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Sagittal T2-weighted MR image shows complete rupture of the quadriceps tendon with a gap between retracted quadriceps tendon and patella (right arrow). Left arrow shows the osteophyte formation at the upper end of the patella.
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MRI showed the bilateral total rupture of the quadriceps tendons and showed the osteophyte in the tibial tuberosity in the left knee (Figure 1).
Kissing large osteophytes of the anterior longitudinal ligament is seen in the lateral view of the thoracolumbar spine (a). Kissing large osteophytes of the anterior longitudinal ligament is seen in the lateral view of the thoracal spine at the time of surgery in 2008 (b).
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A complete analysis revealed ossification and calcification of the anterior vertebral column in the spinal X-rays (Figure 2).
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Early postoperative X-rays of the knees. Left arrow shows a cerclage wire, and right arrow shows the two 3.5 mm suture anchors.
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Subsequently, a cerclage wire was passed around the patella and the proximal part of the quadriceps tendon to reinforce fixation (Figure 3).
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Bilateral knee X-rays after 8 years. Note the spur formations from the tibial tuberosity and patella (associated DISH) in the lateral view of the left knee ((b) right arrow). Bilateral cerclage wires have been broken ((a) left arrow).
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At the last follow-up, eight years postoperatively, radiographs revealed broken wires, but the patient still had full range of motion in both knees with bilateral 15-degree extension lag (Figures 4 and 5).
Clinical appearance of the patient's knees at eight years of follow-up. He has good functional results with full active motion in both knees.
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At the last follow-up, eight years postoperatively, radiographs revealed broken wires, but the patient still had full range of motion in both knees with bilateral 15-degree extension lag (Figures 4 and 5).