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Quadriceps tendon ruptures in uremia.

R Bhole, J C Flynn, T C Marbury

    Clinical Orthopaedics and Related Research
    |May 1, 1985
    PubMed
    Summary

    Spontaneous quadriceps tendon ruptures can occur in patients with chronic renal failure and secondary hyperparathyroidism. These ruptures may be linked to long-standing kidney disease and rejection of medical treatment.

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    Area of Science:

    • Nephrology
    • Orthopedic Surgery
    • Biomedical Engineering

    Background:

    • Chronic renal failure (CRF) and secondary hyperparathyroidism are known complications.
    • Spontaneous tendon ruptures, particularly quadriceps, are rare but reported in CRF patients.
    • Uremia's impact on connective tissues and tendon integrity requires further investigation.

    Observation:

    • Two cases of bilateral spontaneous simultaneous quadriceps tendon ruptures in uremic patients are presented.
    • Ruptures occurred in patients under 40 with long-standing renal disease (mean 12.3 years) who declined medical treatment.
    • Microscopic analysis showed nonspecific degeneration and calcification, with normal collagen fiber structure.

    Findings:

    • The exact level of tendon rupture is inconsistent.
    • Electron microscopy revealed normal collagen fiber structure and maturity.
    • Predisposing factors remain unknown, but potential causes include collagen metabolism abnormalities, ischemia, parathormone effects, and dystrophic calcification.

    Implications:

    • This study highlights a potential, under-recognized complication of chronic renal failure.
    • Understanding the etiology of these ruptures may lead to preventative strategies.
    • Further research into uremia's effects on musculoskeletal health is warranted.

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