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Musculoskeletal and Sports Medicine

Bilateral Patellar Tendon Rupture in an ESRD Patient: A Rare Case and the Role of Knee Injections in Functional Recovery

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks
Has Audio

    Primary Author(s)

  • Panayotis Jusakos, MD

    Resident Physician
    One Brooklyn Health System/Kingsbrook Jewish Medical Center PM&R Program
    Brooklyn, New York

    • Co-Author(s)

  • CC

    Charlene Canales, DO

    Resident physician
    One Brooklyn Health System/Kingsbrook Jewish Medical Center PM&R Program
    Brooklyn, New York

  • MS

    Michael Sposito, MD

    Resident Physician
    One Brooklyn Health System/Kingsbrook Jewish Medical Center PM&R Program
    Latham, New York

  • Suha Qasem, MD

    Resident physician
    One Brooklyn Health System/Kingsbrook Jewish Medical Center PM&R Program
    Brooklyn, New York

  • Bendik Stenersen, DO, MS

    Resident Physician
    Larkin Community Hospital PM&R Program
    Miami, Florida

  • MR

    Marc Ross, MD

    Chair Department of physical medicine and rehabilitation
    One Brooklyn Health
    New York, New York

Disclosure(s):
Panayotis Jusakos, MD: No financial relationships to disclose
Suha Qasem, MD: No financial relationships to disclose
Case Diagnosis: Bilateral patellar tendon rupture with postoperative arthrofibrosis.

Case Description or Program Description: A 36-year-old male with ESRD secondary to FSGS on hemodialysis, secondary hyperparathyroidism, and hypertension sustained a spontaneous bilateral patellar tendon rupture while ambulating. He reported a sudden snapping sensation in both knees, followed by immediate loss of extensor function and inability to bear weight. MRI confirmed bilateral complete patellar tendon rupture with inferior patellar displacement and extensive joint effusion. Surgical repair was performed, followed by immobilization and structured rehabilitation.

Setting: Tertiary care orthopedic and rehabilitation departments.

Assessment/Results: Despite successful repair, the patient developed bilateral knee arthrofibrosis, limiting mobility. Intra-articular corticosteroid injections were administered to reduce inflammation and facilitate rehabilitation. A structured physical therapy program focusing on quadriceps activation, progressive weight-bearing, and range of motion restoration was implemented. Pharmacologic management included NSAIDs and Flexeril. Post-injection, the patient demonstrated improved knee mobility and functional recovery, progressing toward baseline activity levels.

Discussion (relevance): Bilateral patellar tendon rupture is exceedingly rare, particularly in the absence of high-energy trauma. ESRD and secondary hyperparathyroidism contribute to tendon degeneration, predisposing patients to rupture. Delayed diagnosis is common, emphasizing the need for early clinical recognition and surgical intervention.

Conclusions: This case underscores the rarity of bilateral patellar tendon rupture in ESRD patients and highlights the critical role of knee injections in optimizing rehabilitation. A multimodal approach—including early surgical intervention, structured rehabilitation, and adjunctive procedural management—can enhance functional recovery and prevent long-term disability. Early identification and a coordinated, multidisciplinary strategy are essential in maximizing outcomes.