Rehabilitation approach after surgical repair of spontaneous bilateral quadriceps tendon rupture in a healthy mason – a case report.

Quadriceps tendon rupture is a rare lesion, occurring most frequently in males over 60 years following a fall or trauma and associated with systemic diseases and risk factors. Bilateral injury is even more uncommon and disabling. The authors report a case of spontaneous bilateral quadriceps tendon rupture, non-simultaneous (8 days apart), in a healthy 54-year-old Black male mason, that may be work-related. The patient was included in a 6-month rehabilitation program after surgical repair. Pain control and gait reacquisition were particularly difficult. Following the customized and phased rehabilitation program, the patient achieved the 6-month functional outcomes reported for unilateral rupture. The authors highlight the rehabilitation specificities and challenges of the bilateral lesion and discuss the pathophysiological role of prolonged periods of working in repetitive quadriceps overuse postures on quadriceps tendon rupture. Corresponding author: Diogo Manuel Portugal, Physical and Rehabilitation Medicine Department, Prof. Doutor Fernando Fonseca Hospital, IC 19, 2720-276, Amadora, Portugal. Phone number: +351918939162. E-mail: diogoportugal@campus.ul.pt. Author Disclosures: Conflicts of interest. The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript. Funding and Financial benefits. The authors have no funding or financial benefits to report. Authors' contributions. All authors have made substantial contributions, drafting the article and revising it critically. All authors have approved the manuscript and this submission. Previous presentation. This case report was presented as an oral presentation at the XVIII Congress of the Portuguese Society of Physical and Rehabilitation Medicine, 1st March 2018, and won the Case Reports honorable mention. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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