Bilateral spontaneous rupture of the quadriceps tendon is an uncommon and serious injury that usually occurs in middle aged to elderly patients who have additional medical conditions such as rheumatoid arthritis, chronic steroid usage, and diabetes mellitus. Within this group, delayed treatment is an infrequent but difficult clinical situation. Fibrous degeneration, muscle contraction, and poor bone quality of the patient moved us to find new method for restoration. We report a modified technique for the surgical treatment of the spontaneous bilateral quadriceps tendon rupture in a patient with rheumatoid arthritis and chronic steroid usage. We performed only one tunnel to the patella by using 2.5-mm drill bit, and we used Endobutton(A (R)) fixation device (Smith & Nephew, USA) for postfixation on the distal pole of the patella. In this way, it seems safer and may have low morbidity with multi-holes method for the risk of patellar fractures that occurs due to additional medical conditions such as rheumatoid arthritis and glucocorticoid-induced osteoporosis.