Rehabilitation from delayed bilateral complete quadriceps tendon repairs with knee extension assist braces: A case report

Simultaneous bilateral quadriceps tears are rare with fewer than 150 cases reported in the literature and typically occur in male patients greater than 40 years of age. If left untreated or with delayed clinical intervention, these injuries often lead to chronic disability including pain and reduced ambulation. Typical treatments include surgical repair with considerable post-operative rehabilitation and a guarded prognosis. However, given the scarcity of these cases, a consensus on a standard course of treatment remains unclear and ultimately at the discretion of the clinician.

A 67-year-old male presented 6-months after complete, retracted tears of bilateral quadriceps tendons after a fall onto both knees in flexion. Treatment included: immediate bilateral quadriceps tendon repairs, immobilization, physiotherapy, and the daily use of novel tri-compartment offloader knee braces providing knee-extension assist. To our knowledge, this is the first report of a full return to independent ambulation following a delayed diagnosis and surgical intervention of complete bilateral quadriceps tendon tears.