Br J Sports Med 2002;36:152-153 Simultaneous bilateral quadriceps tendon rupture is an uncommon injury in healthy people and only a few cases have been reported in athletes. This is the first report of a patient with simultaneous bilateral quadriceps tendon rupture incurred while playing basketball. The injury was surgically repaired and the patient had a good functional outcome.
Steiner and Palmer 1 were the first to report on a patient with simultaneous bilateral quadriceps tendon rupture in 1949. This unusual injury has been reported in only four patients during a sporting event.2-5 This report describes a patient with simultaneous bilateral quadriceps tendon rupture with no other identifiable risk factors while playing basketball.
CASE REPORTA 39 year old black man with no significant past medical history presented to the emergency room with a two day history of bilateral knee pain and swelling. He stated that the pain began after an injury experienced while playing basketball. He was shooting a basket when he was undercut by another player and fell on to the court with both knees flexed underneath his body. He waited two days before receiving treatment because he thought the pain would resolve spontaneously. He was unable to walk after the incident. On further questioning, he complained of swelling and of not being able to extend his legs. Physical examination showed the patient to be a well developed athletically fit man. He was unable to actively extend his legs and had bilateral suprapatellar gaps. Radiographs of the knees showed an effusion, with disruption of the quadriceps unit on the right and quadriceps avulsion fracture on the left. His haematological and metabolic profiles were all within normal limits. There was no history of use of anabolic steroids, previous local steroid injections, or tendinitis. A clinical diagnosis of bilateral quadriceps tendon rupture was made, and the patient was admitted for surgical repair the next day. With the use of transverse incisions, both quadriceps tendons were repaired with baseball sutures through patellar drill holes. The extensor retinaculum was reapproximated both medially and laterally. Both legs were then immobilised in casts for six weeks. He received physiotherapy on an outpatient basis to regain strength and range of motion. Six months after the operation, the patient had completely recovered, with bilateral knee extension to zero degrees and flexion to 90 degrees bilaterally. He had no difficulties with the activities of daily living, but was not back to playing sports.
DISCUSSIONBilateral simultaneous quadriceps tendon rupture is a rare injury in an otherwise healthy person. This report represents the first case where a previously healthy athlete ruptures his quadriceps tendon bilaterally and simultaneously with minor trauma while playing basketball. Only four cases of athletes with this injury have been described in the literature, but in three of them there were predisposing conditions. [2][3][4][5] Table 1 summarises all of them.Simultaneous ...
The results of this study provide evidence to support the efficacy of group acupuncture for pain, neuropathy, and digestive problems in persons with cancer. A minimum of four weekly treatments may be necessary before improvements are noted. Limitations include a retrospective design, incomplete symptom evaluation, and possible response bias. Future studies of group acupuncture for cancer-related symptoms should utilize a prospective, controlled design, use validated measures to thoroughly evaluate targeted symptoms, and include a more racially and ethnically diverse sample.
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