Asymptomatic Bilateral Patella Alta After Surgical Repair of Traumatic, Sequential Bilateral Patellar Tendon Rupture: A Case Report

Bilateral patellar tendon rupture is rare, and usually occurs in patients with ligamentous laxity, a predisposing rheumatologic disorder, chronic renal failure, or exogenous corticosteroid use1-3. We describe a patient who sustained traumatic bilateral patellar tendon ruptures nearly ten years apart. Surgical repair of each knee was successfully performed with use of an open technique, and the patient was followed for more than two years after each procedure. The most recent radiographs demonstrated bilateral patella alta; however, the patient was asymptomatic. To our knowledge, this is the first case report of an individual with asymptomatic bilateral patella alta after surgical repair of bilateral patellar tendon rupture. The patient was informed that data concerning the case would be submitted for publication, and he consented. A forty-seven-year-old man sustained a patellar tendon rupture in each knee, with the ruptures occurring ten years apart. Both tendon ruptures were repaired surgically. No previous knee problems were reported. He had no other medical conditions or surgical procedures and was on no medication. He had no personal or family history of ligamentous laxity. He denied using corticosteroids, tobacco, alcohol, and recreational drugs. He was physically active regularly and worked on his feet daily as a manual laborer. The right patellar tendon ruptured in 2000, after a fall from a standing height; it was repaired acutely at another institution with use of nonabsorbable sutures tied superiorly through transpatellar bone tunnels with no operative or postoperative complications. The patient wore a knee immobilizer for eight weeks postoperatively, and was fully compliant with weight-bearing as tolerated. After eight weeks, he was allowed full active and passive knee motion and experienced no pain. Physical examination ten years later revealed full active knee extension and lower-extremity strength. He was able to actively flex the hip and lift the …