Simultaneous bilateral patellar tendon rupture: a case report on successful repair with gracilis autograft augmentation

Simultaneous bilateral patellar tendon rupture is an exceedingly rare injury, often linked to systemic comorbidities. This report presents the case of a 31-year-old active male with a history of hypothyroidism, asthma, and chronic anabolic steroid use who sustained bilateral ruptures while running. He underwent urgent surgical repair using intratendinous sutures augmented with a double-bundle ipsilateral gracilis autograft. Postoperatively, a structured rehabilitation protocol was followed. At the 1-year follow-up, the patient achieved an excellent clinical outcome, with an IKDC score of 92.3 and a Kujala score of 95, returning to all pre-injury high-demand physical activities without limitation. This case highlights the efficacy of early surgical repair with gracilis autograft augmentation for restoring high-level knee function in patients with significant risk factors for tendon injury.