PMC3504210_01
MRI of the left knee reveals complete rupture of the patellar tendon and patella alta.
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fig2
A magnetic resonance imaging (MRI) was performed and confirmed the initial speculations (Figure 2).
Nonabsorbable sutures through the ends of the ruptured patellar tendon in the left knee.
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fig3
Through median longitudinal incision, the two parts of the ruptured tendon were identified; thus, complete rupture of the patellar tendon was confirmed and was reconstructed with the use of non absorbable sutures (Ethibond no. 2) (Figure 3).
Tension band wire through tibial tuberosity for reinforcing the sutures.
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fig4
A 4.5 mm screw was inserted in the tibial tuberosity, and the sutures were reinforced by a metallic wire tension band (Figure 4).
Reconstruction of the partial rupture of the quadriceps tendon in the right knee with nonabsorbable sutures.
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fig5
The rupture was similarly repaired with nonabsorbable sutures (Figure 5).
Full extension of both knees in 2-year followup.
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fig6
 Two years postoperatively the patient was still walking unassisted and presented a nearly full range of motion in both knees (full flexion bilaterally and 100  on the right and 110  on the left) (Figures 6, 7(a) and 7(b), 8(a) and 8(b)).