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Author Topic: fractured patella removal of hardware help  (Read 28628 times)

Offline manda20

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fractured patella removal of hardware help
« on: May 03, 2008, 09:52:19 PM »
hello
ive had many problems with my knee im just about to have my 5th operation on my right knee and im only 16 years of age

i fractured my patella in November and had surgery to repair it using tension band wiring with k wires but no pins

i have had alot of pain with the wires and all round just joint pain from my 2 ACL reconstructions and cartilage damage

now i have been put down for the hardware to be removed i was just wondering if anyone could answer my questions about the operation

how long do you stay in hospital ?
how long am i on crutches for ?
and im about to learn to drive soon so how long until i can drive again ?
and how painful is it ? (to anyone who has had this done) because i got told by my consultant that it would be more painful then putting them in is this true ?

thanks for your time
hope to get some information

amanda
 
6.06.06 arthroscopy right knee
10.04.07 ACL reconstruction (hamstring graft) right knee
16.10.07 ACL reconstruction  (patella tendon graft) right knee
28.11.07 fell and broke patella
1.12.07 tension band wiring to fix patella
16.06.08 hardware to be removed
18.07.08 started physio ROM 120

Offline kimmyxs

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Re: fractured patella removal of hardware help
« Reply #1 on: May 04, 2008, 12:03:18 AM »
Amanda,  I just wish I had a great answer for you. My hardware removal was to remove 2 long screws from the patella after ORIF to repair it.  I didn't have any wires at all.  My OS went back in through the original incision site.  Had that been all the work I had I would have been weight bearing immediately.  I had extra work done because my patella wouldn't stay in place which was how I broke the darned thing in the first place.  I did leave the hospital that day, I had only seri strips and glue over the incision site.  It was the best choice I ever made.

Good luck!
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl

fatcats6

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Re: fractured patella removal of hardware help
« Reply #2 on: May 04, 2008, 05:53:01 AM »
Hello Amanda,

Like you, I'm looking at hardware removal, wires and screws.....and I've asked all the same questions.  John Biehn went through this procedure about a month ago.

He told me: 

In hospital for a couple of hours.
Crutches the first week advised
Driving again after 3 days
A few stitches to close where they went back in over the original incision
Pain - minimal, actually I think he said a million times easier than the original injury.  Hardly any medication needed.

Mind you, John's a bit of a superstar as far as recovery etc is concerned.

No one has told me it's more painful taking it out than putting it in.  Did he say why?

I have an OS appointment in 9 days, so I'm going to be asking alot of questions.  Remember everyone is different and it really depends on what happens in your procedure, so I guess no one can cover all the bases.

Adrienne

Offline hopes

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Re: fractured patella removal of hardware help
« Reply #3 on: May 04, 2008, 06:15:47 PM »
I had two pins and figure 8 wire [tension band] around the fractured patella.  Hardware removal, from my own experience, was much much easier.  It was same day procedure[hardware removal and patella debridement; plica removal].  You will feel much better; your ROM will improve.

Best of luck 

Offline zoe203

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Re: fractured patella removal of hardware help
« Reply #4 on: May 12, 2008, 03:56:24 AM »
I look forward to hearing how it goes for you as I'll be in the same situation soon. I had the pins and wire put in days ago and the pain is really getting me down at the moment. Can't wait to get it all taken out!
April 25 - fractured left patella
April 30 - Out of full leg plaster cast and into brace
May 9 - ORIF patella surgery
May 21 - back at work
May 22 - first physio session
June 10 - No crutches
June 19 - No brace
August 2 - Cycled 20km
August 8 - Hardware removal surgery

fatcats6

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Re: fractured patella removal of hardware help
« Reply #5 on: May 14, 2008, 12:02:44 AM »
I just found out that when they take out the wire and screws, the incision site will be totally opened up on the original scar line, so it'll be another 27 staples, Overnight hospital stay, crutches for 2 weeks and no car until the knee has stablised and no PT for at least the next 6 weeks.

Offline kimmyxs

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Re: fractured patella removal of hardware help
« Reply #6 on: May 16, 2008, 03:50:27 AM »
I am so glad I only ended up with seri strips and glue the second time around.  My doctor was pretty sweet about the whole thing, but then he had to do a VMO advancement just to get the patella to stay in place.  I guess I had words to say in recovery, but I really did get out of the hosptial that night.  The scar is a bit uglier now but oh well.  It was worth it.  Eventually I will have the incision site opened up again and made longer to have a knee replacement.  Hum... Not happy about that, but I am hoping to wait another two years.
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl

fatcats6

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Re: fractured patella removal of hardware help
« Reply #7 on: May 18, 2008, 11:00:05 PM »
Hey Manda,
I'll try and post after my op to let you know what it was like.  I won't post scary stuff because no-one needs that going in, just the practical stuff likely to help.  Think of me on the 6th and I'll think of you on the 10th.

Offline JBiehn

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Re: fractured patella removal of hardware help
« Reply #8 on: May 21, 2008, 01:38:29 AM »
Hey Manda and Adrienne,

First I would like to address you Adrienne.  I had two OS when during my first surgery, when they put the pins and wire in.  When I would go to my check ups I would only see one of the OS's.  When my ROM got stuck around 100 degrees (on a good day) he said "we'll just take out the pins..."  Only the pins.  He also told me he would have to re-open the original incision site...  And yes that meant at least another 18 staples for me.  I was bummed.  SO, I called the other OS who I hadn't spoke with since the first surgery and got his take on the situation.  He explained that he would only do two small "stab incisions" and remove the pins and the wire.  He seemed very confident and I liked the thought of a faster recovery.... So, I went with him... Cancelled my surgery with the other OS and set a date with the the other OS.  I am very happy I got the second opinion and would recommend, if you can, that you also talk with other OS who have LOTS of experience with this injury and see what they say.  It can't hurt...

Manda,

Everyone is different and this is a very tricky injury that requires more patience than most people can even imagine.  My removal hardware was very easy for me.  My hardware was only in for 13.5 weeks so I don't think there was as much scar tissue than folks who've had there "gear" 6-12 months.  My OS also slowly bent my leg to 115 degrees during the surgery and my ROM improved nearly 20 degrees within the first week... My other info was already posted above by Adrienne so I won't repeat it.  Best of luck to you and focused and positive during your recovery.  Best of luck!

John
12.21.07  Shattered Patella (6pieces) telemark skiing (with knee pads on)
12.22.07  Surgery w/ 2 pins, wire and 18 staples
01.07.08  First PT session ROM 35
02.04.08  ROM 100
03.27.08  Hardware Removal Surgery;  ROM 115
03.31.08  Rode a Stationary Bicycle
04.27.08  ROM 151; Biked Outside 12 miles

fatcats6

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Re: fractured patella removal of hardware help
« Reply #9 on: May 21, 2008, 07:30:09 AM »
Hey John,
Good to hear from you....ah, the joys of small country towns and only one OS (the nearest one is 400km away).  I'm going to beg and plead for a smaller incision, mind you when you see how much hardware is in there, I can understand why the want a big hole to work through.  We'll see what happens, I have the pre-op checkup tomorrow.

Offline kimmyxs

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Re: fractured patella removal of hardware help
« Reply #10 on: May 24, 2008, 04:29:33 AM »
Very interesting discussion.  I find it interesting that each OS approaches the same surgery so differently.  I had a VMO graft at the same time as the hardware removal because my patella wouldn't stay in place.  My original incision was from the bottom of the joint to above the patella about 4 inches when the leg is straight and 8 when bent.  He went right into the same incision site and did internal sutures and then seri strips on the outside with glue.  He said he did this to reduce additional scaring on the outside of the leg. 

Even with everthing else done, I had great results.  It was the best choice I could have made.  I admit to being pretty verbal when I woke up in that brace again.  The muscle graft was extremely painful, but so worth while. 

Only a short time left and you will be so grateful when it isi all over.  Unlike John, I had no immediate ROM increase because of the graft.   I was completely back at 0 ROM for far too long the second time to let the graft heal.  But wow, life is so much better now a year and a half after hardware removal.  It has been great!
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl

Offline etta

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Re: fractured patella removal of hardware help
« Reply #11 on: May 25, 2008, 05:02:24 AM »
Hi
You and I are in the same boat. I broke my patella last September and was told by the OS that the hardware would need to stay in for a year. I am going back to my doctor this week to get a referral back to the OS to get my hardware removed. By the time I wait for appointements etc. it will be September by the time I get the op. I am much older than you and really feel for a young person of your age to have to cope with this. I have come along really well so says my PT but have been told my knee will never be the same as the other one again. It is amazing how many people I talk to and they just think that a broken patella is just like any other bone in the body to get broken. They seem to forget that it is the muscle wastage when our leg is in the brace and not being used for those few weeks which we have to try and get mobile again.
I hope all goes well for you on the 10th June and you have a quick recovery.
Etta
Patella broken 4th September, operation 6th September 2007.
Left hospital on the 11th September.
Had clips out of wound on the 19th September.
Brace gone on the 17th October.
Appt with OS on the 28th Nov.
See OS on the 2nd July 2008 to arrange for wire removal.
Op on the 2 Oct. to get wires out

Offline etta

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Re: fractured patella removal of hardware help
« Reply #12 on: May 28, 2008, 06:14:48 AM »
Hi Manda
Keep up your spirits, we are all here for you. You having youth on your side should be a help to you, but we all has this muscle problem with an injury such as this and it is just a matter of keeping up the exercises to strengthen the various muscles around the knee. I am finding now that we have winter coming along the knee doesn't like the cold damp weather so try to keep my knee warm at all times. My knee gets quite stiff at times, I have been told this can take up to about 2 years to come right so just have to be patient. I will be glad to get the hardware out as I cannot kneel on my knee and feel quite restricted in my various activities. Get to see my doctor next Wednesday so then will get my referral to the OS which will take about a month or more.
Good luck
Etta
Patella broken 4th September, operation 6th September 2007.
Left hospital on the 11th September.
Had clips out of wound on the 19th September.
Brace gone on the 17th October.
Appt with OS on the 28th Nov.
See OS on the 2nd July 2008 to arrange for wire removal.
Op on the 2 Oct. to get wires out

fatcats6

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Re: fractured patella removal of hardware help
« Reply #13 on: June 11, 2008, 12:09:14 AM »
Helo Manda,

It's the 11th of June here in Australia....so, by my time, your operation was yesterday!  How are you going?  I'm 4 days post op.  27 staples, the whole incision site was re-opened.  Day 3 and 4 were terrible but it feels better this morning, the incision site must be healing and that horrible tightness makes the day miserable.  One thing I didn't realise was that when they re-opened the original incision site, they cut away the keloid scar tissue so they can sew normal skin together.  Walking is alittle better today, I can actually do heal to toe instead of a stiff leg walk.  It will be much better when the staples come out next Tuesday.  I've found I don't like the sensation of showering or bathing when I have the dressing on, it makes me feeling ickky.

Hoping everything went well and all the metal is out, that your pain levels are managable and that your spirits are up.  I'm here if you want to chat.  I'm looking forward to being able to drive again.  For some reason, it really bothers me that I can't just get up and go when I want to.

I can feel where the screws have gone from, it's like the bone is bruised, it doesn't ache at all, it only hurts when you press on it.  Guess the easiest thing is "don't press on it fool".  Most of the pain is the incision site, and really, why wouldn't it be, it's 10 inches! They couldn't do it smaller because I had so much hardware and they said that whilst I would have a bigger incision, in 10 days it would be healed, smaller or key hole incisions and I'd have more swelling after...seems to be true as I've got no swelling at all.  If you look at my knee in trousers, it looks pretty much the same as my other knee.

Hope you're doing ok and someone is spoiling you rotten.

Adrienne

Offline kimmyxs

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Re: fractured patella removal of hardware help
« Reply #14 on: June 12, 2008, 10:58:09 PM »
Hi Mandy and Adrienne,

I hope you are both doing well.  I wish that my experience was the same as yours Adrienne, I didn't touch anything because I was buried in the Polar Ice wrap and back in a brace.  I was weight bearing right away, but the pain the first few nights was horrible.  It was due to the muscle graft however.  I am so glad I didn't have to have staples again, I am sure I couldn't have handled that very well.

Rest, let people spoil you, and look forward to a greater range of motion and a better life.  It was for me. 
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl