Spontaneous, Bilateral, Quadriceps Tendon Rupture Caused by Local Exposure to Methidathion

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2011 Nov 25

PMID 22114623

Citations 1

Authors

Stergios G Papastergiou

Nikolaos E Koukoulias

Evangelos Ziogas

Theofilos Dimitriadis

Panagiotis Koumis

Affiliations

Soon will be listed here.

Abstract

Spontaneous, bilateral, quadriceps tendon rupture is a rare injury. Many predisposing conditions have been reported that contribute to quadriceps tendon degeneration. We report a case of a 42-year-old farmer with spontaneous, bilateral, quadriceps tendon rupture and clear medical history. Clinical and laboratory investigations revealed no risk factors for tendon degeneration but the patient reported that he was exposed locally to methidathion 1 week before the rupture. Methidathion is an organophosphate insecticide commonly used in agriculture that is highly toxic via the dermal route. Methidathion induces lipid pre-oxidation and consequently alters quadriceps tendon blood supply and ultrastructure. The injury was treated with early surgical repair and final outcome was excellent 44 months postoperatively.

Citing Articles

Acute, simultaneous tear of patellar tendon and ACL: possible mechanism of injury and rationality of the two-stage surgical treatment.

Koukoulias N, Koumis P, Papadopoulos A, Kyparlis D, Papastergiou S BMJ Case Rep. 2012; 2011.

PMID: 22687668 PMC: 4545034. DOI: 10.1136/bcr.05.2011.4178.

References

Altuntas I, Delibas N, Sutcu R . The effects of organophosphate insecticide methidathion on lipid peroxidation and anti-oxidant enzymes in rat erythrocytes: role of vitamins E and C. Hum Exp Toxicol. 2003; 21(12):681-5. DOI: 10.1191/0960327102ht304oa. View

MacEachern A, Plewes J . Bilateral simultaneous spontaneous rupture of the quadriceps tendons. Five case reports and a review of the literature. J Bone Joint Surg Br. 1984; 66(1):81-3. DOI: 10.1302/0301-620X.66B1.6693484. View

Yepes H, Tang M, Morris S, Stanish W . Relationship between hypovascular zones and patterns of ruptures of the quadriceps tendon. J Bone Joint Surg Am. 2008; 90(10):2135-41. DOI: 10.2106/JBJS.G.01200. View

Neubauer T, Wagner M, Potschka T, Riedl M . Bilateral, simultaneous rupture of the quadriceps tendon: a diagnostic pitfall? Report of three cases and meta-analysis of the literature. Knee Surg Sports Traumatol Arthrosc. 2006; 15(1):43-53. DOI: 10.1007/s00167-006-0133-7. View

Dhar S . Bilateral, simultaneous, spontaneous rupture of the quadriceps tendon. A report of 3 cases and a review of the literature. Injury. 1988; 19(1):7-8. DOI: 10.1016/0020-1383(88)90163-5. View

Yuan J, Murrell G, Trickett A, Wang M . Involvement of cytochrome c release and caspase-3 activation in the oxidative stress-induced apoptosis in human tendon fibroblasts. Biochim Biophys Acta. 2003; 1641(1):35-41. DOI: 10.1016/s0167-4889(03)00047-8. View

Yavuz T, Delibas N, Yildirim B, Altuntas I, Candir O, Cora A . Vascular wall damage in rats induced by organophosphorus insecticide methidathion. Toxicol Lett. 2004; 155(1):59-64. DOI: 10.1016/j.toxlet.2004.08.012. View

Wang F, Murrell G, Wang M . Oxidative stress-induced c-Jun N-terminal kinase (JNK) activation in tendon cells upregulates MMP1 mRNA and protein expression. J Orthop Res. 2006; 25(3):378-89. DOI: 10.1002/jor.20294. View

Simonin M, Gegout-Pottie P, Minn A, Gillet P, Netter P, Terlain B . Pefloxacin-induced achilles tendon toxicity in rodents: biochemical changes in proteoglycan synthesis and oxidative damage to collagen. Antimicrob Agents Chemother. 2000; 44(4):867-72. PMC: 89784. DOI: 10.1128/AAC.44.4.867-872.2000. View

10.

Sutcu R, Altuntas I, Yildirim B, Karahan N, Demirin H, Delibas N . The effects of subchronic methidathion toxicity on rat liver: role of antioxidant vitamins C and E. Cell Biol Toxicol. 2006; 22(3):221-7. DOI: 10.1007/s10565-006-0039-7. View