Unique presentation of bilateral patellar tendon rupture in a patient with renal failure: a case report

Background: The presence of a bilateral patellar tendon rupture is an extremely rare occurrence. Only a very limited number of cases have been reported worldwide. When it does occur, it is usually associated with systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus, hyperparathyroidism, and renal failure. Our case report is the first in its unique presentation and second case in the Gulf area. Case presentation: We describe a 48 year old female with end stage renal disease and other comorbidities who presented to the emergency department with bilateral knee pain and swelling after experiencing a fall. A preliminary diagnosis of bilateral patellar tendon rupture was made based on the patient’s complain of bilateral knee pain and physical examination which revealed a palpable infrapatellar pouch, in addition to the patient’s inability to actively extend the knee. Confirmation of the diagnosis was done by imaging studies which showed patella alta, and complete tendon ruptures bilaterally. This patient was managed surgically with a bilateral patellar tendon repair using a Krachow suture technique. Post-operatively, the patient was discharged and started on a physical rehabilitation program. Conclusion: our patient post operatively had a good outcome with no complications and complaints since this operation which’s not a standard for this kind of unique rupture went smoothly, as a result our patient gained equal full range of motion bilaterally with no stiffness or limitation and gained full recovery, bilateral patellar tendon rupture is not a relatively common condition, but since the timing between presentation and management is the most important factor in determining the outcome, it is important to have a high index of suspicion in order to reach this diagnosis, and effectively manage it as soon as possible.