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Background: Bifocal disruptions to the extensor mechanism of the knee are extremely rare injuries that are difficult to repair due to the lack of ligamentotaxis. There is a paucity of literature on surgical technique and clinical outcomes following repair. Here we present a variant of this injury previously undescribed. Case presentation: A 24-year-old male landscaper presented to the emergency department following a bifocal disruption to his left knee extensor mechanism from a motorcycle accident. Diagnosis was confirmed on Magnetic Resonance Imaging (MRI). He underwent surgical repair utilising trans-osseous tunnels through the patella and tensioning of both repairs simultaneously. Post-operatively he was allowed to weight-bear as tolerated in a range of motion (ROM) brace locked in extension for 6 weeks with a gradual increase in his ROM. By four months the patient had a full ROM, no extensor lag and symmetrical quadriceps strength and was allowed to return to full duties at work. Conclusion: Bifocal disruptions to the extensor mechanism of the knee are extremely rare injuries with only case reports in literature. To the best of our knowledge this case represents a novel and undescribed variant. Surgical repair should be undertaken with careful consideration to appropriate soft tissue tensioning.