Simultaneous Ruptures of All Four Extensor Mechanism Tendons in Both Knees: a Rare and Challenging Case in a Chronic Kidney Disease Patient

We report a rare and remarkable case of simultaneous bilateral injuries to all four extensor mechanism tendons in a 39-year-old male with a history of diabetes and chronic kidney disease. Physical examination revealed pronounced swelling, palpable gaps above and below both patellae, and complete loss of active knee extension. Imaging confirmed complete ruptures of the right quadriceps and left patellar tendons, alongside partial ruptures of the left quadriceps and right patellar tendons. Surgical repair was performed using suture anchors to ensure secure tendon reattachment. Postoperatively, both knees were immobilized with hinged braces for six weeks, followed by a structured rehabilitation program. At the 12-month follow-up, the patient demonstrated full recovery, with complete restoration of knee range of motion and muscle strength.