Elsevier

The Knee

Volume 13, Issue 4, August 2006, Pages 333-336
The Knee

Short communication
Bilateral dislocation of the knee with rupture of both patellar tendons. A case report

https://doi.org/10.1016/j.knee.2006.04.004Get rights and content

Abstract

Knee dislocations are rare injuries caused by violent trauma. Damage to soft tissues and ligament lesions almost always accompany the injury. Vascular compromise further complicates the situation. We report a case of bilateral posterior knee dislocation with traumatic rupture of both patellar tendons. Treatment consisted of external fixation of both knees. Vascular compromise resolved with reduction and traction pins were placed on both patellae which were connected to the external fixators on following days. Primary repair of patellar tendon was undertaken after gradual distal repositioning of patella. The result is successful with full range of motion. Rupture of patellar tendon should be considered with posterior dislocation of the knee. External fixators provide quick stabilization in case of vascular compromise and can be modified to provide a traction system for distal repositioning of patella which allows primary repair of the patellar tendon.

Introduction

Bilateral traumatic rupture of the patellar tendon is an uncommon injury [1]. Patients with chronic systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus, chronic renal disease, and gout were involved in the majority of reported cases of bilateral patellar tendon ruptures [2]. Corticosteroid medication has also been implicated. Although a few cases of bilateral traumatic rupture have been described in the literature, to the best of author's knowledge no case associated with bilateral knee dislocation have been reported previously. The following might be the first such case.

Section snippets

Case report

A 30-year-old male motorcyclist had a road traffic accident. He was riding a motor bike in the countryside, hit by a car. There were no accompanying injuries, other than bilateral complete dislocation of the knee and a fracture of fibula on the left side. His feet were cool and no popliteal or ankle pulses were detected. His blood pressure and pulse were within normal limits. No other injuries and skin lesions except bruising were noted on physical examination. Direct radiographs revealed

Discussion

Although rarely reported in the literature, patellar tendon rupture is frequently seen in the sporting population, and its usual straight forward treatment makes the injury quite satisfying to manage [3]. Most patellar tendon ruptures occur at the inferior pole as an avulsion or, less commonly, as a mid-substance rupture. Many factors may cause weakness of the tendon or muscle rendering them susceptible to spontaneous rupture. Aging causes loss of tissue elasticity, decreased tissue perfusion

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