We report seven quadriceps tendon ruptures in four patients on chronic hemodialysis. The mean age of patients was 40.0 years and the mean duration of hemodialysis was 8.0 years. Five ruptures were developed, when the patients tried to stop falling to the ground after slipping, one rupture was developed after jumping from a one meter height and one rupture was developed spontaneously without any special strain. Ruptured tendons were sutured to the patella in all patients. After surgery and following physical therapy, all patients were able to walk without any support, but 3 of 4 cases needed a hand rail when going down stairs.
In all cases, secondary hyperparathyroidism (PTH averaged 53.5ng/ml) was seen. Histological findings suggested that bone resorption at the tendo-osseous junction due to secondary hyperparathyroidism was a predisposing factor to quadriceps tendon rupture.
