Spontaneous Quadriceps Tendinopathy Management and Prevention: A Case Report

Introduction: Quadriceps tendon rupture is a rare injury that significantly impairs knee function, especially in patients with chronic kidney disease (CKD). This case report highlights the diagnostic and management challenges of spontaneous quadriceps tendon rupture in a patient with chronic kidney disease, considering systemic disease effects on injury risk and healing. It underscores the need for a multidisciplinary approach and timely surgical intervention to restore knee function and prevent complications like muscle weakness. Case Presentation: A 54-year-old male with stage V chronic kidney disease undergoing hemodialysis presented with spontaneous total rupture of the left quadriceps’ tendon. The patient reported persistent pain, swelling, and inability to actively lift the left leg. MRI examination confirmed a complete quadriceps tendon rupture, moderate joint effusion, and soft tissue edema. The patient underwent arthrotomy and tendon repair using the transosseous tunnel technique, followed by structured rehabilitation. The outcome shows improvement in improvement in pain and mobilization. Discussion: Spontaneous total rupture quadriceps tendon is a rare but serious complication in patients with chronic kidney disease (CKD), particularly those undergoing hemodialysis. This condition is associated with systemic factors such as secondary hyperparathyroidism, uremic toxin accumulation, and β2-amyloidosis, which weaken tendon integrity and increase rupture risk. Early diagnosis using MRI and timely surgical repair are crucial for restoring knee function. Prevention focuses on controlling secondary hyperparathyroidism, optimizing CKD management, ensuring proper nutrition, and implementing muscle strengthening and fall prevention programs. Conclusion: Quadriceps tendon rupture in patients with CKD on hemodialysis is rare but significantly impairs knee function. Timely surgical repair with arthrotomy and trans, combined with structured rehabilitation, can lead to good functional recovery, as seen in this patient’s improved knee flexion and active leg lifting. A multidisciplinary approach is essential for optimal management.