title: Functional results following surgical repair of simultaneous bilateral quadriceps tendon ruptures.
abstract: BACKGROUND
  Unilateral quadriceps tendon ruptures are common conditions treated by orthopedic surgeons. There is a paucity of information concerning functional outcomes in bilateral tendon ruptures. The aim of this study is to assess a series of 5 cases with simultaneous quadriceps tendon ruptures that underwent acute surgical repair with the purpose of identifying the functional outcomes as compared with unilateral injuries. We hypothesize that patients with bilateral quadriceps tendon ruptures have worse functional outcomes than patients with unilateral ruptures.
  
  
  METHODS
  Five cases of bilateral quadriceps tendon ruptures were identified. All patients underwent acute surgical extensor tendon repair employing a 3-patellar hole and a locked, running, nonabsorbable suture technique followed by a 6-week period of immobilization and bracing for 10 to 12 weeks. Mechanism of injury, medical history, social history, operative report, and postoperative exam were recorded with a minimum 1-year follow-up. In addition, each patient completed a subjective International Knee Documentation Committee (IKDC) score at 18 months. Five patients with unilateral injuries and with similar medical history were included as age-matched controls.
  
  
  RESULTS
  The mean age for the bilateral group was 54.8 years (range, 44-68 years). Mean postoperative knee flexion was 129 degrees and all patients had active, resisted knee extension. Only 1 patient had a medical comorbidity (diabetes mellitus). The mean IKDC score (mean follow-up, 25.4 months; range, 22-29 months) was 71.9 (range, 34.4 to 91.6), whereas the age-matched control group had a mean IKDC score of 88.3 (P = 0.23). There was no statistical significance between the 2 groups with regard to range of motion (P = 0.24), IKDC score, and return to activity (P = 0.29).
  
  
  CONCLUSIONS
  Patients with early surgical repair of bilateral, simultaneous extensor mechanism ruptures exhibit adequate recovery and return to a high level of function. Our patients were younger than those reported in the literature and had minimal comorbidities. The IKDC scores reflected good outcomes in the bilateral rupture group, albeit lower than in the unilateral group.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA. Chang.edward@gmail.com.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Chang
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Dodson
authors.forename: Fotios
authors.initials: F
authors.lastname: Tjoumakaris
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cohen
authors.forename: Edward S
authors.initials: ES
authors.lastname: Chang
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Dodson
authors.forename: Fotios
authors.initials: F
authors.lastname: Tjoumakaris
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000534:rehabilitation / Q000601:surgery*; D001915:Braces; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D052097:Quadriceps Muscle / Q000293:injuries* / Q000601:surgery; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome