstance was the most affected location (57.15%), followed by the myotendinous junction (21.43%) and the patellar bone insertions (21.43%). Quadriceps tendon ruptures were more prevalent in patients older than 50 years, while patellar tendon ruptures tended to occur in younger individuals. All but one patient had recognized risk factors for tendinous degeneration and rupture: 75% of the cases suffered from diseases, 50% had history of drug use and/or abuse, and 37.5% had both disease and drug use history. Mean attained values for flexion ROM were 124.64°±9.43 (110–140°) and 89.57±6.02 (78–94) for Kujala score. More than half of the patients complained of residual pain and quadriceps muscular weakness. Mean age was younger in the individuals who complained of residual pain. ConclusionBilateral tendon ruptures of the knee extensor apparatus ruptures are rare and serious injuries, mostly associated with risk factors. Early surgical repair and intensive rehabilitation program for bilateral extensor tendon ruptures of the knee may warrant satisfactory functional outcomes in the medium to long term, despite non‐negligible levels of residual pain, quadriceps muscle weakness, and atrophy.