Bilateral Patellar Tendon Avulsion in End-Stage Renal Disease with G6 PD Deficient Patient: Case Report and Review of Literature.

Introduction: Among the cause of extensor mechanism failures, acute patellar tendon ruptures are less frequent than quadriceps tendon ruptures. Moreover, majority occur as unilateral injuries during athletic participation. B/L acute patellar tendon ruptures are extremely rare and only been documented in literature as case reports with majority having predisposing factors such as tendinopathy, steroid abuse systemic lupus erythematosus, and end-stage renal disease (ESRD).

Case report: We present a case of 34-year-old male patient k/c of G6pd deficency Patient with ESRD on regular hemodialysis thrice a week since 8 years came to A/E with H/O pain and swelling in both knees due to a fall from stairs. Plain X-rays and magnetic resonance imaging confirmed the diagnosis of B/L patellar tendon avulsion from the lower end of patella. Patient was operated according to the Krackow technique Patient recovered well and we achieved excellent result in both knees.

Conclusion: Since B/L tendon rupture is extremely rare therefore there is always a high chance of missing the diagnosis due to lack of other normal knee for comparison. We want to highlight the relation of comorbidities like G6pd def, ESRD with B/L patellar tendon avulsion, and to have a high degree of suspicion if ESRD Patient comes to A/E with B/L knee swelling and pain.