Bilateral patellar tendon rupture

We present an exceedingly rare case of spontaneous bilateral patellar tendon rupture in a fit and well 38year-old Afro-Caribbean gentleman regularly participating in recreational long-distance running. Prior to sustaining this injury, he complained of ongoing anterior knee pain, for which he was awaiting an outpatient X-ray arranged by his general practitioner after weeks of anti-inflammatory medications proved ineffective. The patient was jogging and sustained a fall onto his right knee. The patient was unable to return to his feet, requiring assistance to hospital. He presented to the Accident and Emergency department with pain, swelling and lack of active extension at both knees. Clinically, there was swelling at the patellar tendons, with a highriding patellar bilaterally, confirmed on plain radiography. He was subsequently admitted under the care of the orthopaedic team where he was surgically managed with simultaneous primary repair. Midline incisions were made over both knees, and repair was achieved using Krackow pull-out sutures with fibre wire, ethibond-modified kesseler suture, fibre glass box suture and retinacular repair with vicryl 1-0. The Insol Selvesti ratio was checked as 1:1 on both sides under image intensifier. Finally, cylinder back slabs were applied bilaterally to immobilize both knee joints. Postoperatively, the patient was transferred to the ward where he received a week of inpatient physiotherapy. Post-discharge, he was reviewed in the fracture clinic fortnightly where both wounds demonstrated healthy healing with no signs of infection or inflammation. At the seventh postoperative week, his casts were exchanged for hinged braces to initiate movement from 0–40 and he was referred to the physiotherapist for quadriceps strengthening exercises with whom he made good progress.