Bilateral Patellar Tendon and Unilateral Syndesmotic Injury in a Recreational Athlete.

Introduction: Bilateral patellar tendon injuries are rare, with few case reports in the current literature. To the authors' knowledge, this is the first instance of reported bilateral patellar tendon injury with concomitant syndesmotic injury. Case Report: A 35-year-old African American male presented for evaluation of bilateral knee pain and ankle pain with inability to bear weight after an injury during a recreational football game. He was diagnosed with bilateral patellar tendon ruptures and a right-sided syndesmotic ankle injury resulting in mortise instability. He was taken for fluoroscopic ankle examination under anesthesia and operative repair of his injuries after appropriate imaging was obtained. After repair, he was allowed to weight bear on the left lower extremity but kept non-weight-bearing on the right, with both knees maintained locked in extension. Conclusion: This case report demonstrates bilateral patellar tendon injury in the setting of chronic patellar tendonitis with an associated ankle syndesmosis disruption. We suggest that a heightened index of suspicion for additional ligamentous injuries should accompany the evaluation of these patients with a low threshold for advanced imaging or fluoroscopic examination under anesthesia.