Bilateral, simultaneous, spontaneous rupture of the quadriceps tendon. A report of 3 cases and a review of the literature.

Bilateral, simultaneous, spontaneous rupture of the quadriceps tendon is a very rare injury. It usually occurs in the obese older patient (over 50 years). Often, patients are mistakenly treated for rheumatoid arthritis, mild strokes and even neurological paralysis. This diagnostic confusion can lead to a delay in treatment. There is often no history of significant trauma. The pathognomonic signs are a palpable suprapatellar gap and an inability to lift the straight leg. Surgical 'end to end' repair, even of delayed cases, yields satisfactory results. In none of our cases was protective additional tissue reinforcement or a pullout suture used.