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Four patients with bilateral simultaneous rupture of the quadriceps tendons were each older than 70 years of age. In the first patient the diagnosis was missed and one side was managed conservatively, while the other side was surgically treated. A combination of inadequate postoperative immobilization and the use of chromic catgut sutures probably caused failure of the repair, requiring revision surgery. The other three patients were treated by bilateral operative repair and had satisfactory results. Nonabsorbable suture material use and a minimum period of six weeks of postoperative immobilization are recommended.
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Keogh et al. (1988) studied this question.
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