Advertisement - Hide this advert





Author Topic: Patella fracture, one year later should I get the hardware removed?  (Read 45065 times)

Offline beefrank

  • MINIgeek (20-50 posts)
  • **
  • Posts: 45
  • Liked: 13
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #45 on: March 08, 2016, 06:08:18 AM »
I thought Id provide an update on my progress. Its now just over three months since my hardware was removed and just over 23 months since my original patella fracture.

Numbness I felt in an area from the lower part of the knee and towards the outside of the leg still exists, as does a feeling of tightness across the knee. I can live with these, but Id rather they not be there. The greatest improvement has been the complete elimination of pain above and below the knee when the leg muscles are tensioned. Prior to the hardware being removed, pain and tightness where the figure 8 wire passed through the patella tendons were the main factors that prevented me from jogging more than about 150m.

A few weeks ago and about two months post hardware removal, I ran the first 4km of a 6km orienteering event before being forced to walk to the finish. Although the knee felt weak and slightly unsteady this was not what forced me to stop running. Rather, it was weak calf muscles on both legs that let me down when they cramped up. Up until this time, Id been preoccupied with rebuilding weakened quads and overlooked the calf muscles. Since this event Ive had a minor muscle tear in one calf (now just about completely cleared up) and a recurrence of an old achilles tendon injury that forced me to stop competitive running about 25 years ago. Although Im still daily on the cross-trainer for between 10 to 30 minutes a session, Im now also having to do calf strengthening and achilles tendon rehabilitation exercises!

Since having the hardware removed I found I could push much harder on the cross-trainer to the point where both legs feel like theyve had a really good work out. A couple of months ago I read about the benefits of high intensity exercises, which Ive now incorporated into my cross-trainer routines. The high intensity sessions are never more than about 10 minutes, and comprise four equally spaced 30 second bursts at highest speed and higher resistance. I do three or four high intensity sessions a week. The muscle pains at the end of each high intensity burst tells me that all leg muscles are getting a good workout.

My affected knee is still larger than the good knee by about 1cm, and the quads about 1cm smaller. Although not recorded, I presume the muscles on my good leg are also becoming stronger and larger as a result of the exercises so the difference in muscle size is probably not a good measure of progress in the weakened leg. However, I can see that the quads in the affected leg, especially the VMO, are bulking up. At this stage, Im avoiding any running (apart from bush/forest orienteering events) until Im confident that my calf muscles can take the extra stresses of pounding the streets.

Note the change of attention from knee to all round leg strength, but its taken a long time to get here.

I hope my experiences and lessons learned will benefit some fellow sufferers.
5 Apr 2014 - fx patella, 4 pieces, displaced
6 Apr - splint
7 Apr - 2 pins, fig 8 wire
+ 2 dys - limited physical work
2 wks - start quad exercises
4 wks - first SLL
6 wks - 90 ROM, no splint
12 wks - 120 ROM
20 wks - 140 ROM
18 mns - swelling/pain plateaued
20 mns - h/w removed
24 mns - ran 8km

Offline 121212

  • Regular Poster
  • ***
  • Posts: 86
  • Liked: 9
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #46 on: March 17, 2016, 11:18:13 AM »
Just wanted to chime in with my thanks for your posts, too, Beefrank.  As you can see from my stats, I have waited over-long to address hardware removal.  Most of the delay has been situational.  My break occurred during a transitional time, when I was looking for a new permanent residence in a new state.  The first year of recovery was spent in rented quarters.  By then I had found a house, but it needed major repairs/renovations and I had to step in as project manager.  That process has taken longer than expected (my husband was ill for a chunk of this time) and then our daughter got engaged, with a wedding planned for this coming September.  The timing has never seemed right to take on the unknown of another surgery.

Still, I have been struggling along with those symptoms so well known to many of us patella fx victims and would love to leave them in the past --along with concern about breaking a wire.  I wonder why we haven't heard a follow-up from helenkay or mg701.  I do have an opinion from a second OS saying hardware removal will ameliorate my symptoms, so maybe after the wedding is the right time.  It sounds like 1-3 months amounts to a suffiecient recovery time.  Please continue to post on your experiences.  Thanks!
12-6-12 Fx Right Patella
12-12 ORIF w/pins and wire, Donjoy immobilizer, FWB after 48 hours
12-18 Staples out
12-31 began bending knee
1-8-13 Cleared for pt
1-14 PT Evaluation ROM 65
1-18 ROM 77, 82 with help
1-22 ROM 85
2-8 ROM 125,
2-25 ROM 134, driving
2-28 ROM 140
4-1 ROM 145

Offline lizl

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1104
  • Liked: 0
  • I've fallen and I cannot get up?
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #47 on: March 17, 2016, 07:43:48 PM »
Hardware removal is really a pretty simple operation, and I absolutely have NEVER been sorry that I did it. I had to argue with my original surgeon and got a second opinion in a different city before he would even consider it. I felt my hardware every single day, and it did limit my ROM...so my situation may have been slightly different than yours.

My injury was in 2003, so I'm a long way out; but I still cannot run without a limp and never will. I do, however, walk just fine and rarely have trouble with my knee. Every once in awhile, it still swells and hurts a bit; and it is still weaker than the other knee. Overall, though, life is somewhat normal for a non-athlete. I will never be able to do some types of exercise, such as aerobic exercise.
2003: 1/28-29Fell on wet floor,broke kneecap
ORIF(hdwr&immob)
Post-op drug reaction
3/4-5/13 brace
3/21-8/28PT
12/19Hardware removal,scope,partial meniscectomies
2004: More PT
lost job
Settledw/WC Oct
2005: Personal injury lawsuit--reschedulings,failed mediation
2006: settled out of court in March

Offline lizl

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1104
  • Liked: 0
  • I've fallen and I cannot get up?
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #48 on: March 17, 2016, 07:47:16 PM »
"Giving way" or popping forward of the knee: I had problems with that for around three years after the injury. Now, I am VERY careful going down stairs.
2003: 1/28-29Fell on wet floor,broke kneecap
ORIF(hdwr&immob)
Post-op drug reaction
3/4-5/13 brace
3/21-8/28PT
12/19Hardware removal,scope,partial meniscectomies
2004: More PT
lost job
Settledw/WC Oct
2005: Personal injury lawsuit--reschedulings,failed mediation
2006: settled out of court in March

Offline beefrank

  • MINIgeek (20-50 posts)
  • **
  • Posts: 45
  • Liked: 13
A very, very belated thanks to 121212 (March 17, 2016) for your comment. Like many other fellow victims, within a couple of days of my accident I scoured the internet for information on our fracture. For example, how long to full recovery (my OS said 6 months, but this I now know was highly optimistic), what will I be able to do when recovered, what exercises should I do to regain lost muscle condition, etc. Apart from what I remember the OS saying when I was discharged after the operation and at my six-week meeting with him, I was given no other information. I found this website to be the best source of this information, but still couldn’t find too much on expected rates of recovery (apart from to expect it to be slow) and likely long-term symptoms, if any.

You’ve done really well to have lasted so long with your hardware. I agree, it would be good to read the recovery stories of a few more people. My family doctor was unconvinced that pain around my knee was caused by the hardware and was reluctant to refer me to my OS. This is the only reason I hung on until 20 months to have the hardware removed. When I did get a referral, my OS didn’t hesitate to confirm my suspicion that the figure of 8 wire threaded through the tendons above and below the patella (which is standard practice) was my main source of pain and tightness, and I haven’t regretted the decision to have it and the pins removed. I’m not symptom free, but do feel a lot more comfortable.

Now at just over six months post hardware removal and 26 months post fracture, I’ve been able to run longer distances (up to 8km orienteering compared with a painful 100m before hardware removal). My major restriction now is achilles tendon pain in the “good” leg, which is a recurrence of an injury that stopped me running about 25 years ago. As a result, I’m continuing to build up fitness and strength on an elliptical trainer (low impact, which doesn’t stress the tendon so much) and aim to do at least five 30 minute sessions on the trainer a week. I was surprised to discover that when I do run, only in orienteering events so far, it feels quite easy. The elliptical trainer thus seems to be a good (but very boring) substitute for actual running. Some studies published on the PubMed.org website show that exercises on an elliptical trainer can be as good as treadmill running, which gives me confidence to continue with the elliptical trainer.

A couple more symptoms seem to have cleared since the hardware was removed are a frequently warm knee, and a knee that became stiff after sleeping with it bent. Before the hardware was removed, I had to consciously try to sleep with a straight knee. Pain from the stiffened bent knee would occasionally wake me during the night. Symptoms that persist include a feeling of tightness and occasional slight soreness around the knee, numbness in an area of skin at the bottom of the patella and towards the outside of the knee, and a knee that is still about 1cm larger around than the good knee. The patella also seems to have repaired to a slightly different shape to the one on the good leg – it is more circular in shape and about cm wider at its widest point. When the knee is severely stressed (for example scrambling up and down steep slopes in orienteering), it swells and stays up for a few days afterwards. The quad and calf muscles on the affected leg also stubbornly remain about 1cm smaller than the good leg, but the affected leg doesn’t feel any weaker than the good leg when running.

I hope the above provides some useful milestones against which fellow sufferers can measure their progress.
« Last Edit: June 06, 2016, 08:07:16 AM by beefrank »
5 Apr 2014 - fx patella, 4 pieces, displaced
6 Apr - splint
7 Apr - 2 pins, fig 8 wire
+ 2 dys - limited physical work
2 wks - start quad exercises
4 wks - first SLL
6 wks - 90 ROM, no splint
12 wks - 120 ROM
20 wks - 140 ROM
18 mns - swelling/pain plateaued
20 mns - h/w removed
24 mns - ran 8km

Offline galpal

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 1
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #50 on: July 02, 2016, 07:53:57 AM »
hey, i wanted to ask for some clarification from the posters here in this thread.

is everyone here just getting the figure 8 wire out? or pins/screws too? for people like me with no wire, anyone gotten just the pins/screws out for any reason, or heard of that? my doctor said they could stay there forever, i hope that doesn't mean issues forever!  :-[

Offline jamie-em

  • MICROgeek (<20 posts)
  • *
  • Posts: 1
  • Liked: 0
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #51 on: December 09, 2016, 07:36:25 PM »
To Frank and Mark and all the others who posted on this topic, thank you! I fell and broke my right patella 7 months ago, and have recovered well (thanks to all the PT exercises I did). My OS said one year minimum for the removal surgery and I will most likely have it - there is some small discomfort and swelling on the bad knee, and the pins (two, shaped like "J"s) are quite close to the surface. From what I've read here, I suspect it's the hardware that's causing the discomfort - which seems to be worse when it's humid or cold.


Offline Buckeyegirl80

  • MICROgeek (<20 posts)
  • *
  • Posts: 11
  • Liked: 0
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #52 on: December 12, 2016, 04:44:24 PM »
I am 4 months post fractured patella.  I too have screws & figure 8 wire holding together.  I just left my OS and was released from wearing the brace and am to finish my scheduled therapy (4 more sessions).  I am at 104 ROM with some stiffness & it aches too.  I too have pain at the top of my kneecap when I do leglifts and some other movements, OS said that it is the hardware causing it.  I hate the thought of feeling this for a year but would prefer to not have any pain.  He said that we will more than likely remove the hardware in about a year.  Hopefully removal isn't a long recovery.     

Offline Buckeyegirl80

  • MICROgeek (<20 posts)
  • *
  • Posts: 11
  • Liked: 0
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #53 on: January 10, 2017, 03:32:11 PM »
I went to my surgeon yesterday and he has me scheduled Feb 9 for hardware removal. 
With PT, I couldn't get more than 109 ROM and that was painful.  Leg lifts really hurt at the top of my kneecap and I keep the tightness with most movements.  A lot of that could be scar tissue and can be broken up in surgery.  Doc said that I will be a couple days in a brace, then full weight and movement.  I am looking forward to getting it removed and have high hopes that it will dramatically help my pain & ROM from reading everyone's posts. 

Offline Buckeyegirl80

  • MICROgeek (<20 posts)
  • *
  • Posts: 11
  • Liked: 0
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #54 on: February 01, 2017, 08:34:57 PM »
I am scheduled next week to have my hardware removed (2 screws & figure 8 wire).  It has been 6 months since my break and have ROM back to around 110, but it sometimes hurts more now, than during most of my therapy.  I have a "full feeling & dull ache" most of the time, it also feels like it's catching.  I have high hopes the removal will fix it all. 
Can anyone share their recovery time?  I am hoping it will be a short one, since I'm not waiting on the bone to heal, only the incision.  Doctor said I will be full weight bearing within a couple of days, but am nervous just the same.  I was down originally for 7 weeks in an immobilizer with no movement at all.   Any advise is welcome!!   

Offline KaiserCoze

  • MICROgeek (<20 posts)
  • *
  • Posts: 1
  • Liked: 0
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #55 on: November 21, 2017, 12:54:45 AM »
Wanted to thank everyone here for posting their stories. You made my decision to have the hardware removed easier and much less stressful. Im in a hospital bed now less than 24 hours after my procedure to remove the wire and pin from my patella, feeling good.
As others have mentioned, this one was absolute cake compared to the initial injury and surgery (11.5 months ago). I was up walking to the bathroom (to the surprise of my nurses) three hours from the recovery room. There is some mild pain but again miles better than round one.
Fortunately it looks as though my doc was able to keep the bursa instead of trimming some of the inflamed area.
Can already tell the dull pain and tightness of the wire previously wrapped around my tendon is gone!
Doc wants me to take Rehab slow for a couple of weeks until the staples come out. Im doing seated isometric exercises already to stave off any more of that dreaded quad atrophy.
Looking forward to starting the next chapter - one without painful stair walks and random knee buckling. If any one else out there is wrestling with the decision to have their hardware removed, Id highly recommend doing it ASAP.

Offline Sampson19511

  • MICROgeek (<20 posts)
  • *
  • Posts: 19
  • Liked: 1
Re: Patella fracture, one year later should I get the hardware removed?
« Reply #56 on: January 12, 2018, 08:25:44 PM »
It's been 9 months today since fractured patella surgery with two pins and wires.  I recovered quicker than most since I had worked out for over 42 years.  However, to this day I still have pain, popping and cracking sounds, difficulty up and down stairs, slight jumping is hard, sideways movements are hard.  Dull ache all the time.  I know I will never be 100% again due to arthritis setting in (I am 66).  But I miss hiking in the mountains, running with my dog, in line skating, dancing, and probably can't snow ski.  I have tried every exercise in the book even forcing my leg to do things it can't.  I tried massage, chiropractor, and PT to no avail, just a lot of money spent.  I have massaging what seems to be scar tissue at top of my knee cap, where scar is the thickest.  My patella seems like it is stuck, especially if I do sit for a long time.  Surgeon says I can't have hardware removed until April at the one year surgical anniversary!  ANYONE HAVE ANY OTHER RECOMMENDATIONS FOR RECOVERY FROM THIS. 

 















support