Comminuted fractures in both knees patella + femur fractures

[acg]

First of all, sorry for my language. I am not a native English speaker and it becomes hard to write about complicated medical stuff, I did my best. If something is not well explained or you need more information, please ask for it!

I am 25yo boy, used to be quite active: running around 60km/week and going to gym twice a week.

Last 9th September 2011 I had a motorbike accident, crashed by another motorbike in a street intersection (he missed a red light and hit me at 80km/h). The result of the accident was a distal femur fracture, a fracture on the femur trochanter, comminuted patella fractures in both knees and a crack on the third finger of my right hand.

I was quickly driven to a hospital by an ambulance and assisted on the emergency service, where they diagnosed my injuries and stabilized me. They installed a plaster in my left knee and they drilled my tibia to put some weight hanging on my right leg. Then, they moved me to another hospital, where I waited for a weekend with the plaster and the weight on my legs.

On Monday 12th September I had surgery to fix all my injuries under epidural anesthesia:
     - they installed 2 cloves within my femur (one in the distal part and the other in the trochanter) fixed by two screws near the knee
     - they surrounded my left patella with wires, including the 8 shape and 2 nails
     - they surrounded my right patella with wires, including the 8 shape and 4 nails

The surgery was pretty OK and after 2 days I started PT with CPM in both legs. First week I got to 30ºL/40ºR ROM and they made me walk in the gym assisted with crutches. I continued PT, gaining more than 10º per week and being able to walk by myself with crutches at the third week.

At the end of the third week, the doctors stopped heparin and a crop showed up in my right leg (DVT). The OS suggested the crop was already there and it just showed when they stopped the blood treatment. He admitted they did not use a turnstile when operating my right knee due to the femur fractures and that was risky. They started double-dose heparin again for 4 weeks. After, they moved me to acenocoumarol (Sinthrome), initially for a period within 3 and 6 months.

They stop immediately PT and made me lay in the bed for 10 days, getting up only once a day. Then, they allowed me to return to CPM on the bed, for one more week. I was then allowed to get on a wheelchair and start some active exercises with my left knee. After 10 more days, I was allowed to walk with crutches again. Active PT was only allowed on the left knee (besides the CPM on the right leg) for the next 4 weeks.

10 weeks after the accident, I was released from hospital. Now I am going to PT every day and since I left the hospital I was doing pretty OK, but the right knee is not going further at all. I have 120-130º pain-free ROM in the left knee, but only 90º painful ROM in the right. I still walk on my crutches on the street, although I can move without them at home and in the gym. Stairs are kind of difficult and try to avoid them.

My PT says my right knee is blocked by the hardware and said I will be like this until they take it out. My OS looked at the RX and wanted to remove the wires and pins from the right knee (the bone was already consolidated), but the vein surgeon said no surgery on the right leg until Sinthrome is over.

Nowadays my life sucks: I can barely walk with no pain, I can not sit for long time and my knees are ready to fry an egg almost all day. I could live for 6 more months with my left knee, but the right one is a nightmare. Surprisingly, the femur fracture does not hurt too much, way far from the knees.

The PT suggested to gain some strength on the quads and the hamstrings, so I am ready to recover quickly after they remove the hardware, but I feel like working for nothing.

Any help on what can I do to improve the ROM of my right knee?

Any advise for the DVT? Nowadays I am wearing a tight stock (18mmHg) and taking Sinthrome, the vein surgeon said nothing else could be done, but I do not trust him, he proved to be wrong couple of times earlier.

Any comment on what I will be able to do once recovered? The OS said the articular surface of the patella was correctly fixed and I should have no issues to recover my sport life (besides some future arthrosis), but the PT said it could be hard to run again that long with my injuries.

Sorry for this long post, I felt I had to tell the whole story.
Thanks for your help folks

[Suejs14]

I can hardly believe how well you are doing with such massive injuries!  Typically we are not allowed to put weight on a fractured patella for 6 weeks if in the US . . . in the UK they are allowed to put weight on their bad knee very early.  I'm in US and lost an amazing amount of ROM and quad strength because of being immobilized.  I was slow regaining my ROM, but once I was allowed to begin physical therapy I dedicated myself to it and am nearly back to normal a bit more than 7 months post injury.  It was around 6 months when I was comfortable doing stairs up and down without the hand rail -- it took a long time for me to regain quad strength, and I'm still working on it.  I still have my hardware and am at 127+ in ROM -- not sure if I'll need it out, but considering asking the surgeon at the 1 year mark what he thinks.

Re: the DVT - I've had that once many years ago -- the meds help to dissolve the clot, the stockings help to maintain blood flow.  Have you asked whether heat or ice would be a good idea?  Ice on your bad knees is always a good idea, especially if you're thinking about frying eggs on them.  Plus, elevate your legs whenever possible.

Good luck and definitely keep us posted!

Sue JS

[acg]

Well, here in Spain (or at least in my hospital), they try to make us move asap, in (almost) all the injuries they treat. I understand my injuries are quite severe, but I thought I was doing slowly, or at least is what my PT said. I guess the DVT did not help at all on the recovery process.

About the heat around the knees, I ice them for 10-15min after every PT session (I do 2 sessions/day) and at night using cold packs. It helps a little for a while, but not a miracle. What surprises me is I got the surgery almost 3 months ago, but the knees get very hot every day. Is that something usual? I also try to elevate the legs all the time I can, including sleeping.

About the DVT, the vein surgeon talked about something called the post-thrombotic effect but he was not sure if I would have it by now. He said all I can do is to stick to Sinthrome an wear the stock. Does anybody know if I can do something to avoid this effect in the future? I would not like to wear the stock forever in my life.

[Suejs14]

Hi again - here's a link to info on post-thrombotic syndrome. http://www.venousdiseasecoalition.org/diseaseinfo/pts/.  You may be wearing the compression stocking for up to 2 years to prevent this syndrome from happening.

I still use ice several times a week to bring the knee swelling down.  That is much less icing than even six weeks ago - so there is light at the end of the tunnel.  And, there's still lots of ice in your future.  My knee continued to be hot regularly six months after surgery - and if I'm particularly active, it still can get hot.  I have some hardware (2 screws and tension wire) which may be aggravating the tissue and triggering the swelling and warmth.

When I was actively doing 3x a day rehab, I iced a lot.  Most evenings were spent icing for 15 minutes, bending my knee to its limits for 15 - 30 minutes followed by more ice.  Chilly routine, but I'm doing pretty well now. 

Sue JS

[floridanightingale]

GCA, I am SO sorry to read about your injuries. I had a comminuted patellar fx of the left knee, and can only imagine what you are going through right now.  Recovery will be slow, but you WILL heal.  Just take it one day at a time, work hard, and look to this group for support and guidance. This website was a real lifesaver for me.  You are in my thoughts.

Robyn

[sintu]

OUCH! Two broken knees! You poor thing. I got one on the same day as you, 9th September, and that was bad enough....

I hope your recovery is going as well as possible and agree with Floridanightingale about taking it step by step and that you will get through it.

Positive thoughts from me....

S

[acg]

First, thank you all for your support!

I was already mentalized about a long recovery process, but how long is that? Will I be able to go back to the office (that implies taking the subway and walking up&down stairs) before they take the hardware out? How long is worth to be on PT?

No one talked about sports. If they are right and the articular surface of the patella is fine, will I be able to run again? Will I have some troubles with the cartilage or other parts in the knee? Will I have the same strength in the legs I had before the injuries?

Back to the DVT issue, Suejs14, is there something else you did to prevent that syndrome? Is there any forbidden/recommended exercise? How long should I take the anticoagulant meds?

I know I am asking too much, but neither the doctors nor the PT wants to answer any of these questions and I am worried about them.

[Hobbs]

Wow, it sounds like you have been through a lot. And I thought one comminuted patella fracture was bad enough!
I am very sorry to hear about your ordeal!
Regarding healing: only time will tell. The more you read on this site, the more you realize that the healing and recovery process is a very individual one. It definitely is a good sign that your OS is happy with the articular surface. Although it is hard to believe right now, I can imagine that you'll be back to running one day. You should go over to slowtwitch.com for a minute and read some of the injuries those guys have bounced back from. Definitely gave me some hope...

The heat sounds pretty normal to me. I had heat in my knees for a whole year. Even after the hardware was out. Even now I get it after exercise. I am now 14 months post injury and I still ice after any run longer than 5 km. I am continuing to have some swelling now (had HW removed after 8 months). It is still improving and although I don't feel I am back to normal with my running, it is going into the right direction. I am planning to do my first 10k-post-injury race on Sunday. Just have to come to terms with the fact that I'll be sloooow.... But at this stage, just finishing without pain, would be a success.
Good luck to you and keep the spirit up!

[acg]

Just saw my OS in the corridor of the hospital (my PT is in the same hospital). He said we should discuss on Monday whether to go to the theatre for a MUA on the right knee or not. He believes it could help to improve my ROM, since some adherences might be present on the femur and the patella with the quads.

What do you guys think about it? I still have the hardware in and I am afraid they break something important on my leg with this procedure. The PT said he would suggest not do it to prevent all the knee structures besides the patella.

I neither know if the vein surgeon would allow them to go on with this, will visit him on Monday afternoon.

Hope somebody can give a hint if this is a good way to go or not, I feel disappointed and lost with his words today.

[Suejs14]

Hi again,
Re DVT question: I wore the stockings and kept moving (easy to say - I had two good legs/knees).  You should definitely follow your vascular (vein) docs advice on this with meds, stockings, etc. also make sure your knee doc and PT know you have a vein doc and why.  Finally definitely clear any interventions (like MUA) with the vein doc.

I didn't have an MUA, but many on this site have - and benefitted from the procedure.  I understand there's a point when it may become too late to do the MUA (waiting too long).  It seems most docs do it between 8 - 14 weeks post surgery.  I hear they forcibly bend your knee by bringing it towards your chest.  Your quads are pretty sore for a week or so afterwards.  If you have adhesions (scar tissue) forming which restrict your ability to move your knee, it may be a good idea.  I sense you are getting very good care.  I suggest getting your PT's objections and bringing them to the OS, along with a request that the OS contact your vein doc for a consult.

Best of luck!

Sue JS

[debjoe74]

GCA, my os told me 5 weeks ago I was progressing nicely. Then last week he mentioned taking hw out at 4 mos and doing mua. I am presently at 110 rom, 15 weeks post op. I see pt 3x week. I've decided not to do mua and continue w/pt to continue gaining rom. But I have other medical issues to consider. If you're young enough, I would do mua to progress faster. The hw should not be affected. Deb

[acg]

Suejs14, all my doctors and PTs are in the same hospital, so I hope they usually communicate each other. I was scheduled to visit the vein doctor on Monday to control the Sinthrome dose, so I will ask him then about the MUA and insist about hardware removal. About the DVT, I try to walk all my injuries let me and I am on active PY every weekday, should that be enough?

debjoe74, I am not afraid they break the hardware, I am afraid the hardware breaks some tissue in my knee or ligaments or something around. Are you sure that would not be an issue? Moreover, doing a MUA means I have to be in hospital again for few days and then deal with new pain and swelling. Also, we are close to Christmas and for sure I do not want to be in bed for those days.

[Rollerblader]

GCA-

Hi, I've had a mua and benefitted from it condsiderably.  Sue has explained it quite well.  It is very hard on your quads.  Your quad swells like crazy, with your vein issues, I would be very careful proceeding with one.  Most people have alot of bruising...  Sintu's OS wanted to do a mua and when she went over the disclaimer one of the things that could happen was internal bleeding.  My OS didn't go over any dislaimers which I thought was interesting.  If your vein surgeon has any reservations, don't do it! 

Do you ride a stationary bike?  I would ride half way around as far as I could and hold it and then ride backwards and hold it .  A recumbent bike is good because the seat is comfortable and you can sit and watch tv.  I would do this 5x a day for about 8 min at a time.

Soooo sorry you are going through this.  It's an awful injury.

Take Care,

RB

[acg]

Rollerblader, how long would it take to recover from a MUA of the knee? I would like to be ready to sit on the table for Christmas day lunch, would I be OK if they do it someday this week? How long would it take for the swelling to go away? Would I be able to walk from day one or it hurts so much you have to be in bed?

About the bike exercise, I used to to that, but the PT said it was not worth to loose time on that if I could not do the whole way. I do similar exercices with a soft ball and a skateboard, going front and back for 5 mins with each leg. Can do the full movement with left, only ~90º with right.

[Rollerblader]

The mua is really different for everyone.  I only had about 35 or 40 ROM when I had mine.  My OS got me to 120 ROM during the mua, but it took me over a month to get to 120 in PT.  I got in the 70's with help the next day after mua, then I tightened up a little towards the end of the week.  I started on anti-inflamatories a week after the mua, but should have started immediately to keep swelling down.   What happens is that your quads haven't been used since before your accident and the OS forcably bends your leg until the scar tissue breaks through or till they give up.  They give up when they feel if they push too hard, they could injure you by breaking something, like your femur.  My OS said that, typically once they break through the scar tissue, getting it to bend farther is pretty easy.  What happens is that when they forcably bend your knee is rips your quad and another poster Elewis said she felt like she'd done a bunch of squats without warming up.  Elewis has posted her experience under "general questions"  heading (for new threads). Her thread would be good to read.  I think she was about 90 ROM when she had her mua, so she would be similar to you.  You can also read my thread.  I have two, both are under this section, "bone breaks", one is a 4 mo update and the other is more of a diary, starting at 5 1/2 weeks post op.

To answer your question, it's getting close to xmas, so the sooner you have it the sooner you'll feel better, if you wait until a week before, you should be able to sit at the table, but you might not feel like having alot of company.  The pain meds really mess with your appetite and your mood.  The sooner you can get iff the narcotics the better your outlook on life.  Your ROM is much farther than mine was, so it's hard to say how quickly you will feel bettter.  The mua is just really hard on your quad and hamstring.  I ended up bruising about a week post mua on the underside of my thigh.  Until my swelling went down, i had a hard time sitting, putting weight on my thigh when I would sit.  It hurt the underside of my thigh to sit and let my leg hang for several weeks.  My knee hardly ever hurt except in PT.  I went through a period when I could only sleep a few hours at a time, but I don't know if that had to do with the mua.  That was when I was about 90 ROM.

I hop this helps.

Take care,

RB

[acg]

I went to PT today and the therapist said he was not sure I needed that, although it might help sometimes. I did my regular exercises and they added ultrasounds on my knees, since they suppressed the inflammatory meds. After that, he bended my right knee and was happy to see it was around 105º.

He then called the rehabilitation doctor and agreed no MUA was needed. So it seems no MUA for me (yet)

If it helps to others, my OS said when taking anticoagulant meds it might be not a good idea to do a MUA, since the internal bleeding might generate new scar tissues.

[Rollerblader]

Terrific!  It sounds like they are taking everything into account.  Your ROM is gaining also.  My PT's goal for my ROM was only 120...  I wanted to go farther and worked very hard at home, just pulling my leg towards me and I finally measured 133 at PT, but I can get about 145 at home in the mornings before any swelling.  Keep working hard!

Take care!

RB

[Suejs14]

Holy Cow RB - 145 degrees?  Unbelievable.  You are definitely inspiring. 

Sue JS

[Rollerblader]

I've been measuring with my iphone app.  It seems to work great!  It was only one degree off from my PT's measurement.  She was really impressed with the app.  She even called her boss over to look at it.  My knee has been catching when I fully extend or go from a bend to extend and it makes an awful sound.  My OS thinks its my hardware turnbuckle/crimp catching on the fig 8 wire as I bend.  It doesn't hurt, but it doesn't feel secure either.  I'm planning to have my hardware out in early feb, if I don't chicken out.  I'm a little nervous about the scar tissue...  Since I had it so bad before.  Weird, I didn't have scar tissue very bad in my elbow.  My elbow hardware will prob be the same long scar to get the plate out.  . Not looking forward to going back for surgery #3...I guess 3 times a charm!

Take Care Sue and enjoy your golf!

[acg]

This seems like the never-ending story...

The two extra-nails in my right patella started to hurt few days ago. It's a pain I already had for short periods (hours) in the last weeks. However, it seems now is permanent. My PT said that probably one of the nails touches a nerve and hurts A LOT. I can not even touch te area nor pull the hair there without an intense pain. I can neither wear the high stock I should be using due to the DVT, since it presses the area and hurts.

On Thursday, the doctor made me quit PT for 4 days, hoping it disappears. It's been 3 days and the pain is even worse. I can barely lay down with my knee in full extension and it hurts like hell if I move my leg in any direction. I am taking up to 6 metamizole 575mg per day and even tried acupuncture, but nothing seems to stop the pain.

The doctor who did the acupuncture is a family doctor and she suggested that my OS could take the nails out even with Sinthrome. Though, she suggested the best option was to go back to heparin, use some med to block its effect for the surgery and take it again just after.

I will be visiting my OS on Tuesday, but I am afraid he says nothing can be done without the vein doctor's approval. Does any one know how could they proceed, regarding I had a DVT on that leg and I am on Acenocoumarol since October?

Thanks for your help and support, folks

[Rollerblader]

gca, how did your last appointment go?  Wondering if you've gotten any pain relief?

Take care,

RB

[acg]

uh, completely forgot to update, sorry

The os said the patellas are already consolidated, but he said he could't take the wires out for safety until month 6. However, he said the 2 extra pins I have in the right knee could be released if they hurt, which apparently was the case. He even called another doctor used to work also on knees and he suggested the pins should never have been there and my pain is 100% sure from them.

I am visiting the vein doctor on January 2. If he agrees, the os will be taking out the pins with local anesthesia, sedation and a 1-inch incision on January 10. I hope this solve the pain, it is really killing me.

These days I've been home resting most of the time and I did't wear the high stock, so I am feeling better (but still some pain). I realized the pain gets stronger as soon as I wear the stock (I guess it pushes the pins and the patella and hurts), so I spend most of the time laying on the sofa and I don't have to wear it.

I'll try keep you updated if my memory doesn't fail
Thank you all for your support, it really helps to go through this

[debjoe74]

Hi Gca, I was feeling great and then after pt on Friday, during the evening, my knee started to hurt when I walked on it.  The sharp pain is right below the inner part of my right knee. It hasn't stopped either when I am on it. Could ths be a pin? I am four months post op and never had any problems. I am trying to walk around the house w/out crutches but I still use 1 when I go out. Now with this pain, I've been using 2 crutches again. I was just wondering where and how the knee hurts when a pin shifts. Anyone's experiences would be appreciated. Deb

[acg]

the promised update, i did not forget!

went to the vein doctor, he said my leg looked surprisingly good. he reduced the acenocoumarol dose and in a week he will make an Eco-Doppler to see the vein. If everything is fine (either the crop is not there or it is already integrated into the tissue), he would move me back to heparin and allow the os to remove the pins and make a MUA on my right leg

deb, in my case is not the pins shifted, in the rx they are still in the same place. the os said when the swelling around the knee goes away and you start bending over 90º, the hardware often hurts. is your knee still swollen? how is your rom? currently I am resting home (not going to PT) and the pain only appears when I use the compression stock.

[debjoe74]

Hi GCA, my rom was 121 last Tues and then on Fri the pt did intense strengthening. My hip hurt that night, but the next day I was moving around a bit more w/out the crutch and that's when my knee began to hurt and burn. It's my right knee just on the inside. I have wire and 2 pins. There's also a lot of cracking when I sit and stand. There is no swelling but it only hurts when I am standing on my leg. I am going to call the os tomorrow but I definitely do not want to do pt. I just saw the os last week and everything seemed fine. I am just 17 weeks today post op and was hoping to get to  6 mos for removal. I try not to be intimidated by the os, I am in my fifties, but these drs somehow make you feel like a wimp. I hope you're feeling better. Deb

[acg]

quick update with great news after the eco-doppler: no more crops in my leg, DVT is gone ^_^ anyway, i must stay with Synthrome for 2 or 3 more months :\

today my OS was supposed to talk to the vein doctor, so they agree how to proceed to remove the two pins that hurt, hope tomorrow I'll know something else.

btw, my PT assured a MUA was also waiting for me if I was going theatre. Do I have to stay in hospital for few days after that or can I go home the same day?

[acg]

Finally the pins are going out next Tuesday! Also they will totally bend my knee so I can go on faster on PT.
The doctor said I have to be in the hospital from Monday to Friday, so another boring week Hope this makes the pain to go away and recover better from this nightmare

[floridanightingale]

Awesome news. Happy New Year, and Happy Healing. The hospital stay will fly by and you will be feeling so much better when the pins come out.  Best wishes, GCA

[Rollerblader]

gca,

Congrats on getting to get your pins out.  I know they have been causing you pain.  I'm not sure how the do the MUA when they take the pins out.  Usually with a MUA the OS has you start bending right away, some get put on. a CPM machine.  It seems like when they take the pins out with a MUA the OS doesn't schedule PT until sometimes 2 weeks after the removal.  Do you know if you are going to have a cpm while in the hospital?  I'm sure your OS is going to be watching you closely while you are in the hospital.

Good luck!  Keep us posted.

Take care, RB

[acg]

hei all,

Writing from the hospital. Finally the pins (and so the pain!) are gone and my right leg is bending MUCH better after the MUA, although the staples hurt a little

They did the surgery on Tuesday morning and I was walking and on a CPM machine on Tuesday afternoon, getting to around 120º ROM pain-free (before surgery I was getting to 100º after some exercises and with pain). As I said, little pain on the wound and some swelling on the knee, but not on the quad nor in the patella

OS said I should stay in the hospital until Friday so I can be on CPM as much as possible, but I am feeling positive Now it should be less than 2 months to say goodbye to all the hardware I still have in both knees, hope it's gonna be easier to stand without pain

[Rollerblader]

That's fantastic!!!  So happy for you!  Sounds like the MUA was the right thing for you!

RB

[Suejs14]

Hey - I LOVE good, happy, successful posts!  So glad your vein's doing well, your extra (painful) pins are gone and your knee is bending . . . but mostly that your pain is zipped!  Congrats - and enjoy!

Sue JS

[acg]

Before leaving the hospital, I reached the CPM limit, which was 125ª, with no pain.
I am now going on with PT and it seems it works pretty fine. I can bend up to >125º sitting and I can use the static bike (which I couldn't use before the MUA). Only problem is when the PT makes me lay face down and bends my knee. In that position I only can bend the right knee to 90º and when he pushes further, it hurts like hell. Does that happen to any of you?

[debjoe74]

Dear Gca, RB, Sue, and all Kneegeeks, I got the ok today from the os for hw to come out. I am going to wait 2-4 weeks to schedule surgery since I'm only 5 mos. postop. But it's happening! Deb

[floridanightingale]

Awesome news, Deb:)

[acg]

Quick update, 5 months from the accident today.

I started to go to the pool this week, trying to recover my devastated quads. In the water I can raise straight my legs and can walk easily (no limp!), the doctor said it should help to cheat on the brain make him no to forget how to do these movements. I also try to swim crawl, although it hurts when moving the legs. Today I swam like 25 pools, I walked for another 15, plus the leg exercises.

Did anyone of the shattered-patella club go to the pool? Did it hurt at the beginning? Did it helped to improve? Which exercises should I do?

I keep going to PT daily. I can touch my bottom with my left heel when lying down, ~110 with right one. Both legs still hurt when walking, but walking up stairs is easier now (going down is still a nightmare , that's the reason I still carry a crutch).

My OS said on the last visit I should consider waiting for a year now to remove the hardware: he believes I can have a regular life (he said even running!) with the pins and wires and wants to wait to remove the hardware on my knees at the same time he takes away the Küntscher rod in my femur. I really think he's gone nuts, it's gonna be 6 months soon and my patellas are already healed (he said so when watching the last RX 3 weeks ago), I want it out ASAP!

[acg]

6 months now and good news, I think there's a light at the end of the tunnel

PT is going quite well, just today I reached my back with my right heel when lying down, so now I have full ROM in both legs. Anyway, the right one feels like stiff when walking. Little pain in both knees, the PT says it is the hardware. Working on the quads with some limits due to the hardware, the pool really makes the difference (how come I didn't start earlier?) here.

Best news is my hardware is finally going out on April 10. That would be 7 months from the accident. Hope after that, I can recover much much better and faster I am also getting rid of a chip of my right femur which was not reduced with the intramedullar rod and hurts on the quad.

About the surgery, how is gonna be the swelling? Does it hurt when bending? How long after walking? Remember I have both knees damaged, so I am afraid it might be hard at the beginning, would like to avoid going back to wheelchair and this stuff...

[acg]

I've been willing for too long to post this message, but finally the hardware in my patellas is gone, forever!

I've been in hospital for 4 days. The surgery day I was not allowed to get up from bed (mostly because I was under spinnal anesthesia), but from day 2 I was allowed to walk around as I tolerated. Both knees little swollen and very stiff (because of the wound), but I already feel the difference! I believe they start to be my knees again, they are back

Doctor and PT said I should rest until monday at home, trying to bend as much as possible and ice it continuously. Be back on PT next week, can't wait to start again and recover finally from this nightmare

[floridanightingale]

Wonderful, WONDERFUL news, ACG!!!! Wooooo hoooooo! H/W removal surgery is a piece of cake compared to the surgery when the put it in, isn't it??  I felt a difference right away, too. It will only get better from here.  The first couple months were a little tough for me, mostly because I was afraid I would fall and reinjure myself, but it really is such a joy to feel like you are well on the road to recovery.  I am one year post-accident (comminuted patellar fx), and am doing well. The first few months after the HW removal surgery, I took it pretty easy--long walks, light exercising, a little swimming (my surgeon actually told me not to run until the 1 year mark).  Finally, about 3 weeks ago, I went for my first jog. I only made it half a mile, but now I am up to 1.5 miles (which I follow with a 1.5 mile walk).  The jogging has been the best thing for my knee. It is helping with the stability and strength, and believe it or not, it has helped a lot with the stiffness and residual pain.  I will not be doing any strenuous hiking this summer, but I plan to be back on skis next winter and hiking vigorously the following summer.  This injury is a reall a** kicker, so ACG, I commend you for soldiering through double the trouble, and getting through to the other side!!! Congrats, and HAPPY HEALING TO YOU!!!

~FN

[acg]

Hey there, almost 10 months post ORIF. Still off work and limping, going to PT and the swimming pool every day.

Left knee is fine: I feel it like irritated and it feels stiff when walking. Stairs are way better, even going down. Can kneel on this knee on soft surfaces. The quad is getting better, but still weak. Absolutely full ROM, pain free, except for rigidity when walking.

Problems show when talking about right leg.

The femur fracture is well healed but the rod was covered by bone in the insertion point, near the hip. That makes me limp and hurt on the hip, as if something is nailing in there. Doctor said nothing can be done until the rod comes out (which will never be earlier than 18 months since the ORIF) It really hurts going up stairs and in some exercises during PT.

The knee on that leg still hurts: can't kneel on it and it hurts when I press it. Almost full ROM, although the quad is very very stiff, can't touch my back with the heel by myself (I can if PT does it). It also hurts going up stairs, still can't go down using this leg Moreover, the rigidity in this leg is even worse than in the left one.

It's been very long since I had my accident and still on pain. My OS says the right knee is fine, so nothing else can be done on it. I struggle myself everyday on PT, but neither the right knee pain nor the stiffness in both legs seem to progress.

I was wondering if something similar happened to any of the shattered patella club members or if anybody could put some light for me here.

Thank you folks!

[acg]

Been away for a while, bad news bringing me back Started working on september 2012, but never back to full-activity life.

Had surgery on mid december 2012 to took my femur rod out (15 months after first ORIF). It solved the hip pain, which is much much less than what it was. Getting better of this every day it lasts Muscular tone in the gluteus helps.

However, very bad news from knees. They both still hurt, specially the right one. Quads and harmstrings are almost to the same point they were prior the accident, so more PT was not helping at all. Going to the gym 4 times a week, light cycling and no quad exercises at all (forbidden by rehab doctor).

My OS was not paying much attention to my case and refused to do anything else, so I needed another point of view. New OS ordered an MRI, said never to give a diagnostic without it, while first OS always considered it unnecessary.

Just got the MRI results: grade IV OA in BOTH patellofemoral joints and inflammation on the left patellar tendon.

The new OS will be visiting me next wednesday, but pretty freaked out. Las visit he said it was a hard case and not much could be done. He talked about cortisone shots, hyaluronic acid shots or patelofemoral joint replacement (sic, I'm only 26!!!), but insisted to first see the MRI. He said PRP shots do not work and he won't do it.

I will be also visiting a 3rd doctor in 2 weeks now. Hope some of the new ones could help on pain relieving.

What can I expect? Do I have any good option?
Any help is appreciated ^_^