Abstract
Five cases of quadriceps tendon rupture in patients receiving long-term hemodialysis are presented. The mean age of patients was 39.0±6.1 years and the mean duration of hemodialysis prior to tendon rupture was 10.1 years.
In all cases, severe secondary hyperparathyroidism (2°HPT) and renal osteodystrophy (ROD) requiring parathyroidectomy (PTX) were present.
In 4 out of 5 cases, PTX was carried out after on episode of tendon rupture and hyperplasia of the parathyroid was confirmed.
Four (Nos. 1, 3, 4 and 5) out of 5 cases had bilateral tendon rupture and the remaining one (No. 2) had unilateral rupture.
In 2 (Nos. 1 and 3) out of 4 PTX patients, operative treatment for the ruptured tendons was carried out and the ability of the knee joint was improved markedly one year after surgery. However, in the remaining 2 cases (Nos. 4 and 5) who did not receive tendon suture, the ability of the knee joint was not improved and restriction of joint movement remained.
It is considered that tendon rupture in hemodialysis patients might contribute to the weakening of bone strength and structure caused by bone resorption and metastatic calcification in 2°HPT.
Thus PTX and surgical treatment might be useful for the repair of tendon rupture in long-term hemodialysis patients with severe 2°HPT.
