Quadriceps tendon rupture is a rare lesion, occurring most frequently in males older than 60 yrs after a fall or trauma and associated with systemic diseases and risk factors. Bilateral injury is even more uncommon and disabling. The authors report a case of spontaneous bilateral quadriceps tendon rupture, nonsimultaneous (8 days apart), in a healthy 54-yr-old black male mason, that may be work related. The patient was included in a 6-mo rehabilitation program after surgical repair. Pain control and gait reacquisition were particularly difficult. Following the customized and phased rehabilitation program, the patient achieved the 6-mo functional outcomes reported for unilateral rupture. The authors highlight the rehabilitation specificities and challenges of the bilateral lesion and discuss the pathophysiological role of prolonged periods of working in repetitive quadriceps overuse postures on quadriceps tendon rupture.
From the Physical and Rehabilitation Medicine Department, Prof. Doutor Fernando Fonseca Hospital, Amadora, Portugal (DMP, BDM, IMR, SRA, CVV-C); and Department of Adults' Rehabilitation 1, Physical and Rehabilitation Medicine Centre, Alcoitão, Portugal (JAC).
All correspondence should be addressed to: Diogo Manuel Portugal, MD, Physical and Rehabilitation Medicine Department, Prof. Doutor Fernando Fonseca Hospital, IC 19, 2720-276, Amadora, Portugal.
All authors have made substantial contributions, drafted the article, and revised it critically. All authors have approved the manuscript and this submission.
This case report was presented as an oral presentation at the XVIII Congress of the Portuguese Society of Physical and Rehabilitation Medicine in Coimbra, Portugal, March 1, 2018, and won the Case Reports Honorable Mention.
Diogo Manuel Portugal, João A. Capelo, Bárbara Dantas Martins, Inês M. Ribeiro, and Sofia R. Ataíde are in training.
Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.
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