The patello-femoral joint :

Ruptured Patellar Tendon Surgery - - Posted by EngKnee (EngKnee), 8 April 2004

Last week I ruptured the patella tendon in my left knee and as you all know my life has changed since that happened.  My surgery is scheduled for Monday AM and I feel confident in my OS as he has had 27 years experience in his field.  He told me that I would not be able to put weight on it for three weeks after the operation and that I wouldn't be able to start bending for six weeks and that's with the aid of a motion brace.  This is NOT arthoscopic surgery, he will have to cut and drill four holes in my patella to fasten the tendon.  How much pain should I expect to be in?  How long will it last?  Will I ever be able to go back to normal?  Is this a routine type procedure?  I would like to converse with folks out there in cyberspace who have experienced this particular surgery and how they made out and any advice they might have for me going in.  John
Posted by Janet (Janet), 9 April 2004

John:

Good luck as you start on your knee journey. A ruptured patella tendon is not a fun injury (as I'm sure you've already figured out). I had a similar injury, a ruptured quad tendon (which is on the thigh side of the patella). In my case, I had open knee surgery to repair the tendon. I was in an immobilizer for about two and a half months, then went to a hinged brace. But during that time, I was weight bearing after the first week or so. I started PT at about three weeks post-op. I didn't return to work for about 3 months (I have a desk job), but then only for a couple of hours per day. I didn't get back to work full time for about nine months.

If you go to the top of the page and do a "Search" for patella tendon (or similar search words), you will find others here who have had your injury. I know I was told that it would take 12-18 months before I "forgot I had an injury." But I had complications and it has now been five years, I have had four surgeries, and my knee will never be normal. I would not expect that to happen to you. Just remember that the people you talk to on this forum are usually ones who have NOT had a smooth recovery. Good luck!

Janet
Posted by EngKnee (EngKnee), 9 April 2004

Thanks Janet, I sure hope I don't have similar results to yours as it sounds like a living hell that you've experienced.  My OS hasn't given me the least impression of this outcome which has me worried a bit.  But it may be that it is a completely different set of circumstances in that my tendon is the lower one and it evulsed from the knee cap itself, not sure if that has any bearing on it or not.  I sure hope my recovery is more timely than what you experienced for I will have to go back to work at some point in the next year I'm sure.  Thanks for letting me know how to find stuff on this board, I appreciate it very much.  I will let you know how it turns out if you want, I am looking forward to recovery as this injury is very painful while in limbo. John C.
Posted by Nigel (Nigel), 11 April 2004

Hi EngKnee, just read your posts about your patellar tendon repair in last few days. Hope it's going well post-op. I ruptured mine completely one month ago, below the patella. I'm 45, about 165lb. Was repaired in France (I'd been skiing there), with neutralisation wire loop put in. I'm now back home in UK. French rehab protocols seem more conservative than here...French surgeon wanted NO motion for 4 wks then very gradual passive movement. But Brit ortho consultant prescribed physio from 3 wks and I've quickly managed to get to 90 degrees passive flexion. Subjectively, I'm really glad I've been able to get moving early rather than waited 4-6 weeks when I'm sure everything would have locked solid. Very little pain now and starting to put a little weight on the leg (not supposed to, though!). I'm feeling optimistic about outcome although I know it will be frustrating when I get into the real PT phase. Hope that encourages you at the stage you're at, let us all know how you're getting on. What kind of work do you do (or is the user name a giveaway)?
Cheers! Nigel.
Posted by EngKnee (EngKnee), 11 April 2004

Nigel, thanks for the reply to my post, yours was encouraging and I will try to experience it too with the help of the OS and god.  I go under the knife tommorrow morning and don't expect much to happen for at least a week or so since I won't be able to move the knee or put weight on it for at least three weeks per my Docs orders.  I consulted another OS staff and they indicated two weeks would be enough so I guess it's open to interpretation as to the length of incapacity or maybe its the method by which each OS performs the surgery, not sure which.  I will keep this thread alive with my progress and anyone else who can share similar experiences please by all means contribute.  My OS has not recommended any PT post op but did say he would give me exercises to perform in order to regain strength in my knee, time will tell on that.  Best wishes, John C. aka engknee
Posted by EngKnee (EngKnee), 11 April 2004

Nigel, sorry I didn't answer your queries, I do work as an engineer aboard ships and don't expect to be able to work anytime soon also I was wondering what exactly a nuetralisation loop wire is, it's purpose etc., I'm not aware of that terminology.  My OS has told me that he would drill four holes in my Patellar, (kneecap) and attach the tendon with screws, not sure if it's four tendons or just one  screwed four times for extra strength. Any ideas? John C.
Posted by Nigel (Nigel), 12 April 2004

John: in my case the neutralisation device is a wire loop. One end goes through the patella and other goes through the top of the tibia (shin bone). It's to keep pressure off the tendon while healing. Looks like a bit of old fence wire on the xrays, but seems to work. Will probably need to be removed at some stage.

Sounds like your repair might be to a rupture at the patella end of the tendon rather than a mid-section break? Presumably several screws necessary as the tendon is quite wide where it meets the patella. But maybe the gurus can enlighten!?

I'm finding the swelling and stiffness decreasing daily. Ice and elevation in the evenings (when swelling is worst) helps a lot. Also massaging the knee to loosen the skin tightness. Got 100 degrees of flexion this morning! (op+4.5wks).

I have a desk job so I've been back at work since op+1wk - commuting into London has given me a lot of practice on crutches, there are an amazing assortment of stairs and obstacles on our ancient Tube (underground railway) system.

Anyway keep in touch and good luck!

Nigel in UK
Posted by EngKnee (EngKnee), 13 April 2004

Thanks Nigel, I am back at the school where I'm staying to finish a course started before all this happened.  My surgery went well, no complications were revealed to me so I assume none happened.  The rupture ocurred exactly where you assumed and four holes were drilled for that reason.  My leg is elevated with ice being applied, not sure how much good it's doing since there is quite allot of dressing over the incision for the cold to penetrate.  I had a great dinner tonite as the food in the school's cafeteria is fantastic and I feel absolutely great, what a relief!!!  My OS set me at ease before the surgery downplaying the procedure as pretty routine and also shared with me that I should have 100% movement and confidence in a four month period, that doesn't sound so terrible.  I'm very lucky to be at the school at this time since at home I live alone and it would be extremely difficult for me since I can't drive, here no worries as everything is being attended to.  I hope the worst is over and I can get on with my healing.  Keep in touch and keep the faith!  John C.
Posted by Nigel (Nigel), 14 April 2004

John, fantastic to hear your op went well, and you sound in good spirits. Don't worry if you have some down days (or weeks!) too, I've had a couple. Just take it easy as you can meanwhile.

I can well believe you'll get 100% recovery. Our kind of injury/repair, although a major op, seems pretty straightforward compared with some of the things I read about on this board. My PT was very pleased today as I'm up to 125 degrees ROM after 5 wks - 135 is considered full range I think? - although still not allowed to start any active exercises or weight bearing until 6wks when the brace comes off. Maybe that's when the fun and games will really start.

Good luck with yours!

Nigel
Posted by EngKnee (EngKnee), 14 April 2004

Nigel, you were right about good days and bad days last night was a tough one for me as I think I overdid it on my knee and boy did it let me know.  Swelling and pain increased as I was going in the rack for the night so I remembered to elevate the leg with a pillow and put more ice on it so I could at least get some sleep. Today much better but I won't be taking anything for granted any more.  the wire loop you have in yur knee, do you have to have that removed? I think yur ROM is fantastic and I only hope to have that kind of motion in the weeks to come.  I have to go back in about 8 days to get the staples removed, nothing until then just rest and elevation I guess.  What kind of pain medicene were you on?  I'm on percocet 5 mg and it's not very strong, at least not last night it wasn't, I've been eating them religiously every four hours and it helps quite allot.   The weather here is bloody awful, almost as awful as the speech by our president bush last night, that's enough to make you sick.  Hope all is well with you. John C.
Posted by Rosbif (Rosbif), 15 April 2004

I completely ruptured my Patella tendon (mid) at the end of January. Was able to put some weight on it a few days after the op and bagan passive flexing on a CPM machine at the same time. Think that was the key to getting good ROM.

went back to work after 5 weeks. before that it was just too painful.  Still having problems at work with my kee swelling and muscular problems due to my leg being straight out all day. Think this is because I was given the cheap option of a lightweight removable cast. Think a hinged post-op brace would have been better, but I didn't have the choice.

Now 11 weeks post-op with good ROM (don't know how much) and just 3 more weeks to go before i can finally get rid of my immobilisor.  

Things do improve. I'm now walking at home without my cast. The key to recovery is doing you PT exercises to get your quads going again. Don't give up, at first nothing will happen, but they will come back.
Posted by EngKnee (EngKnee), 15 April 2004

Rosbif, misery loves company I guess, I think it's great that we all can share our experiences here on this bullletin board, it's so helpful.  I see you are from Germany and I find it very interesting that methods of recovery do vary somewhat dramatically between docs.  I am not even a week post-op so I don't have any experience to share on recovery just yet but I do know that you have to keep it elevated and rest it as much as possible during this critical time because the more I try to do the more pain I have to endure, so it's all about rest and elevation at this point for me.  I have been told I have a four month recovery for full range of motion and confidence which in my line of work is very important.  Sounds like you are doing well despite the cast and are on the road to full ROM, good luck. John C.
Posted by Rosbif (Rosbif), 15 April 2004

I certainly wouldn't recommend the German system (I'm English working out here). I had to wait 4 days post-op before I spoke to the OS to find out how it had gone. This only hapenned coz I pestered the nurses.

I would certainly recommend getting a CPM machine at home (if your OS allows this). This really made a big difference to me.

i'm just hoping to get back playing hockey by Autumn.

hope your recovery goes well

Tony


Posted by EngKnee (EngKnee), 15 April 2004

Tony, not sure what a CPM machine is?  My doc hasn't talked with me either post surgery so I have to assume that all went well but it could be that he was on vacation when he performed the surgery and hasn't gotten back to the office yet, I'll have to inquire soon to find out.  Is this machine something they have in the US?  How much does it cost to rent or do you have to purchase one? John C.
Posted by kdhfrank (kdhfrank), 16 April 2004

John

I too ruptured my patellar tendon (or should I say my ex OS did it for me), yep...he snapped the sucker in half and told me 4 days later! my recovery has been long and somewhat grueling due to massive amounts of scar tissue in the joint...the new OS that took over my care was able to somehow repair the tendon damage...I dont think I have a wire loop, but he did drill holes and ran sutures through. I spent two weeks in the hospital due to this mess. I then spent 10 weeks on a CPM set at 45 degrees (that is the level of bend my knee would tolerate post repair in the OR before everything fell apart) I was not to contract my quad at all for 10 weeks and had to be non weight bearing on that leg...I also had to wear a knee immobilizer at all times when out of bed...even in shower. I am now 5 months post op, I go to PT weekly and swim 1 to 2 miles every day to increase my quad (it turned into a rubbery blubbery mess) because my knee will not bend past 45 degrees (this will be operated on by a arthrofibrosis specialist in June). My leg no longer hurts like it did but still feels weak and achey after standing for long periods of time. I returned to my job part time at 12 weeks post op and will stay at that level till scar tissue is removed in June. Post operatively I had no complications from the surgery although I do think I have some sensory nerve damage on the area below the scar. The scar has healed nicely (8 inches) and I dont experience much swelling now. Pain during the 10 weeks post op was a challenge though. Worked my way through demerol, loratab, and ultracet. I was also on bextra which I continue to take daily. Otherwise no pain meds. While I dont know the specific protocol for care post op as patellar ruptures are very infrequent, I do know that passive ROM on CPM was important as was protecting the repair by not actively contracting the quads. Dont overdue it as this type of injury truely needs time to heal...will give you plenty of time to use your laptop in bed and watch CNN (my choice for news as my feelings politically echo yours). I did experiece frustration at trying to make it to the bathroom when I really had to pee bad though, and straight legging it on the toilet is an obstacle you are probably wondering how to get around (there is no way). Anyways, take it easy!!!!

Kim
Posted by EngKnee (EngKnee), 16 April 2004

Kim

Thanks for the post and the encouraging remark to me and my stubborn-self.  I'm sorry to read your story of the bad OS and subsequent long recovery period and restricted ROM, hopefully not permanent.  I still haven't talked with my OS to see how the surgery went but I should  see by his orders that he doesn't want to see me for 10 days to remove the staples, duh, so it's probably alright.  I've had similar experiences going to the bathroom in the middle of the night, some nights on an hourly basis or so it seemed in my blurred state, haven't had an accident yet.....I have been going to class in a wheelchair with the left leg elevated and that was cleared by the OS so I guess it's ok.  Good Luck and keep in touch. John C.
Posted by Rosbif (Rosbif), 16 April 2004

Hi John,

a cpm machine is a Continous Passive Motion machine. It bends your knee for you without using the muscles. this link explains it better: http://www.bupa.co.uk/health_information/html/healthy_living/physical/knee/rehab.html

You can rent them. Think here it cost the equiv of $20 per day, but my insurance covered it. You only need it for a few weeks, just until you are able to bend you knee easily yourself. You really should ask your OS about getting one as it is essential for getting good ROM back.

By the way, how did you rupture your tendon?

hope this helps.
Posted by EngKnee (EngKnee), 16 April 2004

Tony,  Thanks for the info per CPM machine I will talk with my OS about it if I can ever get ahold of him.  I got my injury while thinking I could play some harmless pick-up basketball on a rubber surface, ie an unforgiving surface.  I was just dribbling the ball down the court and trying to be cool by not paying attention to my feet and looking around the court for someone to pass to and then Wham!! all these thoughts went racing thru my mind at once but I knew by the sound of crunching walnuts that it was more than a sprain, then I observed by kneecap being out of its traditional place and hole instead, I knew I was done playing for awhile.  John C.
Posted by Nigel (Nigel), 16 April 2004

Kim, we "tendon team" all sympathise with you, you've had a ghastly time. I can now see why the OSs (especially my French one, and to a lesser extent the Brit) stress keeping the immobiliser one for 6wks+. I've been a bit naughty this week taking it off in the office for an hour or so at a time. From here on I'm not tempting fate!

For me pain relief hasn't really been a big problem since about week 2. In the UK all the over-the-counter painkillers are combinations of aspirin, paracetamol (=Tylenol?), ibruprofen and lastly codeine which is a bit stronger but causes constipation!

By the way, how did the rest of you bust your knees? I was skiing, just hit an icy lump a bit hard in a turn and it went snap. But I'm pretty sure it was a result of a bang below the knee about 20 years ago while I was in the Army. I thought I had it finally cleared up some years back but from what I've read you can build up "microtrauma" to the tendon which finally causes the failure. A healthy tendon takes 17 x bodyweight to break. Apparently once you turn 40 you're more likely to break the tendon above the patella but still in my case (I'm 45) the previous injury was below so that's where it broke.

Here's to quads of steel for us all by Christmas!! What about a "before and after" competition?

Nigel
Posted by EngKnee (EngKnee), 18 April 2004

Hey Guys and Girls how's it going?  Not much in the way of activity lately so I figured I'd ask the burning question that we all wanted to ask, that is, how do you take a bath with a knee that doesn't want or can't be moved?  Since my injury on Mar. 31st, I've had two assisted baths, just two!! Of course I've given myself the ol "spit bath" where you just wet a wash cloth and wipe yourself down along with the occasional shampoo session daily but an honest to goodness, feel fresh and clean bath, naaah!  I've had to enlist the help of a long-time friend's wife who just happened to be a nurse, to help me with my now weekly ritual.  The fact that she's a nurse helps to keep embarrassment to a minimum and then only the first time, now I have no reservations at all to strip down and amble my way to the tub in front of her since it's all about keeping a pathetic gimb clean.  I'm sure you all have stories about this all-important aspect of recovery, by all means, share it with the group. John C
Posted by Nigel (Nigel), 18 April 2004

Re baths and showers, I managed okay. At first just leaned into the shower and at least got my head/top half done. With crutches was able to get in/out properly (but carefully!) after about wk2....blissssss!!

I think you can shower while the staples are still in (I certainly did) but they say don't get immerse knee in the bath until staples come out?

I stayed out of bath until about wk4, tried but leg was too tender without the immobiliser. But now (10 days later) I'm hopping in with no trouble. A good place to do passive ROM exercises as deepish water gives a lot of support, also a chance to massage the knee with various gunk my wife leaves around the place. Never thought I'd become Aloe Vera Man but needs must.

A week or two and I bet you'll be able to go solo. Sorry!!

Nigel
Posted by EngKnee (EngKnee), 18 April 2004

Nigel, I forgot to mention the most important aspect to my latest post, that is, the stool inside the tub, without it I doubt I would be able to get in the tub at all.  I'll be happy to be able to do it myself thank you when the time comes but until then I will enjoy the kindness of my friendly nurse.  I like it especially when she does my feet, incredible stuff   John C
Posted by Rosbif (Rosbif), 19 April 2004

I ruptured my tendon whilst waiting for a taxi. I was stood between 2 friends, next moment I'm on the floor after some drunk went flying into the back of my knee. think his shoulder connected with my knee. Unfortunately he wandered off before the Police arrived so I can't sue. My knee was around to the side and I couldn't even stand on my good leg as the pain was so bad.

ref showers - I started off with a bin bag around my cast, but after a couple of weeks started showering without my cast and just being very very careful. Luckily I have a very low shower basin.

My hospital was on the most famous gay street in Hamburg.
On my first morning in there a very effeminate male nurse came in with a wash basin asking if I wanted a bed bath. I politely but very quickly declined  .
Posted by Nigel (Nigel), 22 April 2004

EngKnee/John,

Just seen the ortho at 6 wk point. Good news is he's okay'd me to lose the brace, start active PT and go to full WB as soon as I can bear. I've got 130 degrees of ROM which he said is extremely good at this stage. Quads are shot to hell of course which is to be expected...I can't even lift my heel off the ground when I'm sitting down with leg straight out! Amazing.

Only bad news is he said they need to open the whole knee up (top to bottom) again eventually to take the wire out. Bit of a bummer as I thought it could be done with arthroscope. Wire can stay in if it causes no trouble but apparently they often break eventually.

How are you doing?

Cheers, Nigel

Posted by EngKnee (EngKnee), 22 April 2004

Nigel,
Great News except for the extraction procedure which I was wondering about earlier.  Tommorrow I get my staples removed from the knee so that is some progress I guess.  I too have trouble lifting my ankle off the ground when lying down and I was wondering if I am able to try to work that to the point where I can do it more easily lest I can't do it at all.  I'll have to inquire tommorrow about that.  Looking forward to getting out this weekend, plan to go to a Redskin party where I'll be able to oogle the cheerleaders and get my picture taken with the super bowl trophies, big deal for me.  Might even try to sneak a trip back home in WV to check on the house......I don't want to try too much just yet.
John C.
Posted by Nigel (Nigel), 22 April 2004

John - they didn't let me do any active leg lifting until now in case I pulled the tendon repair apart. Maybe another example of different protocols in different countries. I think US medics favour aggressive early rehab where possible and I have to say that might be right for a lot of people. I've been pushing the boundaries of what they've said I can do, and so far got away with it.

I've just tried walking without crutches this afternoon, and I can just about manage it...sloooowly.

Should be more comfortable after your staples come out. Then you can start loosening up the skin over your kneecap.

Redskins? - you in DC, then?

Nigel
Posted by EngKnee (EngKnee), 22 April 2004

Nigel
Yes I'm a hopeless Redskin Fan, I live pretty close to DC when I'm home and now that I'm in Md. on the eastern shore I'm only about an hour and change away from the stadium.  They are having open house on Sat. where we can meet the players, coaches, cheerleaders et al and enjoy Draft day where we get the fifth overall pick from the nation's best collegiate footballers.  I'm looking for big improvement this year with Coach Gibbs coming back and a bunch of talented new players.  I've got to get out some as this knee business is very boring to my usually great social life.
John C.
Posted by Janet (Janet), 23 April 2004

I'm so glad your surgery went well. You still have a long road of rehab ahead of you, but it's great to hear things are going well now. Dont' be surprised if you have good days and not so good days, encouraging days and frustrating days. One day it will all be worth it.

I had trouble in the shower because I couldn't bend my knee at all. After a couple of weeks of sponge baths and washing my hair in the sink, a real shower felt so good! I would just go in with my crutches. I couldn't never take a bath because I couldn't get in and out of the tub.

As for me, I ruptured my (quad) tendon with a simple fall on a wet floor at work. I went down in a hurdle position with my leg bent behind me. I was able to get up and walk with pain, and I think I tore it all the way when I tried to go downstairs to get to my car. I'll never again laugh at those stupid commercials: "Injured in a slip and fall, call (some attorney)"!

Janet
Posted by Rosbif (Rosbif), 23 April 2004

Nigel,
Not being able to lift your leg straight up is a little alarming at first, but after a couple of weeks of PT you'll be able to manage it no problem. I'm 12 weeeks post-op and now gradually increasing the weight in my ankle weights for the straight leg raise. Although I still have to wear my immobilsor when not at home. Seeing OS on Monday, so hoping I can get rid of it.

Pity about the wire removal. My OS used a dissolvable wire, so no need to go in and remove it. Apparently it should dissolve completely in 3 months.
Posted by EngKnee (EngKnee), 23 April 2004

I wonder why on earth one doc would use a dissolvable wire and another would use one that doesn't so he has to go back in there and remove it, doesn't much make sense to me. Maybe they have an explanation of  it that would satisfy even the harshest critic. I go to get my staples removed today so maybe my doc will let start doing something except what I'm doing which is absolutely nothing.  This helpless feeling has got to start to go away or I'm going crazy    My class here in Md. ends in two weeks at which time I'll have to figure a way to get back home to WV. that should be a royal inconvenience to somebody close to me.  Hopefully someone will have the day off so they can come and rescue me.  When I get home I'll have a whole bunch of new obstacles to hurdle in that I live in the country and I won't be able to drive. This should be fun.  John C.
Posted by Rosbif (Rosbif), 23 April 2004

John, before my surgery a junior doctor told me they would have to remove the wire after 3months. However, when I spoke to the OS after the surgery, he told me that he had used the dissolvable wire so that wouldn't be necessary.

I know all about inconvenience. I live on the 4th floor of a 100 year old apartment building. NO LIFT . The quads in my good leg are now huge from going up and down all those steps with my immobilisor on. Think when my immobilsor comes off I'll be walking in circles.
Posted by EngKnee (EngKnee), 23 April 2004

Rosbif aka Kim I think,  That is incredible what you've endured on crutches, I can't even imagine trying something like that but if I had to I guess I'd just do it like you did, amazing stuff.  I got the staples out just a couple of hours ago and was fitted with a new adjustable brace, set at zero of course, so I feel like I'm finally making some progress.  Also he surprised me by saying it was OK to put weight on the knee as long as its straight, so far I haven't really put much on it because I'm not used to doing it yet but I will try a little at a time until I feel comfortable. It feels abnormal to put weight on it now, imagine that.  Little steps add up to normality I hope.  The tough part for me now is to try and not put on any extra weight as I'm not doing any exercise to burn it off.  I'm sure I've put on at least 10 pounds in the last month and I've got to stop having sweets like ice cream and brownies.  Now where is my nurse I need a bath badly. John C.
Posted by Nigel (Nigel), 23 April 2004

I LOST weight post-op, I think it was being out of reach of the snacks for a while!!

John, I too was chewing the carpet at your stage at not being able to get about. But within a week or so of that I found I could get in my wife's car and, (a) because it's an auto transmission (unusual here in UK) and (b) because it's my left leg that's hurt, I could actually drive it! Well at first I couldn't because it was just too uncomfortable, but by slackening off the top straps of the immobiliser and tilting the seat forward I could fit. Hope you have the same experiences.

Rosbif, what exercises did they give you for quads (and which do you think worked best)?

Nigel



Posted by EngKnee (EngKnee), 27 April 2004

 Hi All Hope everyone is doing well, at least as well as I am today   What a difference a day makes, last fri. I had the ol' staples removed and the Doc gave me the goahead to put weight on the leg so I very gingerly took his advice and started to put some weight on it, it felt real stiff at first, as to be expected I guess.  On Sat. I went to the Redskin Draft Party at the stadium near DC and I walked and walked and walked to the point where I was tired but didn't feel the least bit of pain at that point, so I walked some more.  All told I probably walked over a mile, all over the stadium, the field, the parking lot for over a five hour period, I did rest some but for the most part I was on the go all day.  It was tough to keep up with the cheerleaders but I tried my best  On Sunday I woke up early expecting alot of pain and discomfort and lo and behold I felt great!  I then took Nigel's advice and tried to get into my Truck, very gingerly at first but I did it and it felt absolutely wonderful to be able to go somewhere on my own for the first time since Mar. 30th.  I was fitted with the adjustable brace this time set at zero position and will have to keep it at this angle for four more weeks until end of May.  The Doc didn't recommend any exercises at this time but I feel like I could probably do some but haven't tried too much yet.  Life is good again!  John C.
Posted by Rosbif (Rosbif), 27 April 2004

Good Morning, Unfortunately I injured my right leg so driving is out. Also I drive a manual so it wud be a bit tricky. Think I really got a bad deal with having a cast instead of an adjustable brace. Spend half the time in my physio sessions just trying to release some of the tension from the muscles in that leg, from having it straight all day (now for 13 weeks).

For quads I'm now doing a lot of straight leg raises with ankle weights. Full arc extensions are still a bit too painfull and difficult. Hope things will improve after the end of this week when I remove my cast for the last time.

Rosbif (Tony)
Posted by Rosbif (Rosbif), 29 April 2004

Will finally take my cast off for the last time tomorrow.

Saw OS on Monday. He had a look at the knee, got me to walk a bit without the cast and said it was ok to get rid of it. But then looked at his notes and saw that the OS who did the op, had put 14 weeks post-op with cast (until 6May). So the OS changed his mind and said keep it on.

Its really a bad system here in Germany. I wasn't able to choose the OS coz it was an accident and was taken to the hospital by ambulance. But you cannot see the OS who did the Op after you leave the hospital. The new OS didn't really seem interested, I guess because he didn't do the op.

Anyway I've had enough of wearing the cast   and its coming off.
Posted by EngKnee (EngKnee), 29 April 2004

Way to go Tony, there is hope after all.  My new found freedom is great but my knee still looks terrible, all hard, swollen and numb to the touch, is that the way your was?  I walked all about an old Coast Guard Cutter today in Balt. while on a field trip with my class and was able to get around pretty good without crutches, just the slow careful limp.  My leg looks wierd with my calf muscle almost nonexistent and flab on my thigh up to my rock hard knee, looks totally different from the good leg.  It's still great to be driving though, will try to get home to WV this weekend to check out the homefront. John C.
Posted by Nigel (Nigel), 29 April 2004

Hi Tony & John, glad to hear everyone gritting teeth and looking forward to being brace-free. I've been a week now - they said I should wean myself off it but I threw it straight under the bed and there it stayed. Been to the gym and doing static cycling and rowing machine, quad muscle tells me "you're having a laugh, aren't you?"

Just had this snippet on an email from an old family contact - I told him about my knee and here's what he sent back:
Posted by Nigel (Nigel), 29 April 2004

...continued (sorry hit the alt-s by mistake!):

"I remember my grandfather showing my sons his left knee cap which was liberally spread about his knee. As they marvelled over this he told them that he had been kicked by a horse when he was twelve. They asked what he did next, to which he replied "Went on to school - couldn't afford the doctor". Tough or what? The strange thing was, even at 89 years of age, that knee was completely mobile with no hint of arthritis. Perhaps we should all be kicked by a horse now and again!"

Best, Nigel
Posted by Rosbif (Rosbif), 30 April 2004

Hi John, yes my knee was very swollen and numb for quite a few weeks after my op. Still a little swollen and a small numb area, but it has improved a lot. My quads turned to mush but didn't have any problem with the calf muscle.

Did u have any luck getting hold of a CPM machine?

seems you a lot more mobile than I was at your stage.
Posted by Nigel (Nigel), 30 April 2004

I suppose none of us are going to win beauty contests at this stage. My knee seems to stick out further than it should and when I get tired it feels like the kneecap is overhanging and, well, drooping. I wonder if that's because the quad muscle isn't strong enough to keep it held up? I did some static cycling and rowing yesterday evening and this morning knee felt really good and tightened up, but this evening..drooping again! Anyone else the same?

BTW can't do straight leg raises at all yet, let alone with weights!

Nigel
Posted by kdhfrank (kdhfrank), 30 April 2004

Nigel

actually i must admit...my scar is quite beautiful...for a scar. thought for sure it will be ugly with a zipper like appearance from the staples...but alas, it is very nice, almost invisible...(i am a nov. 03 patellar tendon rupture done by the hands of my old fired OS)...anyways, yes my quad is still mush compared to the right leg yet i am limited in what exercises i can do until my arthrofibrosis procedure is done in june. i think (as explained to my by cincinnati sports medicine) that quad atrophy does cause the knee cap to ride lower due to the shortening of the patellar tendon. it was stressed to me to get back in the water (i am a recently retired competitive swimmer) as kicking with fins will help build up the quad and keep the knee cap from being pulled lower (this is called patellar baja)...seems the expert on this is heather m. on the forum...you can usually find her posts in the soft tissue healing area. my pt also told me of an exercise to build up the VMO. take a small ball and place behind the knee and stand against a wall (heels to the wall) and press back into the ball...you will feel the burn...great exercise and low impact...i would take it easy on major flexion exercises and high impact so as not to cause further problems if your knee cap is riding low...hope this helps!...i can feel my quads getting stronger daily by swimming 1 to 2 miles every day...and yes i could not do straight leg lifts at first either...and then it just happened!

kim from atlanta
Posted by Nigel (Nigel), 30 April 2004

Kim, thanks, that's really interesting. Not sure what the VMOs are but I gather part of the quad muscle?

I've been lucky enough to get back good ROM (now virtually full) quite quickly post-op, so that has tempted me to start high flexion exercises like rowing machine - but maybe I should take it easy on that. My PT recommends slow static cycling with the seat height set slightly low and a high-ish resistance setting to work the quad. I'll definitely try that ball-against-the-wall trick (if I can find one the dogs haven't chewed). I can believe swimming would be good, it's just never been my thing. Maybe I'll just kick a bit in the bath.  

Nigel
Posted by kdhfrank (kdhfrank), 2 May 2004

nigel

the vmo is the tear dropped shaped muscle (very noticeable on bikers). it is that muscle above the knee cap on the medial (inside) part of the thigh...this is how i can best explain it. i think it helps with patellar tracking and stabilization and thus is very important, ask your PT or OS about it...especially since you sound like your knee cap is moving more that it should.

kim
Posted by EngKnee (EngKnee), 2 May 2004

Kim, Nigel, Tony, Janet et al,  This thread continues to amaze me in it's helpfulness to those afflicted with our plight, I for one am learning all sorts of information about things that we took for granted and assumed would take care of itself.  Lately I have noticed a noticeable improvement in my knee, topically speaking, I have used vitamin E liquid on my scar and have seen the lines of the scapel become less and less visible.  The pain has subsided and last night I even slept peacefully without my brace fully cinched up for the first time.  When we all get over the hard part which it seems like most of us have, we will have a new understanding of the importance of the muscles surrounding our knee and in all liklihood we'll be paying more attention to those muscles in our daily workouts.  John C.
Posted by Nigel (Nigel), 2 May 2004

Kim, many thanks for the anatomy lesson. I see what you mean now. I tried the exercise with the ball and will keep at it even though (because?) it hurts!

My knee cap seems to have tightened up and lifted in the last couple of days and I now have some quad function (ie I can actually lift my heel about 12 inches when seated). I've read others on KG saying their quad started to wake up all of a sudden after a few days of exercise, and that's exactly what's happened to me.

Today I stomped around all day without immobiliser, crutches or safety net. A bit Grinch-like, but a huge improvement. Fanntushhticc. As of yesterday I can climb stairs unassisted, just like real people, but I still have to come back down one at a time. What a difference a few days makes once you're out of the *%^$# immobiliser!!

My only niggle is a pinching pain at the top of the inner calf, an inch or so below the knee when I flex it. Feels like something sharp-ish is trapped inside. I don't think it's the wire in there, feels like slightly lower down. Real bore. Hoping it will go away.

You're right John, what a great board. Almost worth busting a knee to find it...   But seriously, it makes me realise how much some people have to put up with. Now I know I've actually had it pretty easy. Touch wood. ANyone skiing next season?

Best to all, Nigel
Posted by Nigel (Nigel), 8 May 2004

Hey chaps, how's it going? I had bit of a setback a couple of days ago, had to hit the painkillers and frozen peas for about 24 hrs, knee swelled right up. Medics x-rayed me to see if wire still in place - apparently yes, and my knee has since got much better, so a bit of a result in the end. They say I probably just over-did the exercise and paid a price for it. Just thought I'd share that in case anyone else has same experience - I suppose while things are still healing you have to be aware it's still a delicate state even if it feels stronger. But, as ever, a bit of rest and ice work a treat if you hit a snag.

Have a great weekend.

Nigel
Posted by kdhfrank (kdhfrank), 8 May 2004

Nigel

I told you guys to take it easy! remember...I am the furthest out post op (and the only girl) I think. This is  a slow, long and difficult recovery process due to the severity of this injury (remember, there are very few of us world wide who are members of this club). Your quads will come back...just takes time. I still think your doc screwed up by putting a wire in that has to come out, mine was disolvable...too much risk for infection to have to reopen...and I wonder if this might not slow the healing process down. I would certainly discuss this with your surgeon. Cheers!

Kim from Pennsylvania by way of Atlanta
Posted by Nigel (Nigel), 8 May 2004

Well, that's me properly told off...but listen to Auntie Kim chaps, SHE KNOWS!!!


Dissolvable wire!?? That's the kind of thing that put Americans on the moon! Over here we're lucky if we get an old piece of coat-hanger. But actually, Apollo 13 is one of my favourite films ever (I'm a Tom Hanks fan anyway).  The bit where they fix the carbon dioxide scrubbers with duct tape and old flight manual covers is priceless. Maybe it's a guy thing, sorry Kim.

Take care.

Nigel
Posted by Rosbif (Rosbif), 10 May 2004

Hi guys, back after a week holiday and a week without my immobilisor. Had to take it easy and use my crutches for the first 5 days just as a safety net. Had a couple of major buckling incedents so it was I good job I had them. Been without crutches since Friday. No problems but still have to take stairs one at a time (I live on 4th floor (believe that is the 5th floor in the States?) with no lift).

Makes life so much easier not having to wear the immobilisor. Knee still very weak, swollen and loose, but gettin there.

Tony
Posted by Nigel (Nigel), 10 May 2004

Tony, wie geht's?? Glad to hear you've taken off the stabilisers. Remember not to go on any of the big roads without a grown-up.  

Take it easy.

Nigel
Posted by Rosbif (Rosbif), 10 May 2004

Thanks Nigel. Think your german is better than mine.

Got rid of the stabilisers, now just need to lose the "Slow Moving Vehicle" sign off my back. Think a bit of time in the gym and swimming pool is called for.

Posted by Nigel (Nigel), 10 May 2004

Yeah but remember to add ballast or something to the good leg or you'll swim round in circles.
Posted by EngKnee (EngKnee), 10 May 2004

OK guys and girls, I've been away as well and apologize in advance for my inattention to this forum but allot has happened in my absence I see  Glad to see that people are up and around and I am happy to report the same as today marks the first time that I'm walking without my brace and my first foray into the shower without a brace or assistance, what a relief Of course it's still swells up on occasion and I have to rest it from time to time but I am sleeping without the brace as well and that is much more comfortable.  I don't go back to the doc until May 25th for the initial adjustment but I plan on being ready for that by testing my confidence and mobility in the meantime, very slowly.  John C.
Posted by Rosbif (Rosbif), 11 May 2004

Hi John, Nice to see you're improvin. Sleeping without the brace really is a big improvement of quality of life. I started doing without OS approval, I'd just had enough of sleeping with my cast on.

I tried a couple of stairs in the normal way yesterday. i.e. not dragging my bad leg up. Felt extremely odd and un-natural. Anybody else had this feeling?
Posted by EngKnee (EngKnee), 11 May 2004

Tony, I think it's great that you are able to get around as much as you do and that you are doing stairs without your brace, I'm having a hard enough time just getting around the house, all on one floor mind you, without my brace and feel very funny trying to do the steps without the brace.  My concern is that since we are doing this w/o OS orders are we doing any harm by this?  I noticed four holes or indentions in my knee, are they where the holes were drilled in my kneecap?  They are located on either side of the incision and seem to be evenly placed vertically along the scar.  I know it's going to be extremely difficult for me to bend when the time comes but I can't wait to get on with this.  John C.
Posted by Rosbif (Rosbif), 11 May 2004

John, I'm quited amazed you haven't started bending you knee yet. I was started on passive bending 2 days after my op.
Posted by EngKnee (EngKnee), 11 May 2004

Tony, that is incredible as I can't even imagine trying to bend my knee that soon but I was told not even to put any weight on it as well so they were really taking it easy, maybe because you had the wire insert you were able to bend sooner, not sure why but that sounds like a possible.  Maybe some of our other posters will share their experience on this.  If you were bending then I guess me walking on it w/o a brace is A-OK.  We haven't broached the subject of injured-knee sex yet but I find it quite annoying sometimes when I can't do what I want and have to patiently await my partner's whim in order to feel like I'm part of the equation if you know what I mean, kinda detached but still enjoying every minute of it, gimps need love too!!!  It's real tough to remember what it was like to have a good knee at this point maybe it will be different once I start bending but right now I can't even think about the pain associated with that first bending motion and how is it going to be effected, the OS?  John C.
Posted by Nigel (Nigel), 11 May 2004

John - I'm also surprised they haven't got you doing knee flexing yet. Like John I was started on passive flexing early on - though in my case 3 wks not 2 days!

Passive flexing is bending your knee leg using your hands, or gravity, rather than with the leg muscles. I would definitely press your OS on this as you can't do much to walk properly until you have at least 90 degrees range of movement (ROM). The longer you leave it, the longer it will take to get the ROM.

By the way I think knee-bending and weight bearing are completely different things from a rehab perspective and it doesn't follow that if you're okayed for flexing you also have green light for WB. Anyone explain this better?

Tony - know what you mean, stair climbing feels definitely a bit "floaty" and I have to go up quite quickly keeping a rhythm. Which is probably what you'd do if you had two good legs.

I'm now commuting on the trains/tube into London every day with just a stick (cane) as a security blanket and it does help a bit on the stairs. Also can cut a dash with it around the office - my childhood hero was John Steed in the Avengers (Tony will know) with his sword stick/umbrella. I can walk almost normally at a slow pace, but when I speed up I'm still lame. Feels like the kneecap is "heavy" which I think is just lack of quad strength. But improving.

Finally, re the sex positions question John, I'm not going there on this thread...but maybe you should wait until you've been okayed for active physio!   John Steed would have laid back and thought of England.

Nigel
Posted by kdhfrank (kdhfrank), 11 May 2004

You boys are bad!!!  Attempting stairs without your (cast?)...do you mean immobilizer (neoprene thingy with velco straps and a hole in the middle?)...your quads are most likely atrophied to the point of a raisin, thus you are lacking the support, strength, and stability of you knee...the potential for buckling is significant and thus could end up rupturing the tendon all over again. You do not want this to happen again, do you? the stairs are not going to speed up the healing process or build the quads...do the excersises, go to PT, get a cane...this you can use to steady yourself if you must go up the steps without your brace. Do the ball against the wall exercise, Estim (hurts like a mother...) and leg lifts...be good and follow your instructions! again I must point out...sounds like a huge difference in post op care...this could be because most O/Ss have never taken care of patients like us. I was put in a cpm right in recovery from the surgery...set to 50 degrees, 24 hours a day for 10 weeks (mostly at night the last 4 weeks)...out of bed I was totally non weight bearing. Sitting on the potty sucked as did sex (sorry but not fun for me)...I did not ask my husbands opinion. I now walk unassisted, swim 2 miles a day and should have my full flexion back after my procedure in June at Cincinnati Sports Medicine...but I have learned to be PATIENT!..and yes, I am back at work as a nurse practitioner chasing little kids with tongue depressors and needles. So your futures also look bright. I was even told I shoud be able to resume most athletics I did prior....think I will give up skiing and jogging though...but I cant wait to get back on my bike...and yes, I can chase my 9 yr. old around and almost catch him...we actually have races up the stairs to the shower...and it is a lot of fun. He usually beats me but I almost catch him. I think the holes next to the scar (not sure which of you chaps this is) might have been where there were drains placed post op. Do you remember this in your post op drug induced haze? I cannot see where the wires were run through my knee at all, but I did have 2 drains  into my knee post op for about 5 days...maybe this is what the scar is. Hope this answers some questions...and remember Auntie Kim knows best!
Posted by Nigel (Nigel), 11 May 2004

Kim - what's Estim??

Nigel
Posted by Rosbif (Rosbif), 12 May 2004

Nigel, Estim is Electro Stimultion. It uses electric pulses to stimulate the muscles. Not supposed to be much use unless you are doing your quad exercises at the same time. I haven't tried it.

Kim, about 4 days post op I was put in a Neofrakt lightweight polyurethane removable cast. http://www.neofrakt.com/introductie_neofrakt.htm

think the hospital used this because it was cheaper than using a hinged immobilisor.
I'm still doing stairs the crippled way. I've tried 2 of the about 70 stairs upto my apartment in the normal way. I didn't feel any pain, but it did feel odd. I've seen some advice to start practising stairs by using a couple of phonebooks to step up on to and then build up to stairs later. Tried it last night and it does seem to work. Pity your thinking of having to give up some sports. I'm hoping to get back playing Field Hockey goalkeeper, but think I have another 3-4 months minimum before I can try.
Posted by EngKnee (EngKnee), 12 May 2004

Auntie Kim, Nigel, Tony et al, I am really confused and surprised at the discrepancies in our individual programs.  Could it be that our injuries were that different?  My rupture was at the kneecap to the tendons that secure the lower leg and I believe yours were to the upper, also my tendons snapped right at the kneecap while some of yours snapped mid-tendon, this might be an explanation as to the differences not sure.  I am concerned enough to begin the question my OS's post-op care and will give him a call sometime soon to see if he can help to assuage my fears.  I hope I don't need my OS's opinion on everything regarding my day to day existence, I'm from the old school that states if it feels good, do it!  cheers John C
Posted by Rosbif (Rosbif), 12 May 2004

John, my rupture was also below the knee. Not sure exactly as the OS was not exactly forthcoming with information.

Did you have the same op? Tendon sewn up and holes drilled through knee cap and leg for a wire loop. If it was you really shud speak to your OS about getting a CPM machine. I have basically got full ROM now, which is mainly thanks to the machine.
Posted by EngKnee (EngKnee), 12 May 2004

PT Crew, I just spoke to my OS and he indicated to me that it was his experience to let the tendon fix heal for a while before he starts bending, just his way I guess.  He wants the repair to have a chance to gain integrity before we bend it. He said the tissue remodels to gradual stress and I quote.  He also was very pessimistic about me walking around without the brace but I assured him that I was being real careful and not overdoing it to which he said that he doesn't want to have to repeat the procedure.  I forgot to ask him some more questions as we do when in that situation, I wanted to ask him what he thought of me going into my hot tub?  Part of me thinks its ok and another part says no way, what do you all think?  Here in West by god Virginia it's hot and humid already, kinda like summer makes me want to get out and play, NOT. John C.
Posted by Nigel (Nigel), 12 May 2004

John, very dangerous for me to comment as an amateur, but I have to say it sounds like your OS is being ultra conservative. This surprises me as even my French OS was happy to go to 60 deg of flexion after 3-4 weeks (although admitedly protected by a wire), and I actually went to 90 deg+. I wouldn't suggest you go against advice, still I am surprised nonetheless. But, as Kim stresses, it will be VERY important to do any exercise in a controlled way as part of a PT programme, not just hack around and put multiple and inappropriate stresses on an unstable joint.

Have you read the Annunziata & Ignacio paper on PT repair on eMedicine? If not I REALLY recommend it. See
http://www.emedicine.com/orthoped/topic246.htm .

In particular they say: "Multiple authors recently have attributed an earlier return to preinjury activity to a more aggressive rehabilitation program with an emphasis on earlier range of motion." Note that's ROM (ie passive flexing), NOT weight bearing.

I can't imagine that the hot tub would be a problem. Wish we had one. I think for sports injuries generally it's recommended to alternate ice with local heat, which all encourages drainage and circulation. Anyone help with this?

Cheers, Nigel
Posted by kdhfrank (kdhfrank), 12 May 2004

Guys

I too am a below the knee cap tendon rupture. I also have an extremely conservative O/S who took over my care after the O/S who ruptured my tendon and was mmediately fired. My O/S repaired the tendon (I also had massive amounts of scar tissue everywhere from the scope last August...you can read my sob tale under crisis in late November of last year. After he did an inital suture job they then flexed my knee to the point where the repair came apart (45 degrees) at this point they did the permanent repair and kept me on CPM up to 45 degrees, he was concerned that if not kept moving more scar tissue would develop. but did not want to jepordize the repair.  Remember that the CPM provides passive ROM so does not contract the quad like active ROM. The Estim was started at 10 weeks post op when I was cleared to start PT (I told you he was conservative)...it was basically to wake up the quads and get them firing again...I only did it 3 times a week for 4 weeks at PT...once I could do a straight leg raise on my own we stopped the Estim.  I have a jet tub jacuzzi in my house and looked forward to my soak. I just had to figure out how to get in and out when no one else was around...no swelling after, and it felt good to just let the leg float (I had no open wounds at this point). Applied ice pack after. While my case may be different then some of yours my recovery was based on the tendon healing (and it is the same tendon that you all are dealing with)...scar tissue would be addressed later...that is why I am having more surgery in June in Ohio. My O/S consulted with this specialist once it was determined that my joint was bound down by this. My rupture was an iatrogenic injury unlike your many sports related injuries and thus complicates everything, but none the less I feel my tendon is now as strong as it was before...I followed my O/Ss plan very closely...he actually had me terrified that if I even went to the pool to watch swim practice I could rupture it again if I slipped on the concrete. I also read the article posted in email above and printed it out. I think the caution stressed is that even once the tendon is healed the quads are weak and thus may cause buckling of knee and injury to the repair. My Pt also has me stand on a step with my affected leg while other leg is about 6 inches above the ground and I do reps of flexing in sets of 5. I also have a giant rubber band attached to a stairway railing that I put my affected leg in and do lateral crossovers against the resistance. I am fortunate to have a gifted PT. I honestly think that a good PT is quite important and if you are seeing one who isnt doing 1 on 1 with you for an hour, then you should find someone else. Hope this answers some questions.

Kim
Posted by Nigel (Nigel), 13 May 2004

Hey guys, walking practically normally today without support or a limp, provided I don't go too fast. Downhill is a bit shaky.

This evening at home I must have forgotten I was a cripple for a second and tried to leap up the first two stairs in one! Soon realised my mistake  , but it's nice to feel mobility is coming back fast.

Hope all's well with all.

Nigel
Posted by Rosbif (Rosbif), 14 May 2004

Hi Nigel, sounds like your recovery is going very quickly. I was operated on end January and am only just starting to do the odd stair upwards in the normal manner. Havn't even tried going down stairs normally yet.

I have developed a bit of clicking in my knee which is a little worrying. Hope your recovery continues.

Tony
Posted by Rosbif (Rosbif), 14 May 2004

Nigel, forgot to mention. Think your were very lucky having your op in France. The health system there is excellent. I lived there for five years and was treated for a badly torn calf muscle.
I went straight to see the doctor from the local first division football club. He had a radiologists and PT in the same building, so he was able to organise everything immediately. It was a cheaper and far better system than here in germany.
Posted by EngKnee (EngKnee), 17 May 2004

Tony, Nigel, Kim et al, just got back from a weekend jaunt to Boston to witness my daughter's graduation from college and was happy to read the latest posts upon my return, sounds like everybody is doing well on their respective recoveries.  I too am fairing pretty good as I was able to get thru airports and cabs and even the subway system without too much trouble, those coblestone streets are kinda tough though.  My knee looks almost normal with little swelling lately and I was able to raise it one time without thinking about it in the forward direction without pain or discomfort.  I guess time will tell on my complete recovery but as for now I'll have to trust the horse I've chosen to ride and make it to the finish line intact.  Keep up the good work folks. John C.
Posted by misslover (misslover), 18 May 2004

i know how you feel i have all these questions myself as i am going throught the same now i have my operation the beginning of june except my operation is on both my knees! as i am only 17 i did not understand all this talk so can i ask a favour could you please let me know how yours went as i would like to talk to someone who has been through it as i am so scared!! thank you good luck and i hope it goes well
Posted by Rosbif (Rosbif), 18 May 2004

Hi Misslover, welcome to the patella tendon cripple section. My op went fine. Woke up after it, with a bit of pain but nothing over the top that a few drugs couldn't deal with. I can't imgine what it would be like to have both knees done at the same time though. I had my leg in a removable cast for 13 weeks and relied on my good leg for going up/down stairs etc.  It will seem as though your leg(s) will never work properly again for a few weeks after the op, but then you will hit a point where you get massive improvements (probably after about 7-8 weeks). Don't let it get you down and just make sure you get a good physio and put lots of work into getting your muscle strength back. Hope it all goes well and don't worry too much about it . Tony
Posted by EngKnee (EngKnee), 18 May 2004

Misslover,  Love the name but don't envy your position at all with your knees, both of them, to be operated on.  None of us on this thread has had that situation but we've all experienced different bouts of treatment, I used to be the rookie knee person, now you are, welcome to the club!!! How did your knees get hurt?  Where are you located?  We have folks on this thread from all over the world.  Tell us a little about yourself and you can read the five previous pages to learn who and what we are about that will bring us all up to speed.  Hang in there and I hope you become a regular contributor to our message board.  Good Luck, John C.
Posted by Nigel (Nigel), 18 May 2004

Hi Misslover, welcome to the team!

Had any kind of op before? If not it's nothing to be scared of. Having had both general anaesthetic and epidural (lower body pain block) myself, I've found both ways actually quite relaxing, although the epidural is pretty weird because you can feel the operation going on but no pain whatsoever...promise!

It might be a shock how big they make the cuts to do tendon repairs. Will look a bit scary when you first see the scars, staples/clips and all. Don't worry, it looks gruesome at first but heals quickly and the scars should virtually disappear after a while. Be prepared for a LOT of swelling, makes your knees look like balloons and "all wrong" but they'll gradually get back to their original shape.

First few weeks post-op will drag but as John and Tony says it then gets much easier.  PROVIDED you take care of yourself and do the physiotherapy exactly as you're told. Sorry, I sound like I'm lecturing my kids! But take note anyway.

Do you have good support at home when you get out of hospital? Loads of practical stuff on this site for post-op coping - hang out on the board as much as you can before you go into hospital.

Ask us any questions you want. Sorry you've got to have this work done, but nice for us to have a new person...we were getting a bit boring!!

All the best, Nigel in England

Posted by Rosbif (Rosbif), 19 May 2004

Just when I was starting to get too confident about my recovery I stepped onto an uneven bit of pavement last night and my knee hyper-extended quite violently. Bloody painful at the time but know aparent damage done. Bit of extra swelling last night but no pain this morning. Will teach me to look where I'm going.
Posted by EngKnee (EngKnee), 19 May 2004

Close Call Tony I think one of the most important aspects of our recovery is not getting too far ahead in our minds about where we are in the healing process.  I struggle with this every day as I gingerly walk around my flat with no brace, no net as it were, as my doctor instructs me that I'm taking risks unnecissarily in order for me to feel like I'm making progress, are we acting without reason?  I think NOT!  We are human beings who got hurt and are
trying to get better every day that's all.  We will make mistakes or missteps that is a given we will hopefully learn from them and get better at not repeating them, that's all we can do.  I'm glad that you are alright and I hope we all can learn from your episode and try to be cognizant of every aspect of our movement in our daily lives. John C.
Posted by Fisnik (Fisnik), 20 May 2004

Hey guys and gals,

Seems like you wouldn't mind an addition to your club. I'd best start by introducing myself:

I'm a 31 year old Kosovar Albanian, who ruptured his Patellar Tendon below the knee playing basketball 2 weeks ago (May 7th) and had a surgery the very same evening (about 4 hours after the injury).

Considering that, as you may well know, Kosovo is far from posessing the latest of the medical techniques and has some very conservative doctors, I am quite concerned about how my rehabilitation is going to progress.

To make things even worse, I happen to be a 2.00m tall person (that's about 6'7") weighing around 130kg (that's about 270lb). So, there's no wonder I have two wires planted on my knee instead of one, and of course they're not the disolvable sort - that would be just too luxurious for this country.

I consider myself lucky to have been operated by the best OS there is in this country and the top physiotherapist is awaiting my appearance as soon as my OS gives the go ahead, which won't be any time soon.

As I said, the doctors here are very conservative and my leg is at this very moment covered in thick cast, which I'll have to keep for another 4 weeks at least, before I can put a brace on and start moving the leg again.

3 days ago I first started using the crutches and have been instructed to put very little weight on the injured leg, which I find a bit difficult, since I'just getting used to them.

I am undergoing a very strict diet, hoping to get rid of some of the weight and have been spending some time exercising the upper parts of my body to at least give myself some ease when lifting my body (and the extra 15kg of cast I have on my leg).

Tomorrow I'll be having my staples removed and expect a visit from my OS to discuss further development. Considering my special circumstances (size and weight), I have a feeling this development is gonna be very long and painful, which really gets me depressed at times, including now.

I am known to be a strong-willed person who doesn't give up easily, and I don't intend to break down just yet.

I have a question, though: What would be an approximate time when an average person with this injury would be able to be partially mobile, meaning without crutches and possibly with a cane? 10 weeks? 12? I would probably have to add a week or two more for every stage of recovery because of my unusual circumstances.

Thanks for 'listening". Wish you all a fast recovery.

Fis


Posted by Nigel (Nigel), 20 May 2004

Fisnik - welcome to another victim! First one we've had from Kosovo on this thread, I think!!

Probably you've already read back through our "case notes". In my case, I started walking without 2 crutches at about op+8 wks, but via one crutch then a stick (cane).

Today I hit op+10 wks and to celebrate I spent the whole day without my stick. That included walking a mile or so around London at practically normal walking pace, as well as up and down lots of stairs. A little discomfort by this evening, and a slight limp when going downhill.

But I don't think I'll be running around very soon, I'm guessing it will be 4-6 wks more at least before I'm ready for anything like that. Holding me back at this point are: (a) knee still tender below patella; and (b) quad muscle atrophy means some lack of stability in that leg. I believe this is quite normal at this stage and I'm happy to "listen to my knee".

Don't know if I'm typical, but maybe not far off. You are younger than me (I'm 45) so you might do better quicker, but don't push it as tendons take a long time.

Hope that helps! Keep in touch.

Nigel (UK)
Posted by Fisnik (Fisnik), 20 May 2004

Cheers, Nigel!

That was a very comforting reply, mate. Very happy to hear you're up and (not just yet) running. Makes me more optimistic about my case when I hear positive things like yours.

Glad you enjoyed London today. I quite miss it (lived there for the past 12 years, came to Kosovo last year) and have planned to spend a part of my summer there, but alas, unpredictable things happen and they somehow have a tendency to mess things up.

My only problem is that my OS insists that my case is very very special (the sheer size of me and the fact that I have 2 wires on my leg) and needs time to heal, and he also insists that my leg does not move for at least 6-8 wks after the op, which concerns me a bit, because from what I could gather, the longer the leg is immobile, the longer the rehab takes.

In the end of the day, I am in no real hurry. Of course I want to see myself back in my feet as soon as I can, but I'm willing to sacrifice the time as long as the knee gets back to it's shape properly. It is tough to move a guy my size around, and I'm sure my knee knows this best.

I am lucky that I can do 90% of my work from home, although there are things I'll be missing from not going to the office, but that is acceptable for the moment.

I live on the fourth floor in a building without a lift and the cast I'm wearing is extremely heavy, so I don't see myself going out much for the next few weeks.

Are there any food supplements (vitamins or the like) that help the healing process? I've come accross some vitamin supplements that claim to have some effects in ligaments and joints, which I plan to take, although I don't really believe they will help much.

I also happen to be a smoker, and from what my doctor told me, since smoking lowers the blood circulation in the body it is very strongly recommended to quit in order to have a speedier recovery. So guys, since I now consider this forum as a place where I can find a bit of comfort about my state, wish me luck and give me a word of support, because as of tomorrow, I'm quitting the darn thing!

Nigel, my wife will be in London from Sat 22 until Tue 26 of this month and if there is anything you can reccomend for treatment please let me know so she could purchase it there, since most of the stuff is unavailable in this country.

Again, thanks for the reply and thumbs up to everyone!
Fis

P.S. I am deffinitely the only one from Kosovo in this thread, since there has only been one case like mine in Kosovo in the last 5 years, and the guy is probably quite okay now.
Posted by Nigel (Nigel), 20 May 2004

Tony in Germany (aka Rosbif) can tell you all about stairs. He lives a few floors up without a lift, I think.

Sorry, lotions and potions not my thing, so can't really say much about the vitamins. Someone did tell me recently there's now solid evidence that fish oils are good for joints, but can't vouch for that and not sure whether there would be much effect over a short time anyway...anyone any knowledge/view?

The only thing I used was E45 cream (presumably anything would do) to soften up skin over the knee. Became really tight around the scar for a long time, although now almost back to normal.

There does seem to be a body of opinion about getting early passive motion going - Rosbif used a ROM machine although I realise that's probably not obtainable in Kosovo. I would have thought the wires would give enough security to allow for some motion and flexing, not weight-bearing of course. I was allowed to start passive ROM exercises at week 2 or 3 even though I had to wear the brace at all other times, including in bed. But your OS probably knows what he's doing.

I wonder whether your doc would agree to put you in some kind of half-brace to leave the knee open, even if he feels the leg must be kept straight. Then you could manipulate the patella gently from time to time. My physio got me doing that from week 2. Apparently it helps to avoid scar tissue and stops patella sticking to your femur.

Did they say they would leave your wires in place, or do they have definite plan to remove them? In my case they want to leave alone unless it breaks, removal means a full-size incision again.

Cheers, Nigel
Posted by kdhfrank (kdhfrank), 20 May 2004

hi guys and welcome to the newbie!

just a quickie...CPM machines can be purchased online and possibly through ebay. check the medical supply site on ebay or check medical equiptment companies online that sell used equipment. Passive ROM is not the same as active ROM, quad is not contracted on a CPM machine but the CPM keeps the joint moving thus prevents scar tissue buildup and a frozen joint...thus prevents a delay in healing. i was on my machine right out of the OR. got to go.
kim
Posted by Fisnik (Fisnik), 22 May 2004

Hey guys,

The newbie is getting used to the crutches, and he's moving around carrying all his weight + the heavy cast on his leg with much more ease than 3 days ago.  

Won't be before end of next week that I'll be able to talk to my OS, as he's abroad, but apparently I've got 2 more wks (with 2 already gone) in heavy cast and then 4 more on a brace, but I suspect it will be a moving one.

The botom line is, I'll be immobile for 8 weeks and that worries me a bit. The swelling has gone down a bit and the cast is a bit more comfortable.

Does it make a difference if I contract my quads on the injured leg from time to time? I do feel a sensation around my patella every time I do that, but no pain. Will this help my quads retain some of the power? Also, does it make a difference if I stretch my foot and make circular movements? I'd guess thiss stuff can only help the leg.

Has anyone got any tips on what I should do? Apparently, it seems like I have lost some weight according to the people who have not seen me in the past 2 weeks. I have a bit of a problem getting on a scale to weigh myself because a) I'm in crutches and b) scales one can find in this country don't go above 100-110 kilos, and I'm definitely heavier than that.

Still exercising the upper body parts and undergoing the strict diet. Hopefully I come out a new man after all this.

Nigel, according to my OS's directions 2 weeks ago, I'll be wearing the wires for a while before they decide to remove them (at least 6 months).

Cheers to all,
Fis
Posted by Nigel (Nigel), 23 May 2004

Fisnik, I'd say foot exercises are probably fine and a good thing to keep your calf muscle in some sort of shape. But watch you don't do too much of that quad contracting, even statically. That's putting direct strain on the repair I think. Maybe you can work up to that soon, but I'd take your physiotherapist's advice on that.

Don't worry too much about your quad, just accept it will turn to blancmange short term but they will come back. The main problem with prolonged immobility is "freezing" of the joint, which I believe can limit the range of movement (ROM) you get back. But I bet you'll be fine. You're quite young and it's not like you're going to be in a cast for months and months. I had my wrist in a solid cast for 6 or 7 weeks a couple of years ago, and after it came off it felt like I'd never be able to bend the joint ever again, but after a month or two and some not-too-hard physio I had full ROM back.

I guess some weight loss is normal after any operation. I lost 4 or 5kg. A good start in the right direction!

Cheers, Nigel
Posted by Fisnik (Fisnik), 23 May 2004

I don't seem to feel any pain when I contract my quads. In fact, I hardly ever feel any pain at all, except when, in some ocasions, while moving the leg to get up or sit down, I yank the cast quicker than I should. Sometimes I get the feeling nothing's happening down there and then get a tingling sensation telling me there is something going on.

I hope this weight loss is not just because of the op, as I seriously need to lose weight before I start the rehab, hence the strict diet.

Wife's in London right now and she's getting me a few kilos of E45   and some ankle weights to keep my healthy leg in shape. They can eventually be helpful sometime during the rehab, too.

I guess I should just relax and wait for the time to pass until the OS says it's time for rehab. I forgot to mention that my tear was very bad, according to him, because it not only tore completely at the base of the patella, but it tore vertically in the middle, too. Must be quite bad, eh? Hence the moving restrictions.

Oh well, I can only hope for the best. Nigel, you seem to be quite experienced in getting yourself in cast.   Things you say, though, are very comforting.

Cheers,
Fis
Posted by EngKnee (EngKnee), 25 May 2004

Welcome Fis to our thread and our predicament, thanks to Kim for finally giving me the courage to get rid of my OS in Md., I haven't moved my knee either passively or otherwise since my operation over 40 days ago.  I get to move it 10 degrees tommorrow with my brace adjustment, big deal.  I'm afraid I'm going to get frozen knee if I don't do something radically different soon so I'm going to get a referal to a new OS near my home in WV and hopefully we can get going on a newer approach asap.  The knee feels OK but looks kinda grotesque with swelling on either side of the patella almost constant.  I asked my OS about all the different techniques discussed here on this thread and all he said is that he is very conservative in his approach, to me that's not good enough I want action!  I'm hoping my new OS will level with me and tell me what needs to be said regarding my rehab or lack thereof.  I'm glad we have new blood to keep this thread going. John C.
Posted by Rosbif (Rosbif), 25 May 2004

Hi Fis. I was in similar position to you. 120kg and 4th floor with no lift. Because of this I had my leg in a light weight removable cast (abt 2 kilo max) for 13 weeks, although I was walking without it in my apartment after about 7 weeks. I was put on the CPM machine 3 times a day from 2 days after my op. I think this was a big help, so you should ask your OS about one.

hope your recovery goes well
Tony
Posted by kneeDave (kneeDave), 25 May 2004

EngKnee:

Hang in there, it's not fun, but does get better.  I broke my left patella on March 2d, had surgery on the 4th.  Luckily I didn't have to get any hardware put in, and I think that "only" suturing was required.  My OS encouraged me to put weight on the bad leg (IN the immobilzer, however) and to do passive and assisted movement with it to increase ROM after the surgery.  But my situation was different from yours.  While it is not so fun, especially at first, moving around was and is the best thing for healing as the blood flow gets going, etc.

Don't be too alarmed when your quads atrophy away and your injured leg looks like a stick.  I was not too happy about mine being in this condition, but after a few weeks of adding stationary biking and straight leg lifts with weights, it is coming back.  Even being able to put weight on it will help, once you are able to do so.

The little advances are what made the difference for me: being able to shower, sit in the front of the car, drive, etc.  Also I am fortunate that my work is not very physical and I have flexible hours.

While I was unable to use my left leg for much, I did sit-ups and push ups, which were especially good while I still had to use the crutches.  Even when I had to use the crutches (about 3 weeks ago) it was nice to get out and "walk" outside.  You might want to pester your doctor about doing straight leg raises in your brace too.

Anyways, hang in there!
Posted by kneeDave (kneeDave), 25 May 2004

Fisnkik, EngKnee and co:

If you can't get access to one of those passive movement machines, you can always do it by just holding your hands under your knee, supporting it and gently moving it.  This is easier to do on a level such as a couch.

Quite a variety in post-op treatment!

I suppose that everyone's injury is slightly different, and also general condition, age, etc. matter too.  I'm 31 and in pretty good shape (was doing heavy weights, running and playing soccer prior to injury) so this may partly explain my OS's more aggressive approach to rehab.

Hang in there gang!
Posted by kdhfrank (kdhfrank), 25 May 2004

john

hang in there! you are only 6 weeks post op and so far you are doing great. the tendon really needs about 10 weeks to heal (it is not stretchy, thus cannot tolerate tension until healed)...i would absolutely advise against straight leg raises (even in immobilizer) until you get the ok from your O/S...i think the previous poster has a different injury then the rest of us...straight leg raises put incredible strain on quad and tendon! dont do this till you get the okay...i think it is better to be conservative over too aggressive...remember, i wasnt allowed to do anything either...but i do think a cpm would be a good idea as this does not put strain on tendon because quad does not actively contract (i dont mean set the thing at 135 degrees at top speed! mine was set to 45 degrees and was slow and smooth!!! and yes, expect to have swelling still...you had a major knee surgery!!!! give yourself a year to get back to normal and do it the right way! you will get there! kim
Posted by EngKnee (EngKnee), 26 May 2004

Hey Gang, thanks for the encouragement , today ended up to be a most beneficial sort in my rehab as the old OS, the one I was thinking of firing, came thru with not one but two adjustments, out to 30 degrees and showed me how to do the next one in a week or so AND gave me the OK to do some simple exercises.  I feel much more relieved at this juncture and I deserve all the reinforcement that I received here today, thanks to Dave, (where did he come from?) for his advice as well, keep posting!  I went to a baseball game tonite in Baltimore and felt much more mobility in walking with 30 degrees of motion in my knee plus my team, The NY Yankees, smoked the O's which was an added treat to my night out on the town.  All in all I want to reassure everyone that I'm feeling much better now that I see incredible improvement in my ROM with no pain and finally I got a plan to exercise and regain my leg strength, this was a big positive step in the right direction.  I tried to get the old OS to give me up to the new one but instead he tactfully gave me what I needed to hear and deflected any thought of being replaced, pretty cleaver I thought.  I hope the rest of us are enjoying a good week as well, excuse me I've got to go do my exercises.......John C.
Posted by Nigel (Nigel), 26 May 2004

Hey John...what's this "smoking O's"? Is that some recreational drug they have in WV? Is it Oreos? Do they have some pain-numbing effect (maybe like bourbon biscuits for us Brits)?

I think we should be told!!  

Nigel
Posted by EngKnee (EngKnee), 26 May 2004

Common' Nigel, the smokin' O's are to describe our local baseball team the Orioles, anyone should know that I must admit you were pretty close when you alluded to oreo cookies as the O's are sometimes referred to as the oreo's but you can't get high off em, at least I've never heard such a thing..... we used to get..... at the games.....a real long time ago when they allowed such shenanigans, I'm showing my age here....anyway the Yanks beat the O's by 11 to 3 thru the chorus of O's fans chanting Yankees Suck, Yankees Suck.....You'd have to have been there I guess  John C.
Posted by kdhfrank (kdhfrank), 29 May 2004

hey mates

i recieved an email from a fellow patellar tendon rupture survivor. i referred him to this website so i imagine he will be posting soon. he emailed me a few articles regarding this injury (coincidentally the one posted on the www.arthroscopy.com website is an O/S right around the corner from where i live. personally. i would not consider him an expert in this area but the article has some great pics. hope all is well with the "hop along" gang...3 weeks till surgery in cincinnati..at least i will get to see the brood x cidada gang in action...i remember then from 17 years ago when we lived outside philly...millions of the little buggers...we loved to stick them on each others backs! kim

here are the sites:

www.emedicine.com/orthoped/topic246.htm
www.arthroscopy.com/patendrep.htm
www.SMA.ORG/SMJ1999/JUNESMJ99/ENAD.PDF
Posted by Nigel (Nigel), 29 May 2004

Would love to see Brood X in action. I gather there's selective advantage in a "prime number" breeding cycle...then predators have to match it exactly or miss the boat??!!

I'm getting on pretty well here in UK (touch wood). Planning to get on a horse tomorrow for first time since op. Think it will be fine, I'm pretty flexible now, just a bit wonky going down stairs and walking downhill. PT is basically just gym work now, no problem with most of it although my lower leg raises are hopeless, can just about manage it without any added weight. Think I'll just have to chill out on that and work up slowly, it doesn't really affect my mobility anyway.

We went to see "The Day After Tomorrow" last evening. Plot is dreadful, but great SFX --- including in real life, they turn up the a/c in the cinema. Take a coat!! Harry Potter/Azkerban on Monday with the kids.

Cheers, Nigel



Posted by John42 (John42), 29 May 2004

Hi Nigel

Can u give me a clue how I can contribute to this board
following my xchange of e-mails with Kim.

Best wishes
JohnK/Manchester UK
Posted by EngKnee (EngKnee), 29 May 2004

John K. ,  You already have mate!  If you want to catch up with the rest of us and what we've experienced so far just read the first six pages of this thread and then post as necessary as you already did, it's that simple really.  Nigel, I can't understand your inability to do leg lifts, do you mean lifts dedicated to the lower leg? John C
Posted by John42 (John42), 30 May 2004

I have been following your various posts and you will all have realised that we have suffered a very - very rare injury and from experience, the majority of Orthopaedic Consultants have very little knowledge as to the treatment and rehab of a Ruptured Patella Tendon.

It`s no consolation to fellow sufferers that there have been so far only 14 fellow sufferers WORLD wide who have registered on the Arthoscopy.com message board, but this valuable site has been taken over by Scammers, originating in the USA,Canada and Eastern Europe.

In my own case (which seems par for the course) I slipped on ice outside my house in January 2003, emergency operation, eight weeks in a cylinder cast, twelve weeks with two crutches, then one crutch for another four weeks and then a walking stick/cane for ten months.   I am 68 years young - so that does not help.

Like others, I have managed to have three baths in all this time, and must take extra care in the shower

Once the cast is removed, the knee bend kicks off (excuse the pun) with about 30/35deg bend and the physio will start to strenghen the quadriceps.  It took me about 4/5 months to reach the important milestone of 90deg bend.  The good leg is 134deg.  The Consultant states that anything over 90deg is a bonus and now some 16 months later, I have 116 deg and will not reach any more.

Driving is of course quite a problem - the first three months my wife used to place me in a prone position on the back seat of the car.  It was nearly five months before I could drive again, but the drivers seat must be as far back as possible.

Lets not kid ourselves, I only know of one person who regained a full bend after 14 months, but he was a very fit policeman.

I was chewing antinflamatories like sweets, but they did not help - however, I have three Co-Codoamol 30/500 tablets each day and these Do help.

I have recently been placed on water tablets because it was explained to me that during the operation, some veins in the leg, above and below the kneecap are sealed, thus restricting the circulation of fluid.

Several good tips worth noting..........

Sleep with a pillow between your legs.

Purchase a "Pedal Exerciser"... in the UK, look at
www.physio-med.com.

An ice pack or a bag of frozen peas (beans if you dont like peas).

It is ironic, that since I retired some five years ago, I am a volunteer in the out patients department of the North Manchester General Hospital - of all places in the Orthopaedic/Fracture clinic, so I see the Consultant/Surgeon and staff every week and I do get lots of advice which I will only be too pleased to pass on.

Please do contact me if you require any further tips, but meanwhile I am off to Vancouver 31 May for two weeks vacation and I am not looking forward to a ten hour flight.

Best wishes to fellow sufferes

JohnK/Manchester UK  
Posted by EngKnee (EngKnee), 30 May 2004

John K., You are so lucky to be going to Vancouver, I am guessing B.C., it's such a lovely place.  While there I imagine you will be taking ferry boat trips to Victoria and Seattle, relatively cheap and scenic to boot.  Last time I was through that part of the world I had some alcohol confiscated on my entry into Canada from the US so be careful of this, declare everything!  You can add allot of experience to this thread and we all appreciate your insights.  I have taken to homeopathic remedies with regard to inflamation lately and it seems to be working.  If anyone is interested I will be happy to post my magic cure. Happy Memorial Day to everyone on this thread regardless of your country of origin, it is this weekend that we Americans honor our war dead and that of all our allies as well, it's a time to reflect on how lucky we are to be living in a relatively free society even though we have a limp.  John C.
Posted by Nigel (Nigel), 30 May 2004

John C - what I meant by lower leg lifts is this: sitting on a chair with leg hanging down at 90 degrees, then raising the lower leg until it's horizontal (or as close as I can get). I'm supposed to work at this until I can do it against a weight - at the moment it's a struggle just to lift the weight of my leg. But coming on slowly.

John K - sounds like you've had a tough time. Although I have no statistical evidence, I'm surprised that you say you don't think many people get back full ROM. I would have thought most people do achieve pre injury range, or as near as makes no difference. I'm 11 weeks post-op and have virtually full ROM (about 130 degrees). I'm an averagely fit 45 year old. I'm just saying this because I wouldn't want anyone reading this thread losing heart about getting back to normal. We need to bear in mind that posters on this board are often people who've unfortunately had post-op complications, or multiple knee problems - not necessarily reflective of the average person who snaps a tendon, is repaired and gets over it okay. Also, not sure how rare patellar tendon rupture really is - my OS (a generalist, not a knee man) says he's seen quite a few. But it's not common, that's for sure.

Hope you enjoy Vancouver, it's a great city. Very big Asian community there - fabulous Chinese food. We were there last year - took the short hop over to Victoria to go whale watching, which was fantastic.

Went riding (horse) today for first time, not as bad as I thought it would be although lack of strength in my left leg meant it won't be winning any Grand Prix dressage prizes! But nice to get back to it.

Cheers, Nigel


Posted by Rosbif (Rosbif), 1 June 2004

Nigel, I'm also struggling with Full Arc Extensions (lower leg lifts). Find it very difficult, a bit painful and have a bit of clicking in the knee. But I understand all this is normal until the quads are strong enough to hold the knee correctly in place.

I've just started attempting downward stairs in my building. Luckily I have hand rails on both sides, so I can do it resonably securely.
Posted by Teresa_S (Teresa_S), 2 June 2004

The CPM machine is a continuour passive motion machine that the injured leg is strapped comfortably into and it is set to the degrees of extension and flexion that the physcian feels is appropriate. the knee is continuously moved from extension to flexion at a speed precet or determined by the doctor. I bought mine off Ebay for abount $350, and the one I had rented was around $48 daily, and soon exceeded the $350. I used it continuously for awhile. IT is often recommended that people sleep in them  immediately postop, depending on the diagnosis, and never be out of them for over 4hours for the first 2-3 weeks. I thought they were pretty well univerally used.They were always used for total knee patients for weeks postop and immediately in the recovery or patient room. It may not be needed in your instance. IT is a way of starting passive rehab that doesn't usually increase pain significantly.Hope that explains it. THe leg is comfortabley padded and supported at all times, is why it doesn' hurt, as the machine is always supporting the knee. Keep us posted. On my last MRI, both my quad and patella tendons were about 10 times normal size, and the radiologist thought maybe severe tendonitis, but the quad, according to my OS , was the result of his cutting it in two. Quad sets were really hard and I had to use biofeedback to even start strengting it. Teresa
Posted by EngKnee (EngKnee), 2 June 2004

Teresa, thanks for contributing your vast knowledge to this thread as we are all becoming better acquainted with our knees and their problems healing .  Sounds like you've been through allot to get where you are now and your description of the cpm machine was the best one yet on this thread.  Unfortunately my doctor hasn't prescribed this treatment to me although I have brought it to his attention, maybe it's too expensive or something but it sounds like you are sold on it's benefits.  I can move my knee just 40 degrees at this point in my brace and the swelling has gone down quite a bit lately so I've been feeling bold and walking around without my brace when in my house. Will this machine make me feel more confident to walk without the brace?  I'm trying to justify the expense in my head so I can convince my doctor to write for one.  John C.
Posted by Rosbif (Rosbif), 2 June 2004

John, I used a CPM machine 2-3 times a day for 30-45 minutes. Used it for about 6-7 weeks. I could really tell the difference if I missed a day.

Don't know if it will make a difference when you're walking at home, but it will make a big difference when it comes to getting full ROM back.
Posted by just (just), 2 June 2004

Hi, I managed to sever the patella tendon 3 weeks ago whilst playing football on a beach on my honeymoon.  I had a deep 10cm horizontal cut from the volcanic rock which severed the tendon but not the sheath. The doctor on board the ship sutured the tendon and the cut. We got back to the UK and the hospital don't seem to think that I will need any further surgery as I can lift the leg but have been put in a leg brace and will be going back in 3 weeks to see how it is going. When I was at the hospital they only took x rays and did not do a MRI is this normal ? Should I ask for a MRI scan when I go back ? I would be interested in hearing from anyone who has had this type of injury before and what sort of rehab they went through.

Thanks

Justin

Posted by Nigel (Nigel), 2 June 2004

Justin - bad luck with the knee.

I don't think MRI is very common for this kind of thing - certainly not on NHS anyway! I've not had MRI for mine, either in France where they operated or on return to UK. Anyone on the thread have an MRI??

The best "Haynes Guide"   to patellar tendon repair I've come across is the one on http://www.emedicine.com/orthoped/topic246.htm
which is referred to by others in earlier posts.

Go easy with the repaired leg as you don't want to risk a full rupture and tendons take a long time to heal.

Let us all know how you get on!

All the best, Nigel (UK)
Posted by kdhfrank (kdhfrank), 3 June 2004

hey mates

following my patellar tendon rupture (thanks to that jerk O/S that did it to me) my new O/S ordered an ultrasound (done by a physician not a tech)...it was easy to see where the rupture was and how far my quad had receded up the leg..(i managed to watch while the tears of despair were running down my cheeks)...i then had an MRI...this may have had more to do with the scar tissue but I am not sure...I do remember being extremely uncomfortable for it and got an additional dose of demerol IV on top of the epidural in my back...i would think that an MRI would be better in Justin's case as it does layer slices and the ultrasound may not be able to penetrate the sheath to see the repair. if the tendon was fully ruptured the repair would probably have been done differently...wire vs. suture...due to the unelastic quality of the tendon itself...(no flexibility...no elasticity) and the need for healing of tendon before active ROM...i question whether a MD on a cruise ship would even be qualified to do this kind of repair as it is extremely uncommon. (yes...it is very rare but  there seems to be a run of us lately)...so again i would have this looked at by a very experienced O/S who has taken care of this type of injury....i thought you guys would find this interesting...most patellar tendon ruptures occur in the male 35yrs. plus, somewhat out of shape recreational athlete...often occurs playing basketball and overdoin..."showing off?" (just kidding) weekend warrior!...should have been drinking a beer and watching the game instead of playing it!...and i know i am not in this group as i am female, 35+ and in incredible shape!!!!...and damnit ENG...you should demand a CPM from your O/S...they are covered by ins...OR SIGN A MEDICAL RELEASE AND GO SEE SOMEONE ELSE!...you are in the U.S. and your insurance certainly has DME coverage!!! i want to see you get better on time...not later.  a CPM will help with passive ROM and flexion which it sounds like you may be having problems with....and in reality this injury can take up to 18 months to repair...heal. do you guys think we could write a book and start charging these O/S for advice? 2 weeks and counting...and yes, i am scared.
love, auntie kim
Posted by EngKnee (EngKnee), 3 June 2004

Auntie Kim, you're the bomb and you hit it right on the head when you described the out of shape, weekend warrior type who is most suceptible to this particular injury.  Thanks to Tony or Nigel for posting the website of the particulars of the injury as they have shown me more of the why it happened to me  I do need to do whatever has to be done in order to get better in a timely fashion as my occupation depends on it.  I still haven't gone back to work and I couldn't if I wanted to.  That's what I'll use to get my outdated OS to agree to more treatment.  I have been doing my exercises and have increased the setting on my brace to 40 degrees lately and I do notice more confidence in the knee and less swelling and no pain just stiffness when I try to take it beyond the setting w/o the brace.  Sorry for the poor chap who got injured during his honeymoon, hope it didn't cramp yur style too much , I can't believe that the ship's doc was able to patch you up so quickly like that, good for him if it turns out alright!  This thread continues to amaze me and keep me on my rehab  Frats, John C.
Posted by Nigel (Nigel), 3 June 2004

Hey Kim - what's all this about "should be drinking beer instead of playing"? Let me tell you, our kind of Weekend Warrior drinks beer, THEN plays.   At our age we need the muscle relaxant effect.

And what about that Justin, what exactly should he have been sticking to, instead of playing football??  

Posted by kdhfrank (kdhfrank), 4 June 2004

mates

i can think of a lot of other ways of rolling around in the sand on my honeymoon that dont include a football...and probably burns more calories!!!! sounds like our beer swigging weekend warriors are getting a little antsy in front of the t.v.!  ...

cheers

kim

ps
Posted by EngKnee (EngKnee), 4 June 2004

Ok guys, I admit I was completely sober when I did my knee but I'm not going to say what I did in the sand on my honeymoon , I can't even remember being married it's been so long ago..... Kimmy I love it when you talk dirty  John C.
Posted by Fisnik (Fisnik), 4 June 2004

Hey everyone,

Long time no see. Been very busy working these days, and haven't been writing since there was nothing to tell, really. I was stuck in the heavy cylinder cast unable to flex the knee at all and, apart from having stitches removed about 2wks post-op. The only exiting thing was getting used to the crutches and being able to sit on the toilet seat. And oh, I turned 31 yesterday.  

Today, however, 4 weeks post-op to the day, was much more eventful:
For starters, I went out  after a month of house prison and noone could convince me to come back home. The first 5 hours of the day were spent queuing at the hospital (hospitals in Kosovo, by the way, are in awful state and they resemble Timbuktu rail stations in Indiana Jones movies), waiting to see my OS, which I finally did. He decided to remove the cast and put an adjustable brace, which was very relieving, especially since he had said earlier that I should be keeping the cast for 8 weeks.

Had an ultrasound, which, according to him, looked quite good and the tendon appears to be healing slowly, but surely.

He reccomended a CPM machine, which is unobtainable in Kosovo, so I need to urgently arrange one from abroad, so I can start flexing that knee - perfect timing for this kind of exercise while watching Euro 2004 soccer championship. Any other ideas than Ebay? Much easier for me to obtain one in Europe, so if any of you knows where I could get hold of one, gimme a shout, please.

He also set my brace to 20 degrees and told me to keep that setting while walking around in crutches, so the knee bends a tiny bit, which for me is really a big improvement, considerin that initially he wanted me completely immobile for 8 weeks.

Had also a chance to ask loads of questions, and I actually impressed him with the knowledge I had gained about this specific injury. Also gave him about 50 pages of printouts I got from the web, in case he hasn't read any of them.  

Doctors here can be very nasty if you appear to be telling them what to do, but he was quite grateful. I kept asking him why haven't I started flexing the knee while everyone else started doing that in week one post-op. He stated that he didn't want to take any chances because of: a) The rarity of this injury, b) My unusual body size and weight, c) The wires they have in Kosovo are of poor quality and seem to snap easier, hence the reason he put two of them inside my leg (not dissolvable, of course - wouldn't be surprised if he'd said they're made of wool or something) and d) He was worried I might do something against his instructions (yes, I look a bit rebellious and arrogant, but sincerely I'm not - must be my appearance). He simply thought that the first month is very critical and he didn't want any complications, so he played the safe card.

Bottom line is, I am very happy to have gotten rid of that heavy cast - feel like a bird wearing the brace. I'm also happy to be bending the knee a bit (yeah, I know, 20 deg is nothing, but it's a start). I'm happy about the fact that I can put quite some weight on the injured leg and don't seem to feel any pain, and that is a good sign, right?

Content with this morning's outcome, I decided to spend the rest of the day roaming the streets of Prishtina, which was very relaxing, especially while visiting my favourite coffee places. Glad to see friends again, particularly those who didn't have a clue about my injury and looked in disbelief at my crutches. Had some comments about my weight (loss), which was very encouraging, too. Most thought I'd gone back to London or something.

Overall, although a day late, today's day was a perfect birthday gift.

I think I wrote a bit more than I intended. Well, can't be bothered to edit stuff out. Too tired from the busy day, so I think I'm off to bed earlier tonight.

Have a good one, all!
Fisnik

P.S. I truly identify myself as a lame Weekend Warrior who thought he could actually fly and ended up immobilised for god-knows-how-long.
Posted by biged (biged), 5 June 2004

Hey guys and gals
My name is Ed and I ruptured both my patella tendons in both knees.  I am 6 weeks out now and just wanted to intro myself.  I am so excited to be able to talk with people that have gone through the same pain and trama I have. I live in Charlotte NC (and of course the weather is beautiful up here on Lake Norman where I live so the cabin fever is driving me nuts)

Posted by kdhfrank (kdhfrank), 5 June 2004

big ed

i would say congratulations on joining our club but i dont want you to throw your cane at me...in this thread you should be able to: know that you are not alone...but close to it. we are all going mad from being house bound and attached to our laptops and computers. we all think...but might not admit it...its kind of nice not working. most of us are out of shape weekend warriors (except for myself of course). we know more about our injury then our orthopedic surgeons. we could probably write a book and become wealthy... at least in euros. we smile and we cry. we just wish we could sit on the toilet like the old days. we support each other and chuckle at our various ingenious ways of figuring out how to do something without our legs. we dream about someday kicking a football (soccerball) or dribbling the ball down the court without crumbling into a sack on the ground...(except me of course). we give each other the strength to meet each day head first...and pass on the tips on how we did it. we are all united in our cause (to get our quads out of the jelly stage) even though our countries are not. and we pray that a fire alarm wont go off so that we dont have to run down 4 flights from our flat. we wish the mailman would have sympathy on us and bring our mail to the door. we wish we  could potty train our dogs...or at least teach them to use the litter box. we have all become comrades and probably all have the same scar. we all know that some day we will be the same as before even though we dont always hear that from our doctors. we would not be friends if we had not found knee guru. welcome. and may your recovery be faster then the rest of us!!! fat chance against me though!

cheers

kim from atlanta (and the only girl/woman here) and a nurse practitioner to boot.
Posted by Fisnik (Fisnik), 5 June 2004

Auntie Kim,

You definetely are an inspiration to us lesser mortals (read: weekend warriors). Although your last post didn't exactly answer the question I keep asking myself all the time (Will I have trouble because I spent the 4 post-op weeks without bending the knee at all?), it at least managed to cease my violent shaking (I AM dead scared) and stopped me from being on the verge of crying.

In case you're wondering, Ed, it was me who wrote a very happy-go-lucky post a few hours ago when I felt really happy about bending my knee a couple of degrees. Now, after reading a bit more about CPM use (which, incidentally, is inexistent in my country), I come to realise that my OS should have made me use one weeks ago and nearly started crying from worry of how it will affect my rehab in the future. These mood swings seem to one of the most common things we have here, and I'm glad I have a chance to share this with someone.

Has any of you guys (and our muse, Kim) gone through what I have? 4 weeks post-op without flexing the knee AT ALL? How will this affect my ROM and should I lose all  hope of getting my leg back to the previous state of should I still fight?

Gimme some hope, pals, as the articles I'm reading about this surely don't. My mood resembles that of my wife during her last pregnancy - one minute I'm the happiest guy in the world, the next I'm crying like a baby, not to mention hours of anxiety, laughter and fear in between. And the diet I'm applying in order to lose weight (and be fit just like I used to more than a decade ago) makes me crave for even weirder things than she did during her nine months.

At times, I see roasted chckens everywhere I look...hundreds of them! Chocolate with mayonaisse? Damn, I would kill for one of those! I think I'll just nibble on a carrot instead and shut up.

Fis

Posted by Nigel (Nigel), 5 June 2004

Fis, can I chip in a comment on this CPM machine thing? I'm sure they're brilliant and several people on KG speak very highly of them. But if you can't get hold of one, that doesn't mean you can't work on getting ROM. I was never offered a CPM machine, the physio just got me to do my own passive flexing several times a day.

Basically, you just need to move the knee joint without using the muscles. There are lots of ways to do that. The best way I found (at my PT's suggestion) was to sit on a high-ish chair with my bad leg resting on my son's skateboard. Then, use my good good to rock the skateboard back and forward gently, causing the bad knee to bend and straighten. I sat in front of the TV in the evenings and did that.

Also, I was back at work from early on post-op. I used to take off my leg brace while I was sitting down at the desk, with my bad foot planted on the floor, and rock slide my castored office chair backwards and forwards with my good leg.

I think these things, although they were low-tech, contributed to my good experience in getting ROM back quite quickly.

Provided you don't put any active tension on the muscles, I think you can safely work at your own speed to build up ROM passively. At first you'll only be able to get a few degrees of bend, but you should progress steadily.

Hope it works for you.

Best, Nigel




Posted by Nigel (Nigel), 5 June 2004

Fis - BTW, forgot to mention...I think your 4 weeks without flexing will be no big problem. Plenty of people go 12 wks+ in a full cast. Anyway, actually you ARE flexing now - to 20 degrees in your new brace. Obviously if you can start doing passive ROM exercises before too long (with CPM machine or without) it will help you get full ROM back quicker. But try to relax meanwhile and don't sweat it.

If you'll excuse me for saying it, the mood swings problem sound like a crash-diet issue, not a knee issue!! Don't starve yourself or you're bound to end up feeling miserable.

Talking about overcoming an injury, we watched the drama-docu film "Touching the Void" (on DVD) last night. It's the one about the two climbers who got in trouble on a 20,000 ft mountain in Peru. One broke his leg (badly - shaft of femur straight through the knee joint, YUGGHH) near the top, his partner tried to lower him down in stages but then had to cut the rope. Won't say any more, or I'll spoil the story. An amazing study in human endurance and sheer bloody-mindedness, and well worth watching if you get a chance.

Cheers, Nigel

Posted by Omaha (Omaha), 5 June 2004

Hello, I have been following this board now for a couple days and decided I should contribute.

I completly ruptured my patella tendon on May 4th playing basketball.  Surgery was on May 7th.  I am 6 foot 5 inches so the OS used 2 wire loops for support.  If the wires need to be removed the OS says a small incision will be made on the outside of my leg and he will just pull them out.

I woke up in post-op with a hinged brace and polarcare ice unit on.  Surgery was at 11:00 and I was on my way home at 5:00.

Week 1  -  A lot of pain.  Polarcare ice unit ran almost non-stop for the 1st few days.  Pain was all but gone by the end of week 1 and I stoped taking meds.  I will return to work on Monday.

Week 2  -  Visited the OS.  He said all went well and set the brace to 30 degrees.  Started Physical Therapy.  Very passive exercises up to 60 degree ROM.  Instructed to leave brace at 30 degrees for weightbearing and 60 degrees when doing passive ROM.  I could not reach 60 degees.

Week 3 - More of the same untill I visited the OS.  He was much more aggressive.  Changed the weight bearing to 60 degrees and the passive ROM to 90 degrees.  Started to attempt strait leg lifts and lower leg lifts.  Quad is mush and I could not do either one.

Week 4 - PT "encouraged" the ROM to 90 degrees.  He was assisting the the leg lifts at the beginning of the week, but I can now do both unassisted.  It is truly amazing how fast the improvements can come.  I have not been able to reach 90 degree ROM on my own.

Mood  -  Rollercoaster ride.  One day you can't believe how pathetic you are for not being able to lift your leg and the next day the improvement comes along to pull you out of the funk.

My next goal - I need to work on the quads so I can get the OS to let me stop using those bleeping crutches.

I have appreciated reading everyones experiences.          
                                                                  John
Posted by Fisnik (Fisnik), 5 June 2004

Nigel,

You could be right about the diet and mood swings, but if I ate as much as used to and kept still like I do now, the bed would probably break by now.

Not only do I have to be careful not to gain weight, but I'm actually trying hard to lose some in order to make the rehab easier, and I am succeding. I think I can cope with mood swings provided that a lighter, stronger (and hopefully handsomer) version of me comes out of this injury.  

Come to think of it, my worst moments are actually during late nights, deprived of dinner. Once upon the time, pizza delivery used to be a perfet cure.

Posted by Fisnik (Fisnik), 5 June 2004

Wow, John (Omaha)!

We seem to have so much in common! I am 6ft 6in and I also have two wires, I also ruptured my tendon playing basketball and we had surgery the same day!!!

The difference is that my OS is much more conservative than yours and I live in a country where CPM machines are nonexistent. You seem to be improving extremely fast!!!

I'm curious, how heavy are you and how old (if you don't mind sharing this with us)?

Fis
Posted by Omaha (Omaha), 5 June 2004

I am 33 years old and my current weight is 240 lbs.  Which is down 10 lbs, seemingly all from my right leg.          John
Posted by just (just), 5 June 2004

Thanks Nigel & Kim,

I must admit that I never thought that my leg would be the thing that got injured on the honeymoon. You are so correct about not playing footie.  Hopefully depending on how the leg goes we are going to rebook and do the whole honeymoon again next year including the three weeks that we had to cancel. I am now 4 weeks into the injury and the leg is still in a brace at 0% have small amount of pain but have been off the pain killers for three weeks.  I can lift the leg on, where were you all at this stage ?

Cheers

Justin

Posted by Croaker (Croaker), 5 June 2004

Hello,  
I hope you have room for another clumsy Yank.  I ruptured my Patellar Tendon on the 22nd.  I've been in a weight bearing knee immobilizer since then.  I had surgery on the 26th and go in on 7th to get the stitches out.  I'm about to go out of my mind with cabin fever.  I'm glad I found this site so I can communicate with people dealing with the same issues I am.   Below is the story of my adventure.  
Thanks,
Patrick

I went out for a hike on Saturday the 22nd in the local forest lands.  Stepped off a Forest Service road about half mile east of Alsea Falls, Oregon,  just right or just wrong, either way I slipped a bit. Only about a 3 foot drop at 55 degree angle or so. Nothing major right, so anyway I hit the bottom and knew I'd tweaked my knee so I tried to stand up... and fell down and tried to stand up again, and fell down.
I call to various deities in colorful ways and none responded. Now I knew I was truly hosed. Alone in the woods, no cell phone, 50 yards from my truck. I started feeling my leg cause I thought I'd broken it. OK lower leg bone intact, upper leg bone intact, hmmm mushy hole where I had a kneecap before.
So I figured I dislocated my kneecap. I tried to push it back into place as it was resting up on my thigh about 2 inches north of normal. After almost pissing myself I found out I couldn't put it back.
I crawled up the embankment to the road and was laying on my back when I heard a car coming down the main road about 75 yards away. I started yelling, they went past and I heard them slow down and reverse. The pulled up to the Forest Service road and then yelled to me "Are you OK" I thought to myself, well no you idiots, I'm on my back laying in the road. I told them I'd hurt my knee and need a hand.
They drove up to me and asked again. Like I was some crazy guy trying to trick them.
I gave them the run-down on what happened and the Father backed up and got out of his car and came over. He helped me stand up and that's when I found out I had no control of my lower left leg.
He got his teenage kid out and they helped me to my truck. They didn't have a cell phone, didn't have a clue where they were. They even asked me directions to Alsea. I figured these folks were going to be absolutely no help so I said I'd be ok and sent them on their way.
I got into my truck by lifting my left leg and putting it in, any bending of my leg hurt like you won't believe.
I tried to start the truck but couldn't get the clutch to depress enough so I got out and splinted my leg with some duct tape and 2 steel rods I had in the back. Now I could hobble around so I went to the edge of the road and got a stick to push in the clutch.
Got back in the truck, got it started and found out I could catch the clutch with my toes and shift.
Home I went, about 30 miles. Got home, honked until my wife Gail came out and told her I'd screwed my knee up and we need to go to the ER.
They diagnose it as a Patellar Tendon Rupture.  Orthopedic Doctor says only way to fix it is cut and sew.
I had surgery on Wednesday the 26th and now I have a 6 inch incision running straight through my left knee.
I can't bend it and won't be able to for weeks.  
The first half of the summer is hosed.  I'll have to see what July brings.   I might be in a brace by then, now I'm in an immobilizer, so I walk like Frankenstein and not for very far either.
Posted by Nigel (Nigel), 6 June 2004

Hi newbies - Biged, Ohama and Croaker. Hey what is this, Patellar Tendon season in the colonies??  

Loved hearing your story Patrick, made me wince anyway. I had nothing like such a problem as I got bloodwagonned straight down the mountain by very efficient Frenchmen. Although that was after I had tumbled a fair way down with a floppy leg and my ski still on...fortunately just a couple of friends nearby, who had heard that kind of language before.

Omaha, your treatment regime sounds quite dynamic and sounds like you're doing well. Good luck to all, any questions and those of us further down the rehab road will be happy to tell you how it was for us.

Any more tendon bunnies lurking out there? Come on in and say hello...no-one here bites (well Kim does but only if you don't follow your rehab instructions   )

Nigel (in UK)
Posted by kdhfrank (kdhfrank), 10 June 2004

heeeyyyy

just watching out for my cubs! I'm a nurse and i can't help it.

kim

ps

what a bone cruncher of an injury from oregon...how you ever dragged yourself onto the road let alone tried to push your knee cap back into place....makes me queasy just thinking about it...definately deserves a parargraph in Outside Magazine. almost as good as the guy who cut his hand off out west after getting it caught under a 1  ton boulder....Oregon, you are the poster child!
Posted by Rosbif (Rosbif), 10 June 2004

Not been doing my exercises much recently as have recently found out I will be unemployed at the end of the month . Doesn't really put one in the right frame of mind for leg exercises.

However am getting better at stairs and unemployment will give me plently of time to go to the Gym and do some work on my quads. At least the German government are generous with unemployment benefits
Posted by kdhfrank (kdhfrank), 10 June 2004

ros

so sorry about your job...seems everyday here in georgia someone i know or meet has or is going to be let go. they keep saying jobs are coming back here but i dont know of anyone who lost their job that has found one to replace it...maybe in the service industry, blue collar, manufacturing but not upper level higher paying positions. and when you lose your job here the government does not pick up your health insurance...and to carry it on your own is out of many peoples reach financially...i guess that is one benefit to the health system in europe over the private health system here. anyways, keep your chin up and your leg! what do you do for a job anyways? here in the us the medical field is a pretty stable field to go into...i talk many (men and women) to pursue this route from nursing to rad tech... it's not just for women anymore.

kim
Posted by EngKnee (EngKnee), 10 June 2004

Tony, brother I feel your pain man, I just know you will find an even better job in the future if you don't give up hope.  I am doing ok with my knee lately, my rom is at 50 degrees and I'm doing my exercises, I can't believe how this thread has taken off in the last couple of weeks, it's great to see , misery loves company.  I can actually go up stairs with the normal gait one after the other with a little hitch and not as fast of course, I found out during a trip to NYC recently when I had to hump it up to the subway platform and just came to do it quite by accident.  Can't go down steps this way yet only up but I'll take it.  I need to do more exercises as well, how many is enough?  If I thought that doing them all day long would speed my recovery I would attempt it, my doc never told me how often or how many reps to do but I guess the more the merrier. John C.
Posted by Fisnik (Fisnik), 10 June 2004

Hey guys,

Rosbif, really sorry to hear you lost your job. I wish you good luck finding a better one as quick as possible. As a web designer, I experienced the ups and downs of the Internet while I lived in London, and really felt it when the dot-com bubble burst back in 2001, especially after 9/11. Had to change 6 jobs in a period of 18 months because companies kept goin bancrupt. At the time, I thought it will never get better for me, but eventually it did, so do not lose the faith.

It's 5 weeks post-op tomorrow for me and nothig much has been happening here. My OS insists I stay put for another week before I start any rehab, even CPM.

Had a brace fitted last week and set to 20 degrees and been doing well with it, going up and down the stairs and all (with crutches, of course). Quads are mush and the only exercise I was allowed to do is contracting the quads.

Found a CPM machine on ebay and ordered it. A friend of mine in Washington state agreed to bring it over , since he's coming to Kosovo this Monday. OS said that the CPM machine will help me and was really happy when I told him I will donate it to the Orthopaedics Ward when I'm done with it. Cost me only 450 bucks (new ones seem to be quite expensive) and I hope it works.

Gotta hang on for a few more days like this and hopefully things will start changing sometime next week.

I have no idea how long the rehab is gonna last. It'd be nice if everyone summarized their rehab experiences in a couple of paragraphs, so we can do a comparison.

Not much fun sitting and waiting, but if my OS says so, I got no other choice. He obviously does not want to take any chances and is being very precautious.

Not much of an update here. Hope you guys are doing better.

Cheers,
Fis
Posted by Teresa_S (Teresa_S), 10 June 2004

Hi, I , too, ordered a CPM from Ebay, and it works fine, but was a little difficult to get together, and I hope you ordered a pad kit, or can make one that doesn't slide. The CPM is great to sleep in also, and of course you can keep up the amount of flexion and extension you get, if the OS agrees. Good Luck, I got mine in about 4 days here in the states.  I thought if they rent for about $50 daily paying the $400 I paid was a good investment. Teresa
Posted by Fisnik (Fisnik), 11 June 2004

Apparently, the CPM I ordered is patient ready, so I suppose there won't be any problems putting it togedhe and, yes, I ordered the soft kit. Hope everything goes ok and I get the machine over here and start the rehab.

Do you guys think I'll have problems recovering because my OS refused to let me move the leg for 6 weeks?
Posted by EngKnee (EngKnee), 11 June 2004

Fis, calm down dude , we are all still going thru rehab with our respective knees, there is nobody here who  has gone all the way thru it successfully unless I'm missing something here.  We have a few who are further along and are doing quite well but I don't think they are "out of the woods" yet.  Like you, my OS was also from the old school and didn't perscribe any CPM machine, and didn't even put the wire loop like you had but I was weight bearing after the staples were removed and I see a little improvement on a daily basis.  Auntie Kim is the most experienced poster and seems to know more than the rest of us.  I was told four months by my OS so I figure that means I'm only half way there.  My knee still feels wierd, tight, hard and numb in places but I continue to try to go back to normal use by doing the things that I would normally do being careful not to overdo it.  I had a buckling incident the other night as I was walking around without my brace and I tripped over a shoe, I was so mad at myself for that but the knee hung in there and didn't hardly swell or hurt, that's progress for me.  Keep your chin up and be patient. John C.
Posted by Teresa_S (Teresa_S), 11 June 2004

After both of my last two surgeries, my OS didn't order any PT for 4-6 weeks, and in fact, ordered, rest and elevate. IT made me so mad, because when I did get to go to therapy, I worked to the point of tears, and ready to give up for the first two weeks, and made wonderful progress, and then all of a sudden, both after two weeks, the joint went backwards, got hot , swollen, and the therapist could not force it to move. So, I couldn't believe he did the same thing the second time around, and identical things happened. I worked so hard and then could not force the knee to bend and work . IT took me forever to work my quads effectively the first time, as it felt dead. Anyway, good luck, I have had my scar tissue back since the first of March, and am playing a waiting game, looking for the right physcian. Teresa  I have been off work since 02-15-02111 31 months, and no income, thank god for my disability pay. Teresa
Posted by Rosbif (Rosbif), 11 June 2004

Thanks your messages of support.

Kim - I work as a shipbroker. Already have a few possibilities for new jobs, but they are only possibilities. Being in a foreign country where I don't speak the language doesn't help matters, but at least I can live on the amount of benefit I will get whilst unemployed. Would be a lot tighter financially if I was home in England.
Posted by Rosbif (Rosbif), 11 June 2004

Decided to stop feeling sorry for myself today. Have applied to do a law conversion course at a University back in England.
Already been told by one University that with my qualifications they cannot see a reason why they won't offer me a place.

Will start in September. so 2-3 months to get my knee working properly.

Tony


Posted by Nigel (Nigel), 11 June 2004

Hi Tony, the thread's gone mad this week, just catching up with it.

(I'm going to go off-topic so the rest of you just tune out for a mo...) Really sorry to hear about the job. I had v similar experience a while ago, after 15 years in marketing jobs. I too looked at law conversion training but was some friends in the professional advised me it would be really tough to find a job afterwards (I'm 45 and there are lots of out of work lawyers at the moment). But I assume you're planning to specialise in shipping law? That's a real specialism so presumably more job prospects?

Anyway, I eventually decided to re-train in environmental consulting and I'm also off to college (Cranfield), to do a Masters starting in Oct. Getting good experience meanwhile with a consulting firm in London. Get in touch off-line if you like, I'd be interested to compare notes on the career stuff. Where are you going to study? If it's in the south-east somewhere let me know and we can have a beer.

Had a sticky week knee-wise, overdid it a bit and paid the price for 48 hours or so. But it's amazing how it's just settled down again now, like it never happened.

All this CPM talk is making me feel very low-tech. Hey, but I do have some very trick crutches with ergonomic handles, if anyone's interested?...!

Cheers, Nigel


Posted by kdhfrank (kdhfrank), 11 June 2004

cubbies

i think you all would make great nurses! why not consider nursing as a career path! they don't make you wear a cap anymore.

kim

ps

trying to pack for cincinnati...i will post over the weekend with my OPINIONS (which obviously carry some weight around here) and...rambling thoughts as usual...and some rehab protocols. talk to you guys soon.
k.
Posted by EngKnee (EngKnee), 12 June 2004

Auntie Kim, Good luck on your trip to Cinncinatti, are you going to have your surgery done this time out?  If you are then we will all be thinking about you and hopefully your LAST operation.  By the way guys don't want to become nurses they just want to be with them after work. John
Posted by Nigel (Nigel), 12 June 2004

Actually we probably WOULD want to be nurses, if they still had the old uniforms...  
Posted by John42 (John42), 14 June 2004

Hi Folks

Been away two weeks and the board has gone mad with new recruits to the Ruptured Patella Tendon club.

Must inform members, that since the Consultant discovered that I had Veinus insufficiancy ( water circulation problems as some of the veins above/below the kneecap had sealed up) prescribed water tablets and this has done the trick.  This removes all the excess fluid from the leg.

Still have 117deg ROM seventeen months since I ruptured the Patella Tendon, but relieved of swelling and pain but will always have a limp.  

The least of my worry.

Have meanwhile been to Vancouver,Victoria and a twelve day coach tour of the Canadian Rockies.

FANSTASTIC except the nine hour flight from Heathrow to Vancouver - squashed up like sardines in a British Airways 747.  Sat on the stewardess seat - (not her knee) at the very rear of the aircraft to get more leg room and stretch the leg.

Like wise, on the return journey, sat next to the window on the back row of the 747 - perfect.  

Leg feeling much better - however cannot chase blondes!

JohnK/ Manchester UK
Posted by EngKnee (EngKnee), 14 June 2004

Hey John K. how bout those redheads? Sounds like yu had a great trip to the NW, did you see any whales?  I'm interested in yur plight and the water pills, I'm only a couple months out from surgery and my knee still feels pretty stiff and unnatural with some swelling, I have been prescribed leg exercises by my OS and increased ROM, 10 degrees/wk, tommorrow I will increase to 60 degrees, but I still feel like I'm a long way off from normal operations.  When you say you will always have a limp that really got me, as I hope I don't feel that way in a couple of months.  Is there something you could have done early on to prevent what you ended up with?  I take it you can't run either. JOHNC
Posted by John42 (John42), 14 June 2004

Hi JohnC

Have a look at my original posting page 7 about 2 weeks ago - you have to realize that you have a long way to go before you reach the first milestone of 90deg -  average 4/5 months after your operation,bearing in mind that the normal leg will have a 135 deg bend, your next step is to work upwards to stretch the Patella Tendon to reach 110/115 deg. This took me about 12/14 months which is normal. Then depending on how young and fit your were, you might get past this and reach 130deg - lets hope so.

The swelling will continue for quite a long period - the best cure is leg up and an ice pack on the knee.

My Consultant said from the very outcome, that whatever bend you reach after 12 months is as much as one is likly to get, but in practise I got a bit more. This does not restrict any activities but any sport involving kicking/running etc is out.  Most members of the Ruptured Patella Tendon club will end up with some sort of limp/impediment and be thankful thats all.

The water on the knee was only diagnosed some four weeks ago when I complained that my leg was always swollen and this could be an isolated case.

Did not bother to see the whales - as I have seen them in other parts of the world, nevertheless, the Rockies are super - on a par with the Swiss Alps.

Best wishes
JohnK/Manchester UK
Posted by Croaker (Croaker), 14 June 2004

Hi Folks,

I back again, with a few questions this time.  This isn't my first go round with knee surgery.  I had an ACL repair and a Medial Meniscus repair way back in 1979.  They were done at RAF Lakenheath.  The pain I'm feeling now is far greater than I remember from my previous surgery.  I'm on my third try to stop taking the pain meds and wow this ferret won't stop chewing on my leg.  Does anyone have a suggestion?  Heat, cold, massage, anything?  I know the doc is going to turn off the meds spigot soon.   I also have a question about swelling, at least I think it's swelling.  Just between my knee and the top of my tibia it looks/feels swollen.  If I push on it it just dents in like I'm pushing on clay or putty, it fills back in.  What gives?  I go back to the OS on the 24th to get a hinged brace.  Can't wait.
Thanks,
Croaker
Posted by Nigel (Nigel), 16 June 2004

JohnK, welcome back from BC.

Having just recent your post I must say I was disturbed by your comments (a) that it is "normal" to take 12 months+ to get past 110 deg ROM; and (b) that "Most members of the Ruptured Patella Tendon club will end up with some sort of limp/impediment...".

What is your basis of evidence for this? I find both comments surprising: the medical accounts of this injury that I've been able to find state that most patients make a pretty full recovery including resumption of sports. The accounts I've read look for full active flexion after 6-8 weeks as a rehab goal (which, of course, not everyone will attain).

It sounds like, on the one hand, your recovery has been slow and painful, whereas other the other hand (leg?) I have been, maybe, pretty lucky - 130+ ROM after 8 or 9 weeks and now walking without a limp after 3 months. And my point is?...we're both individual cases.

I think it's important for people at the early stages with this injury to realise that they have every chance of a good recovery and that, as with any orthopaedic injury, a positive approach to rehab can make a big difference. This requires focus on the best potential outcome while also understanding that there MAY (not will) be some residual problems to work through.

So I wondered what source you have for your outlook on recovery? If it's based on one OS's opinion I think we need to be cautious. But if you have access to any stats-based info it would be great if you could share.

Best, Nigel
Posted by John42 (John42), 16 June 2004

Hi Nigel

Your thoughts are noted, however my facts have been colated over the last 17 months since I sustained my own injury.

Following the statistics on two message boards, some 28 persons (mainly in the States) have suffered a Ruptured Patella Tendon.  There are no doubt others who have not made themselves known, although in this day and age, most injured persons research their injury on the Internet.  I have over a period in time been in touch with various Consultants/GP`s etc, who all confirmed that the rehab period for any injury to the knee is a long process in particular if the Patella Tendon is ruptured, by the very nature of the tendon. It is also a fact that the Consultants consider an ultimate shortening of the Tendon to be in the range of 20/30%.

It`s true that some individuals will get a full ROM quicker than others and I would be the first to be delighted if I heard or knew of anybody who reached a full ROM regardless of the time frame. I do in fact know of one, a young,fit policeman who lives in Staffordshire,and it took thirteen months to reach this stage.

I am glad that I found this message board as our purpose in life is to give tips and comfort to fellow members of The Ruptured Patella Tendon Club.

Best wishes
JohnK/Manchester UK
Posted by EngKnee (EngKnee), 16 June 2004

Hi everybody, you too Kimmy, why is it that mostly guys rupture their patellar tendons while girls only dream about it.....Hey Croaker, the best way to combat pain and swelling in the early stages for me was ICE and ELEVATION, take it easy and just chill, you won't be climbing any mountains right away dude.  Your story is a great one probably the best one on this thread but the best advice I can give you during the early stages of post op is to relax and do the ICE and ELEVATION, use two pillows if you have to.  It's not fun but you will feel a whole lot better, I guarantee it.
Now as for recovering the max amount of ROM issue before us, that one has alluded me so far since I'm only at 60 degrees at eight weeks post op, increasing 10 degrees/week.  Am I to assume that 170 degrees is the optimum where I can bend my knee all the way against the strain of the tendons?  When I push my knee to the limits, past 60  it feels real weird and tight, is that normal?  Almost like the bones aren't lined up, is that the case?  Yesterday I hurt a distinct crack from the knee when I was exercising it, is that good?  John C.
Posted by John42 (John42), 16 June 2004

Hi JohnC

Get your Consulant/Doctor to measure your good leg -
it should be in the region of 130/135 deg -

Best wishes
JohnK/Manchester UK
Posted by Nigel (Nigel), 16 June 2004

JohnK - I have virtually full ROM (well, 130+ but can't quite sit on my heel on that side). Maybe the French surgeons are specially good!

Not myself convinced that KG and other web board posters are 100% representative. Also I have suspicion that medics generally tend to be over-pessimistic about outcomes, not wanting to set expectations too high. Last time I had injury (broken wrist) I was told I probably wouldn't get full ROM, but in the end I did.

Hard to get a fix on age range of RPT sufferers - apparently mainly under 40s (olders tend to break above patella, not below) but of course Kim points out Weekend Warrior phenomenon!! I gather a lot of basketball players get RPT so maybe more in US than UK? (over here we call it netball and it's a girl's game!  )

JohnC - the advice seems to be "work in the pain-free zone" but I think you have to push it a bit to build up the ROM. As I described to Fis, I found the "office chair shuffle" a good way to do ROM exercise in background while at work. I introduced a bit of side-to-side as well as backwards and forwards movement - seemed to help to ease up the joint. But that variation was my own, NOT advised by my PT!

Not sure about your noise though - sounds like you're popping rivets or something  

Not been to PT this week but started driving my own car - a manual g/box, not my wife's auto I've been using so far. Seems to be good exercise, if only on the basis that it hurts like b***ery after I get stuck in traffic!

Nigel


Posted by Omaha (Omaha), 17 June 2004

I just got back from my 6 week follow-up appointment with the OS.  He is happy with the progress.  I have been crutch free for a week now and have obtained a 100 degree ROM.  I can walk with close to no limp until I get fatigued.  The OS had me put the hinged brace at 110 degrees.  He wants me to start weaning myself off the brace completely.

I was instructed to start going for full ROM (passive) at week eight and to start working with heavy weights at week 10.  I look forward to sleeping without the brace this evening.                  John

Posted by Nigel (Nigel), 17 June 2004

Omaha - sounds like great progress! What weights work have you been prescribed? Is it resisted lower leg lifts?
Posted by Omaha (Omaha), 17 June 2004

Nigel - currently doing lower leg lifts and strait leg lifts with a small ankle weight.  Currently 3 lbs.

Started with a 1 lb. weight progressing 1/2 lb. at a time (as tolerated).  Doesn't sound like much, but it feels like it.
Posted by kdhfrank (kdhfrank), 18 June 2004

omaha

are you sure that you should be using weights at this point? i could be wrong but passive ROM usually doesnt include weights. for the rest of you cubs....patellar tendons take approximately 10 WEEKS to heal!!!! after that it is a slow or fast climb up that mountain to full recovery. and again from the journals....it can take up to 18 months to recover from a patellar tendon rupture....some earlier...some later....i would assume that during most repairs some of the tendon is lost (have to make those edges nice and shiney and strong) so i doubt that full rom is likely but definately can come close. i lost about 1cm in my repair but my surgeon that will be doing my surgery on tuesday thinks he can get most of my range of motion back. i dont care if i can never do yoga and wrap my leg around my head...i just want to be able to ride a bike again. talk to you guys after tuesday...if i am not seeing triple...i will be in the hospital for 3 days post op (jewish hospital of cincinnati at kenwood)...hmmm...i guess a rabbi will come visit me instead of the nun (she was very nice) at my last hospital.

bye

kim
Posted by Fisnik (Fisnik), 19 June 2004

Hey everyone, it's me again!

Unlike Omaha's case, whose physique, injury and surgery seem to be nearly identical to mine, my first PT session started today (yippeee!!), 6 weeks post-op to the day, thanks to my persistency, since my OS initially wanted me to stay immobile for at least 8 weeks.

A couple of days ago, I was happy to receive my e-bay purchased CPM machine (thankya all for the advice), only to be dissapointed soon afterwards when my uncle, in his attemt to help me see if the machine works, blew it up by connecting it to a 220V power supply (the European standard), forgetting that U.S. voltage goes only up to 100V. Yeah, it's a bummer, and I hope the electrician I sent it to will be able to fix it, otherwise it'll be 450 USD down the drain.

At this very moment, my knee bend is about 30 deg, and so is my brace. The PT had the kne iced, massaged and then flexed, before putting it inside this tubular magnetic thingy and then into some electrical impulse thingy afterwards. All felt nice and relaxing, without pain, except the passive flexing, which hurt a bit, and the feeling of the tendon stretching was a bit weird.

As usual, I start bombarding her with questions about other similar cases she had and their outcomes, so she tells me about some good recoveries and some bad ones. What scared the heck out of me was when she told me about some guy who was late with his rehab by starting it 4 weeks post-op and had problems afterwards. I started shaking when I reminded her I was 6 weeks post-op and she wouldn't say whether I'll be having problems with the late rehab or not, insisting that it's still early to come to a conclusion.

Overall, I'm quite happy I finally started the PT sessions, but at the same time I'm scared stiff thinking about the possible problems I might have. Another thing that confused me is when my OS said I'd be reaching 90 deg in a cpl of weeks, while the other OS, who assisted my OS during my surgery, told me that it'll take 3-4 months before I'll be able to flex  up to 90 deg.

It's been a very long day today. I better get some sleep, as I will need to be going to myPT first thing in the morning.

Will keep ya posted with my development.
Posted by Nigel (Nigel), 19 June 2004

I came across an interesting summary of outcome research in patellar tendon surgery. The article is about tendonosis rather than rupture but, still, I think it may be applicable:

"Patellar tendon surgery has a rather unpredictable outcome. A review of 23 papers found that for surgery the combined excellent and good results were between 46% and 100% (42). In the three studies that had more than 40 patients, authors reported combined excellent and good results of 91%, 82%, and 80% in series of 78, 80, and 138 subjects, respectively. The mean time for patients to return to preinjury level of sport varied from 4 months to greater than 9 months. A long-term study (43) of outcome in patients who underwent open patellar tenotomy for patellar tendinosis showed that only 54% were able to return to previous levels of sport activity. In two prospective studies (17,44) that evaluated time to return to sport, most subjects required more than 6 months, and often 9 months, to return to full sporting competition."
Cook et al: see http://www.physsportsmed.com/issues/2000/06_00/khan.htm

It emphasises the big range of outcomes. But the 'typical' times to return to competitive sport seems to be in the 4-9 month range. This may be non-representative of us because it is probably skewed towards professional sportspeople, but it shows what's possible - it doesn't have to take a year or more.

The article also notes that complete rest is not an effective treatment because the tendon collagen needs some tension to heal. I assume this is why the newer, more aggressive rehab regimes seem to work - always assuming you don't overdo it!??

Anyway I found it an interesting article generally, and at the end it has some good stuff on rehab methods.

Nigel

Posted by John42 (John42), 20 June 2004



Hi Nigel

Indeed a very interesting article - perhaps you should also have a look at the article at

www.medscape.com

You must register first ( I used "nurse") and then
read "Primary Patella Tendon Repair"

I trust you find this of interest.
Posted by just (just), 21 June 2004

Hi Guys,

Had my 6 week followup and the hospital are happy that the tendon is healing and that they will not have to open it up again ( Which is good news ).

They have advised to wean myself of the knee brace but to still use the crutches and will be starting physiotherapy this week. So have not had the knee brace on at all for the last 3 days and boy has that improved my sleep not having that on. Can put some weight and can bend the knee a bit but does feel very tight ( am not going to push it till start physio ). The hospital seemed to think that I would be looking at around 6 months for full recovery.

I will let you know what the physio says.

Cheers

Justin

Hi all,

Nigel, a great summary you wrote there about the Medscape research. Couldn't resist reading it myself and found it very interesting.

Seems like my physio is a bit agitated my OS sent me to see her 6 weeks post-op rather than earlier because my patella seems to be a bit stiff when she tries to move it left-right and up-down. It was my third physio session today and it seems to be making a big difference every time. The stiffness of the patella seems to be giving way, especially when moved left-right, since she could move it much easier today compared to the first session.

Still waiting for my CPM machine to be fixed, while in the meantime my physio decided to move my brace from 30 deg to 45 only after 3 sessions, since she feels my flexing is going quite okay (knock wood). She is one tough woman and I love her. When she starts bending that knee, she really makes me sweat from the pain and won't even let me make a sound.

Knee still swollen (not much) and still numb on the left side of the knee region, dunno if that is common 6 weeks post op.

Extremely happy with the PT outcome so far (knock wood again). Progress slow, but every little change is noteicable. She's determined to get my flexion far enough to be able to sit in a car, since she felt sorry when she saw me being carried out my best friend's jeep's boot like a piece of luggage.  

Started going to the office and applying Nigel's office chair technique, which seems to be working well. Cheers for that, Nigel.

Overall, every degree I gain only makes my grin wider and I hope it goes all the way, just the way the late Burt Lancaster used to do it.  

Cheers all,
Fis

Hello, Kim.

I'm a regular poster on the soft tissue problems board (arthrofibrosis  ). Just want to send my wishes for successful surgery and smooth rehab.

You're in great hands with Cinncinati SportsMed. I've read dozens of articles authored by their staff. It really is the place to go for complex knee problems such as yours.

Take care.

Jaci

Hi Nigel,

My physio says that patella is giving way slowly, especially when moved left-right. She said she'll put my brace to 60 degrees today, since I fully reached 45 yesterday. Now, considering that I jumped from 15 degrees to 45 in my first four PT sessions, am I to assume I'll be getting my ROM back fairly quickly? Unless it gets stuck somewhere along the way (which I truly hope won't happen).

The knee is stil swollen, but not much, and seems to be going down slowly every day. Its left side is still numb, though.

Just had my CPM fixed, so looking forward to start using it tonight.  

Kim,

Hope all goes well and we see you back in here soon, before we start becoming careless and messing up our bad knees when our weekend warrior syndrome starts kicking in.

Great to hear from Momma Bear sounds like she's doing OK so far, we'll find out more when she comes off the meds.... sounds like everyone is doing pretty good today making progress and feeling that there is a life after knee surgery.  I go to my doc on Monday and am planning on giving him more reasons to give me a referal to physio so that I can know that the best rehab is being performed, failure is not an option for me and since I'm kinda lazy sometimes I need more supervision and direction regarding my exercises.  I'm in the process of re-roofing my home and am working as the ground man picking up and schleping worn out shingles, now that is great exercise I hope  I'm at 70 degrees ROM but still feel unnatural when I push it to the limit with very little lateral confidence.  I tried to go without my brace for a longer time period and paid dearly for it with the old swelling and pain, had to break out the ice pack for that one but I did get a bit of sympathy from the ladies present.  Hope all is well out there in RPT land. John C.

Hey, where's everyone gone on this thread? All got better??    

I had good OS session last week, he's moved me onto a higher proportion of strengthening exercises, including half-squats on one leg. Can just about do them. Completely overdid it at physio (which is now circuits in hospital gym) yesterday and now hobbling about...but in a "good way" I think - no pain no gain.

How's Kim? You should be over in England, at least you could have your feet up watching Wimbledon. Hope they took that catheter out before you drained away altogether...  

Nigel

Nigel et al, Kimmy probably hasn't come off the meds or her surgeon yet , but I am happy to report my first visit to the physical therapist and he thinks I'm doing OK so far but started me on more rigorous exercises, electric stimulation of the muscle above the kneecap and repetitive movements of the knee with a strap around my foot, not bad for the first day.  I'm at 80 degrees ROM now and hoping my disability insurance will come through so I can make it through the summer.  The roof is halfway complete and the pool is crystal clear today.  John C.

Tony - what's the leg press, is that pressing outwards with foot flat, or lifting lower leg against a weight (presumably not if you're doing 50 kilos!!)  

Hi All

As I have suggested before - get a "pedal exerciser" - a super device.  You sit in a chair and pedal away - not expensive.

I heard from Momma Bear some four days ago in response to a get well card -  I suspect that she is hiding away amongst the bushes like those black bears I saw two weeks ago in British Colombia.

Best wishes
JohnK/ Manchester UK

Hey guys,

Thought I'd give you a little update, too. I've been going to PT sessions daily and the physio is very good. Still doing passive flexion exercises and I have just reached the 90 deg mark today, which is great after 9 PT sessions, I think. Been using the CPM machine, which finally got fixed, and that seems to help, too.

Can't tell if my swelling has gone down much, since I keep looking at my knee all the time, but mum said it has gone down considerably since last week, when she last saw me.

For the first time today the physio asked me to lie face down so she could bend the leg from behind. It was very painful, but as Nigel says, no pain no gain. She said the 90-110 degree region will hurt more than usual, so I'm in for some painful sessions for the next few days. She also says that the knees sometimes tend to "lock" at 45 and 90 deg, so I'm a bit panicky about that. You guys know anything about this?

I'm also starting some work on my quads, doing straight leg lifts while standing. Can't do a straight leg lift while laying on my back yet, but I can feel the power coming back very slowly.

Decided to work from the office from yesterday, so it feels great to be outside again.

Momma bear, great to hear you're doing well. You inspire every one of us.

Laterz!

Hi all,

Can't believe its been soooo long since my operation and I have just found this superb board!! Just spent the last 2.5 hours reading every post. Glad other people are suffering like me  

As a newbie, here is my summary:

- Did my leg playing volleyball (a first for this board). Jumped, landed, and bang, the knee moved, and snapped the patellar tendon (another weekend warrior!!)
- 30 years old, and another one of the giant brigade on this board, 6'7", and 18 stone (whatever that is in kg)
- After the initial injury and trip to A&E, they sent me home for a week. When I returned, the doc didn't like the fact I couldn't lift my leg off the bed, and decided an ultrasound might be useful. And hey presto,. they found the tendon severed!

As per previous posts, I do just have to share one sob story I have had. After the Op, the doctors moved me back onto my hospital bed from the operating table, and then woke me up. Unfortunately, when they moved me back onto my bed, they had left my ankle dangling over the end of the bed!! Total agony!! 5 shots of morphine in 20 mins didn't help until the leg was raised when I got back to the ward 10 mins later. Not a good start to rehabilitation  

Anyway, I had a full cylinder cast on after a couple of days of the Op. Have to keep it on till 2nd Aug when I next return to hospital. That'll be a total of 6 weeks in the full cast (staples were taken out after 2 weeks). I am really hoping they cut the cast off and put me in a temporary brace and start the PT when I go back on the 2nd Aug. But as "Auntie" Kim has said, slow and steady.

Luckily my work has been good in letting me have all this time off work. Going slightly stir crazy in the flat (4th floor, but I have a lift   ) but with food shopping delivered to the door, and a collection of about 230 DVD's, I am keeping sane, just. Although a good woman would be a help  

Good to hear everyone is progressing, and their is hope at the end of the tunnel for me.

Cheers

Andy
(Portsmouth, UK)

Hey big man (Andy),

I am one of the few who has a pretty good idea what you in particular are going through, mate. Not easy for us bigger blokes to be in this situation is it?

I'm now 9 1/2 weeks post op and have reached around 120 deg ROM, walking with one crutch (doing ok without it, too) with a brace fitted.

Mate, the first 6-7 weeks for me were hell, and I assume you're not having much fun yourself. All I can say is hang in there, buddy, 'cos things do get better. Takes some time, but things like being able to properly sit in a toliet seat or front passenger seat in a car will be considered big achievements pretty soon.  

DVDs are lifesavers!

Just discovered that my knee has become a very good weather predictor. Last night, just before I was leaving to watch Spider-man 2, I had some immense pain and wasn't able to move the leg at all! When I came out of the cinema it was pouring very heavily and I got soaked since the car was not parked very close and I had no umbrella.

Sorta makes me feel a bit like a super-hero, having a weather sense now...

Nigel, you were right about the sharp pains. They have subsided a bit and I feel much better. Managed my first unassisted straight leg lifts yesterday. Was very happy about it.  

Oops, there comes the pain again... I can hear the thunder miles away, too.

Off to my PT session. All the best to everyone.

Fis

Hi Nigel,

Good questions mate, but I have no answers. I have seen a total of 5 doc's whilst, and after, I was in hospital. None of then were really forthcoming in telling me exactly what was done and why. I am sure I haven't even seen the doc who actually did the Op. My own fault really, I should have asked more questions. But as with most UK doctors, they all have too many patients and not enough time to tell us what is happening. Its really up to me to ask the questions!

On my next visit on the 2nd, I am going prepared with a list of questions. I did get told before the Op they would be putting wires in. However, I do not know if they did, and what type, i.e. disolvable or not. As for the full cylinder cast, they just said they did not want the leg bending. A pretty basic answer I know.

As for getting back to work, my attitude in the short term till I go back in August is to rest the leg as much as poss, to give the tendon time to heal. Once they cut off the cast, and test the leg and get the results, then I'll decide on going back. Although I am lucky in being able to work fully from home on broadband, and to be honest for getting to and from PT, it would be easier to work from home in the first few weeks.

Talking of PT, how many times are you guys/girls going? What sort of PT are you doing, and how long are the seasons lasting?

As per John K's comments, I am going to have to go back into the plaster room for a new cast. Its slipping down the leg when I am up and about. Should be interesting checking out the leg comparison when I do  

Time to go and get some grub,

Cheers

Andy
(Portsmouth, UK)

Hi all,

I am 10 weeks post-op today. Started my PT 4 weeks ago, after 6 weeks of being completely immobilised (4 weeks in full cast, 2 weeks in an adjustable brace set to 15 degrees).

Been doing PT for 2 hours every day (except Sundays), lasting around 2 hrs. That includes 15 mins on some electrodes running electricity around my injured area to improve blood circulation, ice treatment, aggresive patellar massage for about 10 minutes, passive ROM exercises for another 25 minutes (painful bugger), magnetic treatment for 20 mins (helps blood circulation, wound heal, etc.).

After reaching 110 degrees last week, started doing more aggresive quads exercises, including straight leg lifts and side leg lifts. Straight leg lifts were extremely tough and painful at first, but are becoming easier every time I do them.

Yesterday I reached 120 deg with my physio's help, can't reach it yet by pulling my leg. The post-90deg flexion exercises are going a bit slower.

Been using one crutch for the past 4-5 days, and going around the flat and office without it. Hoping to ditch the crutch by end of July, ditch the brace by end of August.  

I notice that everyone's recovery time is different. Mine seems to be quite slow, but I'm quite happy with the results so far.

Will be going to a spa with a rehab centre very soon. They say it helps a lot.

Cheers,
Fis

Hi All,

Well i guess i am also a member of the RPT club now...

I have ruptured my patella tendons from both legs on the 9th of June 2004 during a baseball match. It happened while decellerating after a sprint to second base.

I am 27 years old working as a structural design engineer living in Rotterdam the Netherlands and have been playing baseball for 18 years now and also been doing bodybuilding since about 7 years. The doc said that my muscles were too strong compared to my tendons. I was at the time of the accident just over 100 kgs (220 lbs)...

All in all it has been a little more than 5 weeks after my surgery. I had the typical treatment from what i read on this board. With the tendons put together with sutures and metal wires. The night after the operation was hell!..So much pain..but i got a cast from ankle to midsection the next day and the pain was tolerable since than.

My treatment from than was a little different than what i have read here because i was put in the cast for a total of only 4 weeks without any movement. I was first told that i would be in this irremovable cast for a total of 12 weeks which rather scared me. But after 4 weeks the cast was removed and i was send away.

The docters in The Netherlands are a lot like the UK docters from what i have read here  ..not much info is given and they are very busy..

I was hoping to get a hinged brace but that was not how it worked they told me..

I started Physical Therapy last saturday with a sport therapist who is actually pretty good. He has accompanied the Dutch Olympic team as PT the last years and is the personal PT of Feyenoord (professional Dutch football club)..

But he told me i was a very rare case with ruptured patellar tendons in both legs  

My PT is three times a week about 40 minutes per session which mainly involves (aggressive) massaging of the kneecap and passive movement of the knees.. (painfull) !!!

After three session my right knee has a ROM of about 75 degrees and my left leg about 60..

I am currently taking:

*Glucosamine 1500 mgs/day
*Chondritrin 1200 mgs/day
*Vitamin C 2000 mgs/dag
and lots of protein (30 grams/day) to speed up the healing process..

The above supplements aid in collagen formation . (Tendons  consist mainly of collagen type I) I have not seen this posted anywhere in this thread but i can advise you all to use it.

The protein is essenial for muscle hypertrophy because my thighs  have shrunk from about 76 cm (30 ") to 52 cm (20 ")

I plan to keep ypu all updated of my progress and i am glad to have found this board for excellent information and "soulmates"  

If there is anything special that you guys are doing to speed up recovery please let me know.

Take care,

Rico

Now that you mentioned it, Rico, I found some vitamin supplements here in Kosovo (made in Croatia) designed for people who have joint problems.

Two pills (reccomended daily) contain:
Glucosamine 500 mg
Chondroitin 400 mg
Vitamine C 200 mg
and some other stuff.

Been taking them for a month and a half now and don't really know if they helped, but I assume they did, 'cos my OS was surprised with my progres after the latest ultrasound check-up.

Maybe I should increase the dose.  

Also, a friend of mine who's about to graduate in medicine in Austria, has read somewhere that eating Haribos helps your ligaments 'cos it apparently contains Collagen Hydrolisat, whatever that might be. I haven't tried it 'cos I just can't stand Haribos and you need to eat around 200 grams to get the reccomended daily allowance, so it didn't fit with my diet.

Maybe some professional could tell us more about the effects of supplements in ligament/tendon healing?

Hi Fisnik,

Good to hear you are doing pretty good on your recovery. I would definately up the intake of those supplements you are taking. Because the recommoneded dosages for tissue repair are somewhere in the range of the dosages i am taking.

Haribos ..yes... i can imagine you arent taking those.

I have done various searches on the internet regarding tissue repair and have found these are the main supplements which can aid in recovery. Also the use of flaxseed oil or fish oil....(essential fatty acids) might be usefull..

Also Human Growth Hormone is usefull (as advised by my Physical Therapist) but he said he wasnt allowed to tell me that, but i am still researching that subject..

Take care,

Rico

Welcome to the RPT sanctuary Rico and thanks for the info on the supplements, I love it when docs or other professionals tell you something and then tell you he didn't say that.....real nice...   Ol Fis sounds like he's doing pretty good too, keep up the good work dude.  Rico it must be bloody awful to have both legs out of commission, does this mean you are in a wheelchair If so I feel for you brother as my time in the wheelchair was brief but the feeling of helplessness lasts a long time I hope you have yourself a nice nurse to look after your bathing and stuff it's great to get another person from another country, we should have a map of the world on this thread and color in the active countries we would be surprised by the numbers I'm sure.  Hope all have a nice weekend, here in West Virginia the weather is very nice, 80's, not much in the way of humidity and sunny.  Good luck to all with our situation. John C.

on 07/16/04 at 20:17:31, Nigel wrote:

Rico - I found your info on supplements really interesting. To be honest I hadn't even thought about what I've been eating since my injury. But my quad atrophy does seem to be taking a long time to improve so maybe I do need to up the protein, either by supps or maybe just eat a lot of steak and eggs!! My normal diet is pretty poor, too many carbs I'm sure. My PT said that muscle strength doesn't correlate exactly with muscle bulk, but still... Just off to Sri Lanka for a couple of weeks, where the food is mainly veggies, so maybe I should take some protein supplement - what does that look like, is it a powder (I've never taken any kind of food supplements in my life so I'm completely clueless about these things)? Cheers, Nigel

Hi Nigel,

Yes correct, a protein supplement is basically a powder which you mix with milk in a blender and than drink..They usually taste very good and can be bought at any sportshop / vitamin store easily. You can also buy these on the internet though..

I typed 30 grams of protein in my previous post that i was taking but that should have been 300 grams. Allthough 200 grams of that is from regular food like chicken, cottage cheese, milk fish and meat...and the rest is from two protein shakes..

Diet is an important factor during life and especially regarding recovery after an injury. If you dont feed your body with the correct "fuel" it will not be able to heal properly

In Sri-Lanka i think you will be able to eat lots of chicken breast..but maybe a protein supplement isnt a bad idea in your case

Have a good trip bro!

Hi John,

Thanks for the welcome

Yes it was quite nice hearing the inside information of my PT. And i kinda laughed afterwards after hearing him say..I am actually not allowed to tell you this...but.......  

They know how it works especially when working with professional athletes all day...who seem to recover in a miraculous time span after injuries..

But i want to give it some more research first before I decide what to do..

Too be honest yes i have been through a very depressive 5 weeks now. I used to be very active with sports 6 days a week and quite a busy social life too. But indeed in a wheelchair now and kinda stuck at home...

But i have a lovely nurse at home
My wife is a school teacher and is enjoying her 6 weeks summer holiday now allthough she hoped for another type of holiday hahaha..so i am well taken care of

A nice weekend to all !

Rico

on 07/17/04 at 18:20:12, Nigel wrote:

Justin - sounds like great progress. Good luck! Rico - just got me some whey protein powder (tastes disgusting in water, going to try in milk). Also glucosamine sulphate tablets. Assistant said 1500mg a day to have a good effect as a treatment rather than just prevention. This ties in with what Paul Clayton says in his book "Health Defence" (seems to be the bible as far as our family is concerned). He cites 2 studies where glucosamine has boosted tissue healing rates by 170%. So I'll give it a go. Incidentally he also says chondroitin is a cheaper alternative to glucosamine, but probably less effective...any views?? Cheers, Nigel

Hey Nigel,

Yup try it with milk, that really makes a difference ...if you add some icecubes in the blender it might even taste like a MacDonalds milkshake!...

I am using both clucosamine and chondritine. They work in different ways regarding joint support. And i would advise you to take them both. They are not that expensive..so it probably wont hurt..

Just had my 4 th PT session this morning and got complements from my PT on my recovery..he said i am doing really good..I am able to walk with crutches and have about 90 degrees ROM in my right knee and slightly less with my left knee...

We started with electro stimulattion today and will try to head to the gym this week to start some upperbody excercises because i am losing weight really fast now

Take care all!

Rico

Hi all,

Another little update from the Netherlands. Just got back from my 5th PT session. ROM increased again by a few degrees so i am quite happy about that. Walking with crutches is getting better too. After 10 minutes of aggressive patellar massage we started with passive stretching. The pain was very bad..but its nice to see a little progress
Than we started active flexion excercises with the help of electronic stimulation this was quite painfull too especially in the tendon area. But i survived

He again said that everything went really smooth. Especially regarding the fact that it has been nearly 6 weeks post operation..

I'll keep you all posted!

Take care,

Rico

Rico, you're the man!  Glad to see you are acclamating to the pain, you and pain will be friends some day and when that happens nothing will stop your progress.  It's when you start really liking the pain that we will have to keep a close eye on you and refer you to one of our most gifted posters, Auntie Kim, she has a wealth of knowledge on this subject and will be happy to share it with you I'm sure . Seriously though I think your patience in this situation is laudable, keep it up and you will get better, attitude is everything, little things mean alot and frustration is normal, all cliche's aside you are doing great keep us informed.  I saw my kneecap today for the first time in awhile since the swelling has gone down some and that in itself was a tiny victory even after three months post-op, little victories are the key to this thing. John C.

Evening all,

Thanks for all the info on PT. Its good to know what I am going into.

Rico, welcome to the club, good to hear you are getting around on crutches already. I also look forward to the pain of PT, when hopefully I start it in a couple of weeks, if I get my plaster off.  

Talking of plasters, I finally managed to get out of bed early enough in the day to get to the hospital plaster room and get mine changed. I got fed up of moving around and it slipping down my leg every 2 steps. My leg was an interesting sight for the first time in 4 1/2 weeks since the Op. The calf muscle didn't look too bad, but the thigh muscle was just skin, bone, with a bit of jelly!!

Even though it will be painful, PT can't come soon enough!!

Keep up the good work all,

Cheers,

Andy
(Portsmouth, UK)

Hi all,

I returned to hospital yesterday for my 2nd appointment post op. I finally had my full cast removed to be replaced by a "cricket-bat splint" to keep my leg straight. I should be starting physio next week.

I finally did confirm that in my surgury, no wires were used. I did have holes drilled through my patellar and tibia, with only sutures used through them, and connected to my ruptured patellar tendon. Maybe a first for this board, no wires used for a full rupture.

Regarding PT, get this, it will take 4 working days for my notes to get through the hospital system from my clinic to the PT department, which are part of the same hospital. Then I have to phone PT to get my first appointment. This makes a mockery of the exact words of my doc, "you require urgent physio to get the knee moving again"! You can't beat the NHS  

Anyway, its good to get out of the cast at last.  

Cheers,

Andy
(UK, Portsmouth)

Hi Andy

Glad that you are now at stage two.

According to my Consultant, they only use wires if you are tall and well built !!!!!!!!!!

Four days for your file to walk from one clinic to another clinic in a NHS hospital is quite normal, so get ready for the next stage.

Did they measure bend having taken the cast off

Best wishes   JohnK/ Manchester

Hi John,

Well, given I am 6'7" tall, and around 17.5 stone, it was surprising to me they did not use wires.  

As for measuring bend. When my cast was taken off in the plaster room, I put on the cricket bat splint (which I had been given when I was waiting for my op 6 weeks previous), and waited to see the doc back in the clinic waiting room. When I saw him, he didn't even take the splint off, so no bends for performed at all. He bearly even looked at the joint, which to me looks a lot different to my good knee, with swelling on the inside of the joint  

But hey, he's the doc, and they always know best, right? Even though he was the 6th or 7th doc I have seen in the same hospital, and doesn't know me from Adam.    

One piece of good news though, this afternoon, a small step was taken closer to normality. After lots of practice, and courage (with little to hold onto and no splint on!), I managed to step into the bath to have a shower, for the first time in 8 weeks. It was tense, but rewarding in the end. Hopefully thats one step forward, just waiting for the 2 steps back next  

Cheers

Andy
(Portsmouth, UK)

Hi All, it's great to see that the vets are still around this thread and that they are doing well.  I too have good news to report since the last post, my knee is finally starting to feel semi-normal;  that is, what I remember to be normal some four months ago, my memory isn't the greatest after all.  I just got back from a week at the beach in NC ( where the hurricane is currently hanging out) and I found a two mile walk on the sand surface was just what I needed to strengthen my knee muscles to the point where my pt thinks I can go without my brace and I've gotten almost full ROM to boot.  It's been a long road but I now see the light and fully expect to be brace-less soon, as soon as the doc gives the OK.  Might just keep it around for some nostalgia just the same The knee cap area is still swollen compared to the good knee and the cap itself seems to be riding somewhat higher but I'm gaining confidence more and more each day.  John C.

Hey guys,

A quick update from me.

Just over 12 weeks post-op and things seem to be going really well (knock wood).

3 days ago I officially reached full active ROM, without assistance, and can now bend the injured leg the same as the healthy one. That was a great relief.


Been crutch-free for the past 10 days and I'm really getting around quite easily with the brace, including going up the stairs unassisted (leg still a bit shaky, but getting stronger every day). Going down the stairs is harder and I still ned to hold on to something for that.

Been doing straight leg lifts for a while now and can actually see my quads getting their shape back (used to have quite an impressive quads) and I can manage lifting 2.5kg (that's about 5lb) in straight leg lifts. Lower leg lifts are still a bit hard and a bit painful, but I can manage about 10 of those whenever I try. Physio says that will improve as quads get stronger. She also says that I can remove my brace when I'm capable of lifting 1.5kg in lower leg lifts (active extension). Been doing okay with walking carefully brace-less around the house.

Physio says I don't have to go see her any more since I got my ROM back and my quads have started improving, and has instructed me to visit a swimming pool every day, do a set of exercises and get on a stationary bike as often as I can. Need to take out a 15 year old bike from my dad's attic, fix it a bit and bring it to the office.

Swelling has considerably gone down and the difference compared to my other knee is very small now. Need to take the tape measure out and see. 3 weeks ago my swollen knee was 3cm bigger in perimeter than the healthy one, and my left quad was 5cm smaller than the healthy one.

Overall, I am very pleased with the development so far (knock wood again) and it's up to me now to improve this, so I intend to get on with it slowly and carefully, hoping to remove the brace by the end of this month. To be honest, it looks quite cool on my leg and everyone's calling me the Terminator, so I might wear it until the end of the year just for the fun of it.  

Great to hear everyone's doing well, and I really wish all the newbies fast recovery. Fells weird to be considered a veteran on this board. Still remember the days when I admired Nigel's recovery and wished for those days to come. They eventually did and you'll be surprised how quick everything will go once you start the rehab. So hang in there!

I wonder how John (Omaha) is doing. His rehab was so aggresive, he's probably preparing for the Olympics or something. John, if you're still reading this board, do drop us a line or two.

Cheers everyone, and thank you for all the support you've been giving me in the past couple of months. Wish I had a chance to buy you all dinner sometime.

Fis

okay guys

two glasses of wine....and i am ready to type!!! so glad to hear that everyone is making progress...baby steps count! i am so glad that our friend from albania? slovakia? fisnik? is doing great! i really was worried about him being such a big teddy bear with a soul...it is okay to cry once in a while you guys! and being the only female i have no problem admitting that once in a while i let my armor down and rust out the face plate.

cant wait to hear how nigels trip to sri lanka? was...where in the hell is sri lanka!! guess you can tell i grew up in the usa! are there alligators? crocodiles? anancondas? army ants?....oh god...i hope nigel can limp fast!!! i swear i was swetting bullets (and i am an antigun liberal KERRY fan)on those bike trails on sanibel...you guys....there were alligators everywhere!! and not the kind that you see on national graphic home pets....these guys were the kind that stalk the water wells in sub? africa...sri lanka? just waiting for a ""slim"" athletic beautiful blonde to come walking by with a walking stick of course! (and yes, i am all the above) but you know....they did not want me....I WAS TOO FAST!!!! thanks to my husband and the cool bike we rented that had a wheel  chair slapped on the front! i was....lance...for a week.

anyways....i am doing great also! i can walk again!!!! i know i may never be able to match you guys in a squat match! wait a minute,,,,hmmmm....think this is worth investigating.

my knee is still a little swollen....but i can bend to 114 degrees (remember 122 is my max thanks to that talented surgeon last august) and no one stares at me when i am at the pool...dammmn i am doing good. went back to work part time on monday (love my pediatric patients) and i can do a squat!!!! it has been years since i could do that. i truely believe that dr. l in ohio has a gift when it comes to surgery. i can even sit on the toilet....

anyways i am so happy you guys are doing so well...keep up the good work! and come visit if in georgia (sorry about the politics here) though...and i am coming back to europe next summer with my niece! italy! again! cant wait...maybe some of us can meet up

bye

auntie kim

Welcome back Aunty Kim to the land of walking - we are all delighted that you will now be able to chase all!! us young men.

I`m afraid it`s back to school for you......... Sri Lanka is the Island south of India, used to be called Ceylon. A wonderful place for holidays, although a little hot spot in more ways than one at the moment

I am still still suffering (after 18 months) with Venus Insuffency - non technical term means that some of my veins below the Ruptured Tendon have sealed up causing a restriction in the circulation of fluid in the leg.

Ooooooh it`s painful, but should clear up in a few weeks.

By the way you are not the exclusive women with a RPT - I am in touch with a female who lives in Acton - Antelope Valley, Southern California who has Ruptured her Patella Tendon TWICE.

She has running in her back garden raccons, great horn owls, golfer snakes and rattlers

Can you beat that!!

Best wishes
JohnK/Manchester UK

Hey all, I'm new here. I'm a 19 year old girl who has been suffering knee pain for a year and a half after twisting my knee playing sports. My doctor decided to to arthroscopy after multiple MRI's came back inconclusive. He found a torn meniscus and also did a partial lateral release. However, the pain persisted and I began to rapidly form scar tissue. I would then have two MUA's and another arthroscopy, to no avail. He eventually sent me to a pain management specialist who put me on multiple medications including Actiq (a breakthrough-cancer pain medication), Neurontin, Skelaxin, Bextra, and also did multiple lumbar sympathetic blocks (he had thought I was suffering from RSD). None worked, and I was still in severe pain. Physical therapy also did not work, it only made the pain worse due to aggressive stretching to maintain range of motion (which was my biggest problem).

Finally, a couple weeks ago I got a second opinion and found out that both my menisci were torn, my kneecap was dislocated, AND my patellar tendon was COMPLETELY ruptured! My doctor said it probably occured during aggressive stretchfing at PT or during one of the manipulations, but now I'm facing open knee surgery this coming Tuesday (the 10th) to repair the tendon and meniscus, while sliding the patella back into place. He also said he's going to insert pins in my tibia to prevent scar tissue from forming. I will also be in a full leg cast for 6-8 weeks which makes me a little nervous about the possibility of scar tissue redeveloping (   )

While I've had a couple knee surgeries before, they were all athroscopy and this is definitely more on the "major" side than a scope or MUA. For anyone who's had this type of procedure happen, could you give me any tips or advice for post-operative care? I don't want to have the same thing happen again (go another long period of time in severe pain and frustrated due to lack of answers from doctors). Also, I want to make sure I can rehab correctly and effectively for a 100% recovery. I would like to live a normal life again, my knee has taken away that liberty for too long now (ugh).

Thanks!

Patricia

John,

I was both frustrated and relieved when I found out about my patellar tendon being ruptured; on one hand I was very disappointed in my original doctor for missing it all this time, yet I was relieved to know I'm finally on the right track now. Many people have told me to consider a lawsuit against the original surgeon, but I don't think I'm going to take it that far. While it's true that I've missed a year of school (and haven't been able to work) and have suffered depression due to the whole situation, I feel like this does seem a little out of the ordinary (the injury itself and HOW the injury occurred), so who knows.

Now that surgery is merely two days away, I'm starting to become very anxious about post-op care and the pain/discomfort itself. I guess I shouldn't get myself worked up too badly because I've already dealt with a lot of pain this past year and a half (I'd say walking on a ruptured tendon for months(??) was pretty crazy!), so maybe it won't be as bad as that. I'm also very nervous about lying down a lot of scar tissue again. My doctor (who is a knee specialist) told me to remain as calm as possible, nervousness does lead to more scar tissue forming (ugh!).

I've spent the past year in and out of a CPM, I'm wondering if my doctor will put me in one again post-op. I've read through many of the posts in this thread (which really calmed me, made me feel better to know I'm not alone and many people HAVE had success)  and it seems like each case is different in regards to the use of a CPM or not.

I do have another question though for anyone who's had the same injury -- how long had you been injured before being operated on? I've read a few articles online that state surgicial treatment is neccessary between 2-6 weeks after the injury for best results. This worries me because I may have been walking on the ruptured tendon for up to OVER A YEAR (the doctor compared MRI images from May of 03 and July of 04...it happened between that time frame) and I've been told there IS the possibility that the tendon may not be able to be salvaged and that there is the potential for many complications to arise during surgery. Has anyone had a similar experience, and if so what happened and how is your knee now?

Thanks, and I'm glad to be in the club (I guess! I'd rather have a good knee, but I'll take what I can get )

Patricia

I'm from New Jersey, btw

Hi all,

And a big hello to the newbies Patricia and Doug. Sorry I can't really ask either of your specific queries.

I haven't got as far as kneeling yet, far from it, haven't even got the go ahead to straighten the leg yet!!   And I thought I had it bad having 9 days in between injury and surgury, but Patricia's injury puts that well into perspective. Good luck Patricia with the surgury, I am sure I speak for the board in saying we are all thinking of you in there.

A quick update from myself. I rang up this morning to get my first physio appointment from the NHS and initially got given a date of the 25th Aug, meaning 2 more weeks of in-capacity, and 11 weeks in total since the injury. Anyway, I managed to argue them down to an appointment of the 19th Aug. Makes a mockery of my doc's words, "you need urgent physio to get your knee moving again".

Hey ho, things can only get better    

Cheers

Andy
(Portsmouth, UK)

Thanks for the kind words, everyone. My surgery is now just a few hours away and I'm getting more and more anxious, however I'm also kind of pumped at the same time. It's an amazing to feel like this may finally be solved and I will finally be on the "road to recovery" instead of the "road of uncertainty". It'll be a tough road, of course, but I found a lot of comfort in reading through many of the posts on this board -- hell, this board has been so helpful these past few days, I wish I had found it earlier when I was struggling through all the uncertainty and excrutiating pain. *sigh*

Kim --

Oh believe me, I was VERY frustrated in my surgeon for not discovering this. At the time, I felt as though HE gave up on me, I became so depressed after learning that he was just "shipping me off" to a pain management doc. I felt like the PMD wasn't going to FIX the problem, he was only going to mask it by giving me drugs to make me feel better...not actually BE better. Probably the lowest I've ever felt in my life, and I've been through some pretty tought times.

The thing that really upsets me is how much my physical therapist would tell me that there was nothing structurely wrong with the knee and that it was essentially 'all in my head'. Yet, every PT session I'd point out SPECIFIC spots of pain (below my patella, where the tendon is, to the right side of my knee, and on the top of my knee where the quad starts). I didn't have general pain, I didn't have shooting pain -- it was SPECIFIC. How could that just be in my head?

There was a point where I just wanted to settle and live with my knee the way it was, I was so convinced by my PT that it WAS in my head. It was awful. Suffice to say, I'm NOT going back to that particular facility to rehab when the time comes again.

You're completely right, this SHOULD have been discovered. It's very frustrating. Enough for me to want to get the phonebook, look up the first attorney I see and file a lawsuit against the practice.

I will try to keep you all updated on my surgery, post-op, and the rehab itself. I probably won't be around for a little bit because it will be hard to get to the computer (the comp in my house is on the top floor, I'd have to go through two sets of stairs to get to it...not fun on crutches and in a heavy cast!), but I'll make an effort

Well, keep me in your thoughts guys! I'll surely be thinking of you all!

Patricia

Hi all,

Just had to say, I am a lot happier today.    

Decided to lean on my private medical insurance and got an appointment with my local BUPA hospital tomorrow morning to start my physio. The thought of waiting till the 19th for the NHS was too much to bear. Given the massively various recovery timescales of everyone on here, thought it would be better to start earlier rather than later to start bending the knee.

Welcome Hjumper, good to hear your recovery has gone so well, so far, keep it going.

Cheers,

Andy
(Portsmouth,UK)

Hi Hjumper et al, I'm glad you found this site as well since your surgery and post-op was similar to mine I can hopefully help with your situation.  Not sure what the bulge is on the side of your patella but if the doc says its a clot then it probably is.  I am four months post-op now, braceless for the first time , and able to leap small steps with reckless abandon .  My ROM is at 115 degrees and I'm deep into PT doing all kinds of exercises that I couldn't do just two weeks ago.  I'm balancing on my bad leg without too much trouble, bicycling for ten minutes but I could do more, and doing leg lifts with five pounds of weight on my ankle, this is leading to  more confidence in my walking around.  I try to do a couple of miles daily on a hard, flat surface but the best therapy so far has been walking on the beach, at least that's the best progress I've made in four months after a week at the beach and walking two miles plus/day.  You are at the beginning stages so take it easy until your doc/pt tells you to do more, I didn't even start pt until after almost three months post-op and I'm doing pretty good, everyone else on this thread started much earlier and did well but they all had the wire loop which I didn't have either.  My doc told me that it might be a year before the knee feels normal, whatever that means, I hope he's wrong as I want to get back to work asap.  Good luck in your recovery, be patient!  John C.

Nigel, I always wondered what a "pathetic quad muscle" was until today that is while doing escentric leg extensions on the machine my left knee (the bad one) started fibrullating uncontrollably, twitching as it were unsolicited by me at which time I asked my PT about it and he told me that the muscle is just now starting to get stronger, after four months it's finally starting to get there?  I guess I have a longer way to go than I thought.  My ROM is at 118 and I have no problem walking without my brace anymore or going up and down steps but......won't be playing basketball anytime soon or climbing mountains either, maybe I can play some golf though!  Haven't heard much from you lately, what are you up to man? John C.

i guess i will have to come up and visit john to walk on the beach as my favorite shoreline is about to get pummeled by hurricane charlie...sanibel island.
and yes, walking those long stretches of beach really helped build my leg muscles up too.

john, i also have quad shaking when my muscle is being pushed to the limit...kind of freaky to watch it quiver and shake...glad to hear that yours is coming along. i still have not managed to walk down stairs yet but then i just started walking after 4 weeks the first day of my vacation on sanibel...made it to 113 yesterday...got a shot of cortisone/lidocaine in my knee last friday and it seemed to really help. maybe you want to ask your o/s about that.

kim

It's good to read that many of the RPT victims are on their way to a good recovery.

I went to my first PT session last week. It was nothing high tech, mostly different types of straigth leg lifts and ROM exercise by sliding heel back and forth. I was able to bend by knee 65 degrees which is better than I expected. My doctor expects me to be able to increase the ROM by 10 degrees every week, so if everything works well, I should be able to reach about 120 degrees in 6 weeks. My  therapist wants me to do 3 sessions at home every day, though I think this is not very practical. I can usually do one or two full sessions per day, and then I do my own version of the exercises -  the ROM exercise in the office chair which was suggested in this forum or going up the stairs at work using my injured leg for stepping up every step.

At this point, inside of the knee (right side of the PT on the left knee) is in pretty good shape. There is minimal swelling and/or scar tissue and not much that limits ROM. The outside, on the other hand, does not look so good. I do appear to have a lot of scar tissue just on the outside of the tendon. I almost reach a hard stop at 65 degrees as the knee cap apppears to refuse to move any further. Hope this will get better over time.

Within the last week, I have gained noticable amount of strength on my left quad. Now I can go up the stairs without holding onto the handrail, though I still cannot walk down. Observing the healthy leg, it looks like one needs at least 80 degrees of ROM to be able to walk down stairs.

As for the olympics, the high jump competition will be pretty good as there are 11 athletes who jumped 2.32+ this year. Of course, yours truly won't be competing for obvious reasons...

Hjumper - sounds like good start on physio. Don't worry if the ROM progression isn't a steady 10deg/week, I think that's just a medics' rule of thumb (or knee??). Just keep at it. Hope your scar tissue/blood clot problem resolves itself, try not to get too discouraged meanwhile. I had a persistent twinge of something rubbing on the inside of of my knee for several weeks, but eventually it just went away.

I'm sure 3 "proper" exercise sets a day is ideal, but I never managed that. I just tried to be as active as possible generally (and I'm thinking of patenting my "office chair" method!!). Also did lots of flexing of the ankle (eg foot rotations while sitting at the computer)...although I'm no expert I think it must be important to get back lateral movement around the knee as well as the flex/unflex movement. Also, my physio explained you mustn't ignore the other muscle groups (hamstrings, adductors etc), and even torso strength, as they all contribute to knee stability. As I've been getting back to normal that's helped a lot.

Incidentally it's been interesting to see that US posters seem to be told to keep wearing a brace long after the first 6 weeks of full immobilisation. I was told I could get rid of the brace as soon as I felt comfortable after that, while building up to full weightbearing. I never used a hinged brace, just went from the straight-leg brace to nothing. Seemed to work for me. Anyone know why the US medics like braces - is it something to do with the American love of technology...?   Or as Hjumper suggests is it a liability thing?

Cheers, Nigel

Afternoon all,

Just thought I would add to the recent good news by all. I have had my first 3 PT sessions in the last week and a half. I am now upto 35 degrees bend. I am over the moon about that after 9 weeks at 0 degrees!!

A couple of days ago, I was given my first weight bearing exercises, and I can really feel them working now. My quad tendon is extremely tight, which is slowing my progress. Even after just 2 days though, my walking with crutches, but without my leg splint, is really coming on. The physio has no plans to give me an adjustable brace, given the relative strength I have got in my leg.

I only have a couple of concerns with my scar still "welded" to my tibia and patellar, but with some good moisturising lotion, it has been getting a little bit better over the last week. Also, like hjumper, I do have quite a bit of tough, hard scar tissue on the outside of my patellar which may need further surgury according to the physio, but I'll cross that bridge should it be needed later.

Now that I have started PT, I am well pleased, and am looking forward to the pain at the 2 PT sessions a week I am getting, if it means my ROM gets better.  

Cheers

Andy
(Portsmouth, UK)

Hi all,

Cheers John and Nigel for the words of wisdom.  

And welcome back Patricia. Sorry to hear about your cast. They can be real pain if you don't get a good one. I did notice that it did take at least 3 days with my 2 that I had put on, for my leg to adjust to each of them. But I was lucky where I did get good ones put on where padded areas were added at the top and bottom of the leg to avoid rubbing. I think as other people have said though, if it does hurt, even after a just one day, get back to the hospital and get another one. Its their job to avoid pain, not add to it.    

As for your fall, that reminds me, I had one bad one as well. Whilst getting out of bed at night, I managed to trip over my own crutches that I had left on the floor. My bad leg tried to take the strain, but couldn't, and I ended up on my back on the floor, after almost smashing the glass sliding doors on my wardrobe. Luckly they did slide    One things for sure, which you have probably learnt, I did my best not to do that again. Having one leg out of action certainly makes you concentrate more on where you are putting them, and your crutches!!  

It was 8 weeks before my first shower. I to had sponge baths for that time. And as with you, its happended during the best of the British summer. Which, as you can imagine, is nothing like the summers you get over that side of the pond, but its still hard work sitting in the living room all day.  

Its hard to accept, it took me a few weeks to do it, but the best thing I found I could do for my knee, was to do nothing. Sit back, leg up, and relax.  

Good luck at your next appointment, hope your new cast is better than the last.    

Cheers

Andy
(Portsmouth,UK)

Today is the exactly 8 weeks from the day of my surgery. I went to my third PT session today an I am up to 80 degrees ROM! I could only schedule one PT session last week instead of two, and it was with a different therapist who was a bit on the conservative side. After about two weeks of work, I am very comfortable with straight and lateral leg lifts (with leg fully extended) now and I can do about 30 (slow) reps at a time. The swelling around the knee has come down quite a bit in the last two weeks, though it still looks nothing like the healthy knee. The firm mass under my skin on the outside of the knee cap seems to be slowly disappearing, so I am a lot less worried about it now. I am also feeling much more comfortable walking. I can even stand on the injured leg and balance myself comfortably. I was also given OK to sleep without my brace at night. If my recovery keeps going at this pace, my goal is to reach 120 degrees ROM 12 weeks after surgery and get rid of the brace.

Nigel, I do think that I could survive perfectly well without the brace at this point. I have been able to take a standing shower (obviously without the brace) for quite some time now. Initially, I was using my temporary knee immobilizer fromt he emergency room to get in the shower (since it was much easier to put on and off) but I could walk to the shower without a brace by the 4th week. (This is probably not recommeded for most people as I probably had stonger than average ligaments and hamstring muscles at the time of the injury). At this point, the brace is  only there to protect against an accident as my left quad is still pretty week and the at a ROM of only 80 degrees, any stumble could potentially put a lot of stress on the repaired tendon and the knee.

Patricia, sorry to hear about your pain and cast problem. I also did have very serious pain after my surgery - I had to stay at the hospital one extra day since I had to be on morphine for more than 24 hours. Luckily, most of the pain quicklywent away. I was off morphine in about 36 hours after surgery and I was compeletely off pain medication by the 10th day.

As for your problems with the cast, I can appreciate how awful this must be. Although I was not in a full cast, I was in a weird immobilizer for about two days that etched big purple areas in my hamstrings and the upper portion of my calves. After persistent complaining, I was able to get them to give me a different brace (IROM) that solved the problem. In your case, it may be more difficult because of the cast, but as Andy pointed out, as you are had serious pain, there may have been something wrong with the way they did the cast and they may have to do it again. Even though cutting part of if may have given you comfort, I am a bit worried if the piece you cut out of the cast might have somewhat reduced the functionality of it.

Went to my OS today and got a full release.  My quad isn't back to 100% of pre-injury strength but he's said I don't have wear a brace or do any more therapy.   My ROM is almost the same as my other knee.  No swelling and the pain is something I can live with.  I got the OK to get back on my mountain bike so I'm going to start riding again.  It has been almost 3 months since my injury, how time flys when you're having fun.  
Good Luck to all on the forum
Croaker

Evening all,

Great to here everyone's progressing well. Patricia, good to hear your more comfortable, as well as you can with a cast on.    Hjumper, superb progress, and Croaker, wow!!

Can't say my progress is quiet up to your guys standard, but I am still progressing. 2 and a bit weeks into my PT and I'm upto 55 degrees so far, but it is slow. The good news is I am now completely out of my splint. With 55 degrees, walking isn't perfect yet, but its a hell of a lot better than having a straight leg.  

My thigh muscle is still waaayyy behind my good one, but there is enough overall strength in my leg to support my body when moving about. I am not quiet upto walking any distances, but I feel comfortable.

Managed to tick off a few "things to do since my injury" this week as well, like putting on a sock, and cutting my toe nails    Small progress, but progress  

Keep up the good work all,

Cheers,

Andy
(Portsmouth,UK)

Hello all on June 13th I tore my patella tendon in two, it was a complete total rupture. I had the surgery two days later! I was out of work 1wk and on the cruches, two weeks. By week four I was playing pool volley ball and hobbling around theme parks all day while on vacation..  Week 7.5 PO I had full rage of motion and my PT was cut from twice a week to three times a month. I have another doctors appointment this Friday I think he's going to release me from PT all together. I workout on the knee atleast twice a week and have even managed to run a bit ( up to full speed yet ) I do atleast 15-20 mins cardio four days a week with weight vest. Will I make it back before the end of the season.....Only time will tell but I don't feel like I'm rushing it but I'm taking what the leg/knee gives me... Always Ice, strenghen and rest when possible....... It's all good!
Trust in God! Believe that!

Welcome to the Ruptured Patella Tendon club!!

You must have had the fastest recovery known to all members on this board. Three months in total - seems incredible.........

What degree bend do you have today - any swelling or has your leg/knee returned to normal.

How did you do your accident?  What is your aagen and what part of the world do you live in.

Best wishes
JohnK/Manchester UK

I'm soooo not done yet but I'm getting there!!! But you guys are doing great!! Everyone keep up the good work! You know your body better then anyone else...listen to it..

[b]Oops!  I guess I was wrong, I ruptured my patella tendon 6/13/04 I have been released as of
9/3/04.... Is that cool or what... I'm getting my b-ball
game on!!!!! [/b] I can't believe it  Doc. Johnson of Indianapolis,In is the man!!!!!!! 82 days!!!!

okay

now i can get on from the lap top but not my main desktop computer which is the one i use. the "a" key sticks on this old lap top. i still am coming across as a guest on the other computer so do any of you have any ideas how i can patch back on via the desktop?

and by the way, the last part of johns message does not apply to me, my legs are quite lovely and i dont have water retention or high blood pressure!

bye
kim  

just to let you guys know, i did email knee guru for a "forgot password" cookie?? remember i am a nurse not a co mputer whiz. each time i did this i would check my email for my password and nothing was there. i got a prompt to check the spam folder...and voila...there was a password (not the one that i gave)...hmmm...never knew how things ended up in that spam folder to begin with! i will try the new password on the desktop and see what happens. i blame all these problems on my husband...he is the one who wanted to reformat the hard drive not me...i just wanted a faster connection....i was ready to throw the computer out the window when he caved    so now i have a faster connection, a new internet provider and a huge mess (he also decided to go wireless during this)...and remember, my husband is an artist, not a keyboard whiz...thanks for the directions heather but they were way over my head....sort of like when i explain something to one of my patients and they have the most dumbfounded expression on their face! have to lay off the medical jargon.

anyways, i hope to be back on board and thanks for your help and i am glad to hear that so many of you are doing great!

kim

ps

i am typing this on our old piece of junk that wont die...this so called laptop that weighs at least 10 pounds and will never be on my body anywhere near my knees.

Off and running again in just 82 days, I'm sooo excited!!! Doc Johnson cleared me today!!! He's the man, I can't belive it!!!

Hi. Hope you're pulling through, EngKnee....

WOW, what a resource Here's my sorry tale. I've just ruptured a patellar tendon... the second time I've done it! (so forgive the length of the posting)

The last time was eight years ago in Chile. Right leg. It just snapped as I was running with the kid. Great surgeon. I was in plaster six to 8 weeks, then started very painful physio to free the knee up again. Got full mobility and strength back, though...

This time, Thursday (26 Aug) I was playing table tennis with a friend in France and... bang - the left leg snapped. I knew straight away. But the local hospital disagreed, said I had probably only ripped a bit of cartilege or bruised the knee, that a ruptured tendon was very rare, and that I should continue my holiday. Oh, he also said I could drive  

I managed to find an ortho specialist - but it took to the Saturday evening. One look and he agreed - patellar tendon gone. But, can't you believe it, there was a possibility of a surgeons' strike the following. He said I was fit to travel and I flew back Monday (August 30th) with a brace on and crutches.

Thanks God for the National Health Service! An hour after arriving at the John Radcliffe in Oxford, I'd been seen by an ortho consultant. By the next morning I'd been operated on, with an ortho consultant, a radiologist consultant and a consultant anaesthetist!

They repaired the leg, which was a mess. Drilled Patella, neutralisation loop. Now I’m seven days post op. Big difference from last time is the split cast and physio insiting on flexing the knee (which is up to around 25%).

Trouble is, I HAVE to start a new job – big job – in two weeks. Any tips to speed up recovery? I can take it easy for the next two weeks. Nigel, I’m going to have to commute to London – any tips would be welcome…

Cheer… and solidarity  

Spend sometime in a swimming pool, It helps moblity and swelling... Atleast that helped me...
Good Luck!!

Well guys, I just hit another bump in the road...seems my knee doesn't want to cooperate AT ALL anymore.

So I woke up on Sunday morning feeling pretty yuck-o. My knee hurt badly, and I had a lot of your run of the mill flu-like symptoms. I also noticed blood all over my cast. Great.

Called the on-call doctor, he told me to get in ASAP to get the incisions checked, I'd need my cast changed (at the least) but I probably had an infection. Being the holiday weekend at all, I wouldn't be able to get an appointment until at least Tuesday. Problem is, my doc is in surgery on Tuesdays, so that meant Wednesday was the earliest I could get in, unless I wanted to see a different doctor.

Felt even worse on Monday, so I called on Tuesday just to see what was up...turns out my doc was going to be in the office in the afternoon for a little while and would fit me in right away. Yey!

So my OS cut a window in the cast, and there was all sorts of fluid, blood, and other type of drainage all over the place. And yup, he could tell right away that my body rejected the sutures and I had an infection. Lovely.

I got my incisions cleaned up good and a new cast put on, doc cut out another window in the new cast (which I can call the big BLUE monster this time!)  and wants me to come back in tomorrow morning to get my knee drained. He also gave me a script for an antibiotic to clear up the infection.

Problem is, the infection will most likely not be cleared up in two weeks, which is when I should get my cast off. Now I'm looking at an additional one-to-two weeks in the cast. UGH! I'm not liking this!

I guess if anything I should be relieved that the problem was spotted before it got any worse...I'm really glad I got into the office instead of shrugging it off as PMS-problems or a general "not feeling so hot" type deal. Oh well. Guess it's like Murphy's Law...if it can go wrong, it will!  

Hope you all are having pain-free days! ...and I hope I'll have a pain-free night! Yikes!

Patricia

kim -

I've had my knee drained twice before, not too fun. The worst was the first time though, I was only 13 years old and I had no clue what the heck was going on...I tensed up so badly (I'm a very tense person by nature) that I think it just made things worse.

I'm on an antibiotic right now, so hopefully I can get this cleared up as soon as possible. Not fun though!

As far as getting in for an appointment, I really didn't know what else to do. The on-call doctor told me that I *should* be okay until Tuesday (I called on Sunday), it was just so tricky with the holiday and all. Had it not been the holiday, I would have definitely gone in on Monday. The doc also said that if I started to feel any worse then I should just go ahead and go to the ER. I was able to tough it out and I doubt that I caused any further damage (*knock on wood*), but of course if something like this (God forbid) ever happens in the future, I'll definitely get it taken care of ASAP.

Like I said, it's Murphy's Law over here! I didn't think I'd get a stupid infection...but hey, if it can happen with my knee, IT WILL!  

Hi Folks


Having been away for a few days vacation, I see that the board has been hit by a number of new messages :-------

[/b]AFF2   Have noted that you are up and running 82 days after having Ruptured your Patella Tendon.  I am of the opinion that you are pulling our leg!!!(excuse the pun).   It takes between 8/12 weeks for the Tendon to heal and weeks of physio to reach full ROM.  How come that you are different to everybody else or more importantly is there something we ought to learn by your experience!!!!

[b]  Manxman - welcome to the board - Not heard of anybody doing the same injury again so many years apart.   Assume that you are in a full cast and on crutches - You are going to have a nice job hobbling and negotiating the London underground system and then commencing a new job on top of all this.  Hope it`s a sit down job where you can elevate your leg!!!


[b][/b]  Poor Patricia   What a weekend you must have had - chin up and keep smiling - it will take time but walking down Manhatten will have to be put on hold for the next few weeks - think of all the money you will save.   Like the photo of your knee - cool !!!!!!!!!!!

Best wishes to all

JohnK/ Manchester UK

Hi All, it seems as if this thread is burning up lately, that's a good thing and I'm glad that everybody seems to be making progress even though to some (Patricia) it seems a long way away.  My personal recovery seems to be in a lull as it were, my leg muscles seem to be getting stronger but the kneecap itself seems to be so much bigger than the good knee both in length and width, what's with that?  It also seems to be riding a little high on my leg compared to the other one.  It's almost like they took out the old patellar and replaced it with a bigger one.  Looking at it next to the good one it still looks swollen and all puffy.  I can reach 130 degrees ROM now so that's good, my good leg goes to 141 so I'm almost there but it's been quite awhile if you know what I mean.  I can't wait for it all to end but I'll try to be patient and keep to the regimine. John C.

Marcia

I had a lot of trouble getting mobilility in the knee after the first time when I had a full cast. I needed very aggressive physiotherapy to break down the scar tissue. It worked. But I would check with both the physio and the doctor first. It was painful, but long term it was worth it.

I think ROM means range of movement, but correct me if I'm wrong.

I just got back from the physio today - a week to the hour after the op. I have a split cast on - and I managed a 50 degree bend! Having done both, there is a lot to be said for the split cast and physiotherapy as soon as is possible.

But don't worry. Talk to the doctor and physio to make sure there is no other reason, then get the physio to turn it up a notch... and be ready with either soothing words, painkillers or a decent whisky - or all three

Good luck

Thanks, Patricia, and hang in there. You have had a really tough journey. You'll get there.

I think there is a difference between the UK and US protocols. I think - I may be wrong - that the Brits are less keen on MUA. As I say, I had some scar tissue last time, but it was broken down gradually in physio and the tendon was fine. I don't want you to think, Marcia, that further surgery is the only way. But do talk to your doctor and physio - I'm just a patient, not a doctor or practitioner. It may be that they need to up the amount of physio or make it more aggressive.

I have to say, though, after my experience first time in Chile, then this time in France and then here, I have a lot of faith in doctors in the UK. Good luck.

On another point - SOCKS - anyone any tips to get them on? I can't reach!!!! Suit and no socks looks yeuchhhh!

Hi all,

Slow bending and scar tissue seems to be a common topic lately, so I'l add my comments of my injury so far.

The bend is upto 90 degrees, with (painful )pressure applied, and about 75 degrees totally weight-free. This has been acheived by my 8th physio appointment now, over 4 weeks. I was either in a cast or splint with the leg totally straight for 9 weeks before physio started. My main problem in getting this far has been the muscle wastage in my thigh, causing the thigh tendon to shorten. This has been stretched a lot in physio to help me get this far.

However, now I am starting to really feel the effects of the scar tissue around my patellar tendon. The knee cap does feel as though it is pushing down. It almost feels as though it is bone on bone grinding of the patellar on the ends of the femur as the leg is bending. Having nice knobbly knees,   the good knee cap does does raise away from the knee, but the bad one just cannot coz of the scar tissue.

I am going back to the docs on Monday to discuss my progress.

Just to end on a positive note, my physio is happy with my overall strength in my leg. I am able to walk around comfortably, for upto 20-25 mins before the leg starts to feel tired. I am also managing going up stairs without support of hand rails. Going down is still supported, but thats getting better as well.

One note for Manxman, the great sock debate. I'm afaid I haven't got an answer to that one. I ended up going just over 11 weeks without a sock on my bad leg. I tried all sorts of methods using my grab stick I had been given by the hospital, and wire coat hangers!! I treated it as just one of those things I would have to live without, but put it on the list of things to do when the knee gets better!  Although I did have the benefit of being signed off work for the duration of injury so far  

Keep up the good work all, and don't lose hope to those that are struggling. We'll all get there, eventually  

Cheers

Andy
(Portsmouth,UK)

[/b]AFF2   Have noted that you are up and running 82 days after having Ruptured your Patella Tendon.  I am of the opinion that you are pulling our leg!!!(excuse the pun).   It takes between 8/12 weeks for the Tendon to heal and weeks of physio to reach full ROM.  How come that you are different to everybody else or more importantly is there something we ought to learn by your experience!!!!  

I live here in Indianapolis, Indiana and a Patella tendon rupture is handled a little diffrent here. Pluse my Doctor is just off the chain! He's great! The only thing is he has released me to do everything except return to the field
( American Football Field ) Doctor Johnson had the rupture repaired within 72 hours of the tear, which makes a big difference. I also think his knowledge and conveying information to me as well as expectations of
what I should do an precautions as well as mistakes..
Knowledge and knowing your body are the keys....Just ask my wife, she's very happy I'm on my knees again!!!

If my experience can help anyone just drop me a line.

[b][/b]

Hi Folks

Continuing the  ""big sock debate"""

Get a young lady to do it for you - it`s the only way acceptable!!!!!


JohnK/Manchester UK

8 - 10 weeks I'm sorry if my post offended you but I'm only telling you what my experience has been why would I say something other than the truth My ortho has been doing this for years and he's does a great job. I honestly have never heard anything about 8-10 weeks for the tendon to heal, it was more like 6-8, with PT starting week five.  But I was informed that I could get into the pool while on vacation after my staples where removed after week three. Not swim! but enter the pool and wade around...Important! your knee will burn and peal if exposed to direct sun light shortly after PO. Maybe my doc is more aggressive and that's why a large number of our athletes utilize his services.. Bottom line he gets the job done. I'm not trying to instill bitterness in anyway shape our form I'm just sharing my experiences. If you are offended by a professional utilizing a different approach, read this post, take it for what it's worth an move on...I'll still be up and walking in the morning....Later

Ugh, guys it's getting tough to keep my chin up, especially today.

Went to the doc AGAIN to get the infection checked, it's not getting ANY better at all so the doc went in and tried to clean out the knee himself. He finally cut out the stitches (my body rejected them so badly), and he also tried to scrape all the yellow stuff (puss?) using a scalpel. I was on a lot of morphine at the time, but nonetheless it was VERY painful.

Problem is, I have very bad circulation in that leg (from a previous injury, I have nerve damage in that leg), which means theres a bloodflow problem in the knee -- he can't get the incision to bleed! He was trying everything he could to get it to bleed today, he finally succeeded and I bled pretty badly in the room, which was quite nasty.

So after he was finished gouging things deep inside my knee, I was left with a VERY large hole. The big incision expanded so badly that it's literally a HOLE now. Because of this, he's sending me to a plastic surgeon to see what they can do, it won't heal on its own at this point.

Ugh, I really wish my body would stop freaking out, seems like if I get injured my body just doesn't know what to do so it just shuts down! It's extremely frustrating and painful (you wouldn't believe how much pain I am in right now), very upsetting too!

I'm trying hard to stay positive. Just a bad day, that's all. Hopefully it'll look better when I go back to the doc on Wednesday (that's the fifth time I've been to the doc in a little over a week!), so PLEASE keep me in your thoughts!

Hope you are all having painfree-knee days!

Patricia

Hi all,

Marcia, good luck to Hugh on his PT. 6 months seems a long time for the wire to stay in, and now its out, hopefully it should help the flexion. It will be painful in getting it going, but it will get going again.

Patricia, our thoughts are with you and your extended recovery!! A bit off topic, but your "hole" in the leg reminds me of the person who was in the next bed to me in the hospital ward. He was on holiday in Portsmouth visiting family, and went fishing with friends. Whilst fishing, a bug bit his shin a couple of times just below his leg. He just swatted it off and thought nothing of it. He then noticed after a couple of days it was infected, and went to hospital, and they operated the next day, leaving him with 2 holes in his leg, just below the knee. For the first couple of days he was in a lot of pain also, but it did get better, and enough for him to go home after the third day. He still had to see a local district nurse to get the dressings changed regularily, and was also asked to see a plastic surgeon also. This just shows how the easiest of things can cause so many problems. Like Kim has said, keep badgering the docs, and it will get better.  

As for my progress, had my PT today, and was able to get my leg around to 105 degrees bend. I was very happy about this. Unfortunately,    , after seeing the doc yesterday, I am now able to go back to work full time, subject to continued PT. Reality bites!    

Keep up the good work all, and grit your teeth through it where necessary (as I am doing at every PT session     )

Cheers

Andy
(Portsmouth,UK)

Well done, Andy. Hmmm. I'll have to rethink the idea of fishing being my only sport from now on

Patricia, hang in there. We're all supporting you. It's hard sometimes, but you seem to be making progress, slowly - but steadily. Keep speaking up when you are not happy, demand an explanation. You are a patient - which means you are not an object and more than a customer. I never stop asking questions - which is probably why the nurse laughed out loud today and showed me my medical notes, where it was written: "patient is journalist and can look after himself"!!!! I'm not sure what they meant... You do need to check and question doctors. Mine today absent-mindedly put down that I needed an appointment in four months!!! I pointed out he meant four weeks. That's quite long enough, thank-you

Anyway, if it will help you, I have now had four tendon problems - two patellar tendon ruptures and operations on both Achilles tendons. Apart from the latest snap, the other legs are fine. You'll be back enjoying yourself once through this and it will all seem like a distant dream. And it does teach you things - patience, for one. And in my case, to slow down!

Best news was, I complained hat I hadn't had a badge when I went to the clinic today, so the nurse came into the public waiting area and stuck one on my shirt with a tortoise saying "I was monstroucly brave" If they haven't given you one yet, Patricia, make one for yourself!!!!

Cheers

Manxman

PAIN AND PILLS....

When is pain good pain, when doesn't it matter and when should you watch it?  I've started my new job - which involves getting the underground (tube) into London. Knee is a bit sore today (day 3) around the kneecap where the tendon is tied in but nothing major at all and I can keep the leg up all the time. Should I worry or is this a healing pain?

And pills. I'm taking a multivit and vit c, but the physio seemed pretty sceptical about Glucosamine, Chjondroitin and/or MSM. Any views?

Hoep you're all hobbling back to full recovery

Hi Manxman


Pain is always to be expected around the knee area for
some time - however are you still in a cast?

Are you taking pain killers - Co-codomol or anti inflamatories?

Best wishes to your new job

JohnK/Manchester UK

Hi JohnK, Nigel and EngKnee... what a team

John - yes, I'm stil in a cast. It's not a major pain, just discomfort at the point where the patellar tendon goes into the kneecap. I know the surgeon drilled the kneecap and then sutured the tendon in as well as using the wire, so I'm sure it's normal. I just wanted to be sure I wasn't overdoig it. The right knee is very sore - which is a bit worrying as that was the one that went 10 years ago.... I've got painkillers, but I'm not taking them - I wasn't prescribed anti-inflammatories, so I decided not to bother. And after your comments Nigel (which confirm my assessment) I'm not about to invest vast amounts in Glucosamine. A multivit and vit c it is then (they were free!)

Thanks for the feedback people. Good luckl on the road to recoevry. Make sure it's smooth for whe I get there
Cheers

News hasn't been all that great. While I did have my cast removed this week (hoorah!), everything else hasn't been so good. I went to the plastisc surgeon, who wants me to use something called a Wound VAC; don't know much about it, but I don't really need to get into that now because now I'm not even sure if I'm going to be using it or not.

I *did* start PT on Thursday, but my session was cut drastically short because the therapist (I'm at a new facility, new therapist guys! ) wasn't sure how much he could "torture" my knee in terms of ROM with the large hole still in my skin.

It did feel good, however, to find out that my doctor and the therapist had a meeting the night before I started PT and created a whole new program for me. Doc is making sure I have the best care possible, and I feel really safe knowing that.

I went to the doctor today, and he was still not impressed at the rate of the healing. He wants me to go to a Wound Clinic on Monday with him so we can hopefully find something that can speed up the progress. He also ordered a third round of the antibiotics (new drug this time), because the infection has yet to clear up either. Ugh.

So, until I go to this Clinic, I'm not allowed to bathe (I had just started showering again, too!). Sucks, but oh well.

BTW, I'm in an IROM brace now, if I didn't mention that already.

Therapist is getting me a home electrical stim machine (sweet!) and he's really pushing for the CPM. However, I can't really do much bending until the hole closes somewhat. This creates quite the problem, especially with my history of scar tissue problems. My doctor is especially concerned with this as well, he fears that if we cannot get the knee moving within the next week or two, I will be back in the OR for another surgery.

I guess I have to take the good with the bad, eh?

Pray for me guys!

Patricia

Hi all,

I am still progressing as the weeks go along. I am up to about 120 degrees bend, when I give the leg a tug   . It is more difficult bending using just my leg muscles when standing, getting only around 90 degrees. But it is feeling a lot better.

My PT has changed this week from one-on-one, to a group session, with another 9-12 others. We all have various knee injuries, but I am the only RPT sufferer. I am now doing about 1hr 15 min group sessions, twice a week.

I have been able to ride the static bikes in the PT gym, with normal peddle settings, for about a week and half now. I am going to get my own bike out of the garage and give that a go this week. This will be a massive step forward for me, as I don't drive, and before the injury, cycled to and from work. Given my progress on the static cycle, getting going should be ok, its just the stopping and starting which should be fun, testing the strength and control in my bad leg. All I can do is take it easy, and slowly.

I have been back at work full time for 2 weeks now after 3 months off. It has been weird having to iron shirts and put on trousers, instead of just shorts and t-shirts   . One good thing has been that I am walking in and out of work daily, about a 25-30 min walk. I have been clocking up a few miles over the last 3 weeks, walking daily to help my strength and bend with regular motion. I have found this really useful.

Patricia, glad to hear you are out of the cast and into your brace. Hope your appointment on Monday goes well at the wound clinic, and you get the right treatment to get that infection beat!

Keep up the good work all,

Cheers,

Andy
(Portsmouth,UK)

Hello all! Dose anyone have any ideas on how to breakdown scare tissue?   Just wondering what others have or had done?

There seem to be different approaches in different places. The final option seems to be surgery, but in my case (the first time, years ago ) I managed to do it with careful (though painful) physio with an excellent physiotherapist. Best thing is to discuss it with your OS and physio. Is there a problem? Is it interfering with the running?

ANOTHER POINT - My wife is planning a long weekend family holiday in December - probably going by train from the UK to Paris or Prague, doing a bit of sightseeing and sitting in warm restaurants   It'll be 10 to 11 weeks after my scheduled release from plaster (two weeks away and counting). I'm now at about 80 degrees bend when doing physio (I've a split plaster on), but the quadriceps are still weak. Can anyone suggest how much/far I'll be able to walk by then, assuming normal recovery?

AFF2?? You have made remarkable progress on your injury, congratulations are in order for such a fast recovery.  Are you at full ROM?  I'm not sure the exact nature of scar tissue but it has been discussed on this thread quite often so I think I know a little about it.  Some folks have so much of it that they have the tendency to rush to the surgeon to have it removed, most folks on here say that's a NO NO.  I think with an injury like the one we sustained we ALL probably have a little scar tissue to deal with and it can probably be dealt with best by exercise and massage in a timely fashion before it gets out of hand or gets worse.  I feel it when my knee feels stiff sometimes so I exercise and massage the area until it feels better and loosens up some.  On rainy days, like today here in WV, it seems to be worse so I'll go down in my basement and work out on the stair-stepper until it feels better.  I think in my case the scar tissue is pushing my knee cap up and away from the joint to give it a slightly displaced look but I'm not positive about that just guessing with some experience and reading what others have posted on this thread.  Keep up the good work!!  Nigel, I would love to have a beer with ya someday, it's great to hear from ya. John C.

Hi Folks - in particular to Manxman .......

Have noted your intention of visiting Paris or Prague in December - I have been to both many times - from a sightseeing point of view with your limited walking, Paris would be better because you have the choice of three hop on/hop off sightseeing tour busses -  which will avoid much walking.

There is no doubt  that Prague is in my opinion the finest city in Europe, and I have been to every country in Western/Eastern Europe - but a lot of walking,particually in the old town on cobbled streets.
  If you want any further advice, dont hesitate to contact me.  Hotel rooms are very difficult to obtain & they are pricy.

Best wishes
JohnK/Manchester UK

EngKnee,
Thank you for the advice. I've been wondering about that the scare tissue and how it also maybe affecting the slight numbness. I'm just trying to work thru the weirdness of the new knee..I'm use to feeling some pain in it from the tendonious but now it's pretty good.  I had a complete tear in two, there was no pain or feeling what so ever. From the stories I've heard I think I got lucky with mine. I think it's odd how I've become more aware of people rupturing patellas all over the place. Last year I never remember seeing this at all.. I'm sure that with PT my cost where somewhere around 11.000 is that about the same across the board?

Once again, thanks guys. This board is really a boon. Paris over Prague it is, then (although knowing my wife, the destination is likely to change). But perhaps I should rule out climbing up the steps of the Eiffel Tower The folding cane is a great idea, too. My father in law has one with a little flask in the top - just right for a shot or two of a decent Highland malt

Patricia, hang in there. You really are having a b*m time You will come through and we're all behind you. I don't know if it helps, but your posts help us all to keep going. I hope you've got good friends who are spending time with you. Don't just sit alone. You can still have fun - and one day this will be behind you.

Cheers - and sending positive vibes from the RIGHT knee - which went eight years ago and is proof you can recover well...

Hi all,

Patricia, ouchie!!    As the other have said, our thoughts are with you. There will be light at the end of the tunnel, and we're all here for you pushing you along. Hope the VAC process goes well.

AFF2, scar tissue is a tricky subject. I like many others were worried about it when I finally came out of my cast, the the few weeks after. It was solid as a rock, and did seem to be hampering my bend, as it covered most of it!!

But as the physio has progressed, both my bend, and the scar tissue has improved. I massage it, with some Vitamin E lotion, everyday, plus the exercise has helped in difussing it. I still have it over the patellar tendon, about the size of a playing card. Its slighty softer now, but is noticeable to the eye. As long as it does not restrict my movement, I am going to leave it for now.

As for the cost of all the treatment, getting mine through the NHS, it doesn't cost a bean. Whether the treatment is any better or worse, is a question I cannot answer  

Keep the progress going all,

Thanks

Andy

Andy_H
Hey we had our work done the same day!
I still ice atleast once a day and take anti-inflamatories.
I think the turn around was rather quick for some reason
but I also think I have a ways to go. The knees sure don't look the same any more.. I also massage it once a day and it's weird because I can feel the tendon in there but some places on the knee I can't feel my finger touching the knee... Strange!

I only wish we had the NHS as an option! Out of pocket cost even after insurance are pretty steep!

Patricia I  will keep you in my prays and I hope others will to.. Stay up!

AFF2, close but no cigar  

On the subject of your knee not being the same as before,I have that same issue. I don't take anti-inflamtories or ice anymore. I haven't taken A-I's since the week after my surgury, and haven't iced since the first couple of PT sessions. I think the differences between our need for these is the time it took us to get back on our feet post surgury.

As for the the look, when I stand up straight and look down, my knee looks like a Telly Savalas crome dome   I used to have knobbly knees, but no more! Due to my scar tissue, I still can't feel the tendon itself. And when I touch the knee, their is very little feeling, the same as yours.

I have resigned myself to the knee never looking like the other one. Now I am getting close to full bend, as long as it doesn't cause me pain or restrict my bend, I can live with it.

Patricia, hope you are able to give us some good news on your next post. We're all thinking of you  

Cheers

Andy
(Portsmouth, UK)

Don't worry, Andy, the knee will eventually go back to looking something like normal - on the basis of the one which ruptured eight years ago and seems to be holding up fine, even with the additional pressure of putting up with the other one in plaster... Your legs won't look like Marilyn Monroe's but they may end up looking better than Marilyn Manson's  

Now, although I did my first one eight years ago, I also suffer from old age and my memory is going. I hope to get out of plaster next Tuesday. I have a split cast and I'm very close to 90 degrees bend, but there has been quite a lot of wastage on the quadriceps (3cm at last measurement). Can anyone tell me what the normal protocol is (preferably in the UK...). Is it normal to be released from plaster at 6 weeks? Are you then told to do physio and start walking as normally as possible or is there an interim stage - ie brace or lightweight splint? Any other tips? I think I have abused the hospitality of the mother in law enough (I've had to stay in London to get to the new job - it's been hell. Woken up with a cup of tea, driven to the station, hot meal and a glass of wine waiting at night.... hold on a minute, why do I want to get btter ) and it'll be back to commuting on the main line trains. Given that the missus is off for a two week business trip and I really need to be around for the kids in the evening, that's not a bad thing, but again, any tips on the first week or two out of plaster very welcome.

And Patricia - hope it's going well. There are plenty of people out here rooting for you!

TTFN

Hi Manxman

As you will know, once the cast is removed, the leg will feel very light.

Don`t  try and be clever and run at once - work on it slowly to build up strength in the quads first.  Reaching the magic 90deg is the first achievment.

Are you still taking any pills?

Only a suggestion from my Consultant ---- sleep with a pillow between your legs - it takes the weight of the injured Tendon.

Best wishes
JohnK/ Manchester UK

Hi,

Manxman, thanks for the advice.

As for your queries, I was in plaster for 6 weeks after my Op. When it was removed I was advised to start physio as soon as I could, although being the NHS, they couldn't fit me in for 2.5 weeks!! They told me to wait 4 days for my notes to hit the PT department before I made an appointment, which due to timing over a weekend, was actually 7 days. My advice would be phone straight away, and get the appointment as soon as you can, which should still be longer than the time for the notes to get to the PT dept. I ended up wasting a week of my recovery for this.   As such, I did lean on my private medical insurance, and got a weeks worth of physio before the NHS took up the baton, so losing only 1.5 weeks in total between cast off and physio starting.

Whilst waiting for my physio, I was using a cricket bat splint, which I had handy at home from waiting for my Op. I did find this very useful in providing support, whilst being light enough to be better than the full cast. I was also using my crutches out of the flat. Once physio started, it was only about a week and a half before I was able to ditch the splint in the flat and start to get back walking again, with crutches to hand just in case   And only a couple of weeks more before the splint got ditched altogether.

As John has said, just take it easy. Wait for the physio to get going before you try and be too adventurous, i.e. going up and down stairs, or running. Just listen to what your knee is telling you. And the pillow between the knees is a great suggestion, I found it very useful.

By the way, I have managed to get back on my bicycle now, and have been riding in and out of work this week. Even in this short time, my knee does feel more flexible, and is taking only 4-5 steps in the morning to get going again. Makes me wish I had a static bike at home so I could have used it between PT sessions, or gone to a gym. But hey, I am on it now, and its all good  

Cheers

Andy
(Portsmouth,UK)

Hellllo All!
Hey Andy_H,
Funny thing, I was just told by my Ortho that I shouldn't be leg press the 695 that I have been pressing and he wants me to go back down to between 3 & 400 pounds.Now, how, where and when should I make gains  I felt like if it feels good do it but it appears that the feelings not the same between the Doc and myself! If it's reps at low weight then how many reps are we talking?
Anyone keeping up on Patricia?
How was the trip?

Thanks, guys

No pills, John 42. I've been put off by physio who has said there is no evidence of improvement plus newspaper articles suggesting little evidence of improvement for mega vitamins - but I'm happy to be persuaded...

(What I AM doing is - having convinced the missus that Egyption holidays were not ideal and initially considering a short break in Paris - planning a Mancunian mini break! Back home for me... an exotic trip for the Chelsea girl I married! )

Thanks for the advice, Andy____H. I've got a splint from the time the French doctor refused to accept I had ruptured the tendon (meaning it took me 6 days to get from France to a UK hospital with the tendon ruptured... Ouch ) The static bike is an interesting option. I'm likely to be stiffed on the physio, though. I have a session immediately after the consultant (already booked) but I suspect I'll have problems after that as I'm working in London and the physio is officially in Oxford - and as I've started a new job with the tendon, the private medical insurance won't cover it....

Hey ho... and thanks again

Hey Hjumper, could you describe some of those workouts. That sounds interesting. I'm always looking for something new and ways to improve.... Thanks! I figure a little change never hurt anyone.... Man, let's compare some notes !

Hey guys, sorry I haven't been posting much, it's been a rough few weeks and I haven't been in the best of spirits lately.

I currently have the Wound VAC plugged into my leg, it's definitely not the most enjoyable of things. Basically it's a machine that suctions the drainage out of the wound and speeds up the granulation. Problem is, another incision has opened up so while the VAC is doing its job on the big wound, the little one (one of the scope incisions) is draining more than ever and is SO painful.

It's also very frustrating because people are constantly staring at me. I have a long tube connected to my knee, which is connected to a machine I have to carry around. It has a strap so I can tote it with me, but people find the need to make me feel awful by shooting me dirty looks. I can't stand it.

I'm also going to PT every day, have the CPM at home finally, and also have a personal stim machine for home use. I'm pretty much always connected to something. My range of motion is suffering, and I'm getting really nervous that there's a lot of scar tissue building up in there.

My doctor thinks the reason my body is reacting like this (the constant drainage and opening of the incisions without them being able to close up again) is because my body is horribly rejecting the sutures holding my newly-constructed tendon together. If that's the case, then he'll need to go in with a plastic surgeon and take the sutures out and find a new material to put in there. He said the sutures are supposed to be non-reactant, but about one out of every 1000 patients will have a reaction to it. Of course I have to be that ONE person, eh?

Aside from all the health drama, I'm really suffering, mentally speaking. My spirits are very low and I'm having a hard time keeping my chin up. My doctor tells me to go out and try to have some fun, but it's impossible when I'm always supposed to be hooked into some machine or in a lot of pain. Plus, it doesn't help that after going through this for over a year and a half, many of my friends have since abandoned me. I pretty much have nothing going for me. It's just a very difficult time right now.

I'll keep you all updated. Thanks for keeping me in your thoughts and wondering about me.

Patricia  

Hi Patricia,

Great to hear from you again, even if you are not in the most positive of moods. I wish I could give you some practical advice and support, having gone through the same extended problems you have, but I can't. My surgury and recovery is easy compared to yours.

All I can advise is what I would do in your circumstances, in not to let these problems beat you. Don't get even, get MAD. SHOUT, scream, swear, break something, but avoid your leg please! Get a box of pencils and break them into little pieces. Buy some oranges, position yourself over a sink, and sqeeze the "pulp" out of them. That leg of yours is NOT going to beat you!!

You say you have lost friends, but you have gained quite a few here on this board. You can be reassured we will not abandon you. Any frustrations, disappointments, sadness you have, we're all here to listen, and help where we can. With most probably with more practical help and advice than mine.  

I've said it before, and I'll say it again, THAT LEG OF YOURS IS NOT GOING TO BEAT YOU! It takes will power and belief in yourself, you can do it.

Cheers

Andy
(Portsmouth,UK)

Absolutely, hjumper....

Patricia, we're with you. Firstly, don't worry about people looking at you... It's better than them not looking at you

Seriously, though, worrying about people looking at you assumes they're being in some way critical. They're not, and anyway, what does it matter...

Your friends... Have you tried calling some and suggesting they come and spend time with you? Sometimes people get embarrassed and don't call (I'm terrible at asking for help or for company!)... and if they don't all come round, at least you know who your best friends are...

Hjumper's idea is good, too. Have you a project you could get stuck into? I know it sounds daft and it's hard to get started, but having something to complete is a real motivation - and there have been lots of talk about people with a positive attitude getting better quickly. The first time I did my tendon (right leg) I put all the family photos in albums - it may sound boring, but they're the only ones in albums. The rest are all loose in boxes!

Then I had to commute to London - at least a three hour journey - only there were a number of crashes which meant the journey was hell (tho not as bad as for the victims of the crashes, which luckily, I missed). So, I started studying for an MBA by distance learning. I've just got it with distinction and won a prize for the university's best student. That's led to a bigger job, more responsibility, more money.

Of course, doing the left leg just before starting wasn't great, but I used the time to complete another management qualification - and I'm now in the running for another prize...

So, you can turn this time into a really positive period  that can have lasting positive effects on your life. Most people are rushing around all the time and don't have the space. But doing the leg/s in means you have to slow down. It's hard to start a project, but you learn so much about your own strengths and determination - and then when people look at you, it's because they're impressed with your determination, not your plasters

So don't give up. Hang in there, we're behind you... albeit from a long way away (England)... and think about what you can use the extra time you have because of Stupid Knee

Cheers

Hi Patricia,

Me again, full of useless advice  . Here's another way I describe my situation.

When I talk about my injury, I call it a life changing injury. The reality is I will think about my knee in everything I do, not trying to over strain it. I will probably never play volleyball again. I won't get to use my specific volleyball shoes and knee pads that I ordered on the internet and were delivered the day after the injury (you think I jest, but it is true, a real bummer   )

But then again, its just one change that has happended in my life so far, and will continue to change in future. My (messed up   ) family, my life at school, onto university, onto my 1st real job, and the 2nd 300 miles away, and now the 3rd 600 miles from the 2nd(!), not to mention the relationships in between, all have changed my life. The announcement we had at the office (a BIG BLUE office, can you guess?) a couple of weeks ago saying our job roles are due to move to another country on the other side of the world, with us not welcome to follow the jobs  ,  is just another life change I will have to adapt to.

Throughout it all, I have learnt to adapt with what happens. Change where and how I live to get by as best I can. If I can do it, anyone can  

This injury has, and will change your life. But you can control it. Use some of the advice the other guys have said, find your distraction to get you through this, and onto the next change in your life. If everything was the same all the time, life would be boring.  

Anyway, that's enough of my late night rantings.

Bye for now,

Andy
(Portsmouth,UK)

THanks for the well-wishes and suggestions everyone, it really does mean a lot. It's nice knowing that I can come here and find all the support I could ever ask for

As for an update on me, things still aren't all that great. I had my nurse come in on Saturday to change my Wound VAC dressing. Everything was going fine until she took the gauze off my other open incision, which had thick pus all over it. She started pushing on spots around the incision and all sorts of stuff would come out of the incision. It was awful. She said that I should call my doctor immediately about it because it looked very infected and was a concern to her, especially since I was already on antibiotics.

So I called the doctor's office, who contacted an oncall doctor. He told me that I could either go to the ER and meet him there where he would surgically clean out my knee, or wait until Monday so I could see my doctor and then he would probably do the surgery himself. Said that if it got any worse or if I developed a temperature to definitely make a trip to the ER.

Thankfully I didn't get a temperature, but it did get somewhat worse. Later on during the day, I took the dressing off and noticed that the incision had now been bleeding. WHenever I'd push on one particular spot about an inch or so away from the incision, a lot of pus and blood would come out. It was also very hot, red, and painful. I didn't go to the ER (still opting to go to the doc on Monday...I did contact the oncall doc again and he said this was okay), but now I'm very nervous.

I don't know what's going on with my knee. I'm still very frustrated, but now worried and scared. Please continue to keep me in your thoughts. Hopefully I'll find some answers on Monday.

Patricia

Keep your spirits up, Patricia.

Just a thought, and I know doctors don't like to be told things, but it's worth stressing that you're on antibiotics but stil having this problem. There have been some cases in the UK of antibiotic-resistant infections (antibiotic-resistant Staphylococcus aureus  or sometimes methicillin-resistant S. aureus [MRSA]). Once spotted, they're relatively easy to sort out.

Also, if I were in your position and had a problem, I'd go straight in to A&E and not wait. Apart from anything else, things will just prey on your mind. Surely it can't do any harm, other than losing your time, and you'd set your mind at rest quicker. Of course, I know things are different there than in the UK, but you have a right to insist on the best care.

Good luck, keep us informed and remember, we're right behind you (if a little lame )

Manxman

Your such a strong person that we all can learn so much from, your courage and strength inspires us all.
Keep your head up and stay strong you'll have that train back on track sooner than you think!
I'll keep a candle burning for you..... Our prays will be answered...

Hi Patricia,

You give the saying "no pain, no gain" a whole new meaning!

We all wish you the best for your next turn on the operating table. Please post back soon with some news, good or not so good  

Byeee,

Andy
(Portsmouth, UK)

At least they're moving with purpose. Do rest and let us know what happens.

In comparison with your news, mine is progressing. Plaster off today after six weeks, but another four weeks in a cricket bat splint. Things seem to be going OK. I'd like to move faster, but - and your story Patricia puts us to shame - it's better to take it easy. Lots of exercises and knee bending. Wire loop being left in. I'm at 95 degrees, which at 6 weeks I reckon is pretty good

So hang in everyone out there.... and especially Patricia. Let us know how it goes...

Hi everyone..
Im a former pro bball player who in april completely ruptured my left patella playing SOCCER ..
since this is not a common injury im SO HAPPY that i found u guys..i´ve been through hell and now im on my way back..I was in a cast from heel to buttcheek for 2 weeks and then in locked don joy for 6 weeks.. i have the wire around the kneecap and back to screw which is inserted where the shin meets tendon..i hope and pray that im gettin it out nov 23..
my question is:
Do any of u guys know if this type of injury is carreer ending..do u know of any famous atlehtes who been through this...
sonshyne

Hi Sonshyne

Welcome to the "RPT club" - as far as I know, you are the 32nd person world wide on two message boards to have suffered this very rare injury since December 2002, ( the first in Denmark).

You will be able to access lots of useful information from fellow sufferers on this message board - please keep the message board in touch with your progress.

The most famous person to have had a Ruptured Patella Tendon was RONALDO, the famous Brazilian football player - it`s perhaps no consolation that he was out of action for two years, but he did manage to return to proffessional football.  It is certain, that you wont be putting on your soccar boots on for many months, but we keep our fingers crossed for you.

With best wishes
JohnK/Manmchester UK

Hi Sonshyne - and John 42. Hey, since I've snapped the left tendon (8 years ago) and then the right - ie not at the same time - do I get a special prize

I love the fact that Ronaldo is the other top athletic sufferer. The injury - of the patellar as opposed to the quadriceps tendon - is supposed to be a younger man's injury (Clinton - that's the US prez - snapped the quadriceps). It's particularly nice since I'm closing in to the 50 mark (couple of years to go yet )

So, Sonshyne, you can get back to top level - but speaking as someone who ended up having another tendon injury) you may want to consider your future sporting career and decide whether you need to ease back a bit

First day in the office without the full plaster - just the cricket bat splint. Left leg v sore. Anyone else had this? I presume it's the other leg compensating.

And John... after the info on the board about where to go at Christmas - one creepy thing is that we were considering the Taba Hilton... so now the idea is Manchester! Back to roots for me, but it'll be a culture shock for the Chelsea girl I married!

Cheers

Hi John and manxman..
So far my my progress has been positive..
My PT says that im doing a very good job and i haven´t had any complications so far..my ROM is 110 but thats because of the wire he says..
PT says that with the progress im making i should be back on the soccer field in april..(im a 6"8 goalkeeper)
and my plan is to go to the UK for a tryout next summer..so i can prove to myself and to all of u that everything is possible if u want it bad enough and u work hard for it..

I might see u in manchester someday
john
to all of u outhere
remember to never lose the faith and always do the best u can to get well...life is what u make it..thats my belief..
Stay strong.Sonshyne

Hi Guys,

Havn't posted for a while as a lot going on. Moved back to England (from Germany) and have started a 1 year law conversion course at university (aged 33  ).

To remind you had complete ptr end January - 13 weeks in removable cast.

Still feel that the knee is very weak and am getting frustrated about not being able to do any sport (keen field hockey & Squash player). Have been very lazy with exercise though.

Has anybody else started sports again? How long did it take?

Tony

hi tony..
From what i heard it takes about a year to make a comeback.. this is not the time for lazyness..rehab and hard work is the way..
Best wishes
Sonshyne

Funny thing I've noticed that the NFL has taken notice of mystery behind the ruptured tendons. Given the numerious incidents that have occured and the dollars
spent on the athletes they have setting out the season. Something good may come of these studies. We may just gain some insight into what causes this and why tendons weaken Maybe?
I figure any info might be handy to have..

Hi Invent, John 42, Sonshyne...

Agree with John, Sonshyne, how did you manage to get around for two years I had six days in France when the doctor refused to diagnose a ruptured tendon (despite me telling him in perfect French what it was... "une rupture du tendon rotulien" ) I was in a cricket bat splint and in pain, though the rose wine helped

Also agree on the cortisone/steroid (my understanding is that cortisone IS a steroid). Cortisone injections are/were common as a pain management tool. I remember a Sale Harriers 800 metre runner snapping his Achilles tendon in the Olympic semi finals after cortisone injections. I had one - against my will. I was on a treatment table and the doctor injected me. I sat up and agued furiously, but it was too late.

The pillow between the legs is great, John. I'll take you up on the beer! Legs a bit sore today, but taking it slowly....

Hey Tony, it's good to hear from ya dude.  I have the same trouble doing my exercises lately, I think I have a false sense of security going on.  My knee has improved tremendously from what it was just a couple of months ago but I do need to keep exercising.  Saw the doc last week and he wants me to be evaluated via a Functional Capacity Evaluation in order to determine if I'm ready to go back to work on the ship, that should be interesting.  Anyone know what this entails or if I could possibly reinjure the knee by trying to perform this test?  Should I study, sic, for it by doing massive exercises first?  Maybe I'm just blowing this thing out of proportion but I definitely don't want to go thru this disability again.
Invent:  how the heck could you have ruptured your patellar tendon and not known of it?  That is beyond my comprehension but come to think of it there are many things that fall in that category.
Sunshane:  welcome aboard and you are 100% correct about the exercising, it's just that some of us are exercise-challenged, so to speak
Patricia:   Your condition is utmost on all our minds and we are all praying for your complete recovery, keep the faith!  John C.

Well guys and gals, I had my surgery on Thursday (10/14). I'm still in a lot of pain and discomfort, but hey -- it's nothing new

So, like I mentioned earlier, I had two surgeons operate on me -- my OS and a plastic surgeon. They cleaned out the knee (scar tissue and infection), however could not go inside the joint to clean out more scar tissue because of fear that the infection would spread deep inside the joint (very bad!). So, that is somewhat of a problem, but we'll just have to deal with that later.

Doc said that the tendon was scarred down to the bone! He said that even though I told him before that I develop scar tissue very easily/quickly, he still was surprised to see how much was in there.

They also took out all the sutures that they could find (apparently they were all over my knee...kind of scary, seeing as they were SUPPOSED to be in my tendon ). My plastic surgeon said that that should cut back on the pain now that the sutures are out; I hope he's right!

The plastic surgeon also made the smaller incision that had opened up bigger. It's now a good few inches long, maybe about a half an inch wide. It's nice and nasty looking, but it's supposed to help with the draining problem, so I'm on board for that.

Finally, my OS did a "gentle manipulation". He got my knee to 90 degrees, but didn't want to go any further for fear of tearing the tendon. It's only been eight weeks since the surgery, so it would have been VERY risky to go further. He said that he will probably have to go back in and clean out the rest of the scar tissue after the infection finally clears up; the joint itself is still pretty scarred.

I tolerated the surgery pretty well, but when I first woke up I had terrible coughing fits. I also had a steep drop in temperature; when I woke up I was freezing even though I had tons of blankets and heating lamps on me.  Yikes! The nurses told me to keep a close check on my temperature, which so far has been normal, no drop or hike. At least that's good, eh?

As for the coughing fits though, that stunk pretty badly. I was coughing so badly in the hospital that my chest, ribcage, neck, and jaw were absolutely KILLING me. Even today, I'm in a lot of pain. And yes, I'm still coughing a lot. My mother looked at the back of my throat today and noticed a little blood (from coughing so much; according to a nurse I spoke with), which was kind of scary. She also said my tonsils looked VERY irritated. Funny, I've NEVER experienced this many problems after a surgery, but I guess each operation is different. Maybe the tube down my throat really bothered me this time around, who knows.

Aside from that, I'm re-starting PT on Monday, also seeing my doc for a second post-op appointment on Monday (saw him Friday, day after the surgery). I *do* have a few stitches in my knee (to keep the two large incisions closed), and I also have a different type of sutures in my tendon. Doc is going to keep a very close watch on it, make sure that my body doesn't reject THESE either. I hope so, I don't think I could go through this mess again!

Time to lie down, get back in that damn CPM again (lol)...BTW -- if some of this didn't make sense, I apologize; I'm <i>very</i> medicated right now

I'll keep you all updated when I can hobble back to the computer!

Patricia  

Hey Patricia, glad to have you back with us. I was keeping fingers crossed (crossing the knees was a bit painful). It sounds positive. Sorry the coughing is making things difficult, but John42 is right, progress comes, if sometimes slowly

So, here you are...

My leg is progressing - coming up to five days in a cricket bat splint (what is that for our US friends?. I have to say that at home I'm managing without and gradually trying to strengthen the knee. The bending takes time. I'm wondering if the restrainng wire has an effect. Anyone have any experience/views? How far can you get with the wire in?

Hang in there everyone, and especially Patricia...

Manxman,

The wire shouldn't stop you as far as I know. I still have a wire (it's being left in "permanently") and I have full ROM.

So no excuse to stop with the bending  

Nigel

Thanks, Nigel. Oh well, back to the exercises

It does get sore and swollen at the end of the day - though it's only five days since I've been out of plaster, and I seem to remember that's normal...

Don't forget to get in touch when you're in limping distance

Cheers...now where was I. Ah yes, straight leg raises...

Hey guys,

Long time no see!  

Greetings from sunny California (well, it rained for the first time today after months of sun). I'm in Sacramento visiting my wife, who was sent here for a 3 month training programme.

A quick update, 5 1/2 post-op: No crutches, no brace, full ROM, no swelling, a bit of stiffness first thing in the morning or after sitting in a car for longer periods, still pathetic quads due to laziness, walking normally with no particular side-effects if I walk longer distances.

No problems doing straight leg lifts, but lower leg lifts seem to still be somewhat difficult. Has anyone had this problem? Any particular exercises to improve this?

I arrived in CA two weeks ago and I'm having a helluva good time. Went to LA and Las Vegas last week, where I finally married my girlfriend of 14 years and 2 kids.


Will be in London on Tue 26th all day, before flying back to Kosovo on 27th. If any of you is in town on 26th, we could have a drink (or two).

Glad to see everyone making progress here! Patricia, you hang in there, girl, 'cos you'll overcome this in no time. Thumbs up to all the rest of you "weekend warriors" and thanks for all the help, advice and support you've given me when times were hard.

Cheers,
Fis

Hi Fish..
Standup with your back against a wall,place a bball in the lower back and one between your knee and press it..then do squads 4x15..this will help your quads and your balance..
Sonshyne
6"8 250lbs former bball player with squirky knees

Hi Tony

Likewise, after I slipped on ice outside my house, I lay there an hour before the newspaper girl was delivering the papers and saw me lying on the drive.  In no way could I stand up as there was no Tendon to support my right leg.

Interesting that no two persons are the same and I am still battling on two years later -  I have learned to take each day as it comes and hope for continued improvement.

JohnK/Manchester UK

First time, I was rushed into hospital Second time, I was rushed into hospital only to be sent home by French doctor who said it was not serious The pain was there, but once I'd got a brace and kept it stable, the pain went down (or maybe the alcohol and my pain threshold meant I didn't feel it ) I then had to be driven across France and fly back to England on Ryanair before getting to the hospital (God bless the NHS )

Sorry to hear you're having problems. I'm quite pleased with my progress. Seven weeks on and I'm regularly walking around at home or close to my office without any plaster or splint and the exercises are going well - if slowly and certainly not full range. Have you talked to your doctor about scarring and/or any problems caused by the wire loop?

Hang in there. Wonder how Patricia is....

How do you know when/if the wire has snapped? I've had very vague answers from the medics. The knee is progressing well, but the odd sharp pain to theright of the kneecap - nowhere near the tendon...

Nice to have you back with us Patricia. Of course it's hard and you have our sympathy

"I guess I have a lot to talk about with my doctor tomorrow, eh?" - I know I'm getting old fast, but it helps me to write down the things I want to find out from the doctor and go through the list. If I don't I always come out thinking I've missed something

You say all your mates are away at college. Is there any distance learning course you could do? I did an MBA recently by distance learnign and it's had a major impact on my life - plus I enjoyed it. It would give you something to do and they can be really useful later on if you pick the right course... Just an idea. It might take your mind of stupid knee

Hang in there....

Went to the doctor today, discussed a LOT of things...here goes:

He was quite pleased with how the incisions are healing now. Says it's *good* that they have been bleeding a lot; means there's bloodflow in the knee again. Since the fourth surgery (patellar tendon reconstruction), I had pretty much lost a lot of circulation in my entire leg, no feeling whatsoever around the entire knee and it wouldn't bleed at ALL. Still suffering decreased sensation and nerve damage but at least there's that oh-so-important bloodflow.

Doc is letting me start up PT again, also letting me stim my quad and I can ice the knee again hoorah! Initially he wasn't allowing me to ice the knee because it would constrict the bloodflow, and as you can very well imagine now, that's a big no-no! He said that while it's still a concern of his, he'd like me to be as comfortable as possible. As long as I continue to bleed, things will be a-okay. But if I start to drain a lot (with no blood) again, then to stop icing and to immediately call him.

BTW, back to the incisions -- they still basically look like two big holes in my knee, but at least they're starting to properly heal. Looks like I won't need the Wound VAC anymore (THANK GOD! I *hated* that thing!). Even though they look really nasty and disgusting, there's at least granulation and like I said earlier, bleeding ALONG with drainage. That's very good!

Scar tissue is still a concern (especially since there is still a lot left in the joint itself), but at least it looks as though we don't have to worry about the incisions opening up worse; that was the problem, I couldn't really do anything with the opened incisions, they'd just get worse and worse when I worked on my ROM. UGH. But anyways, the scar tissue issue (tee-hee) will be dealt with later; if I need another surgery, so be it. I probably will, but I'm gonna stay positive and hope for the best.

I still am on antibiotics (both oral and topical), and probably will be for another few weeks but I guess I gotta deal with that, eh? Sucks, but whattaya gonna do?

*Finally* I can really start rehabbing now, it's been LONG enough! He said I can start as early as Monday, which was music to my ears. I was also able to talk to my therapist as well, he ended up stopping in the office on the way out of the building (my PT is in the same building as my doctor), so that was good to let him know what was going on.

In terms of the painkillers, my doctor agreed that while it stinks that I have been on the percocet for so long (14 months now), it's necessary. I completely understand, I just don't like being on them for such a long time. He also gave me a script for a larger amount of the percs, which was what a desperately needed. Like I mentioned in an earlier post, I couldn't even get in my CPM after I ran out of the pain meds; he realized his error in not giving me enough and agreed to give larger portions.

I'm seeing him again on Wednesday, hopefully I'll have made some progress in PT by then. I hope so!

Unfortunately I'm not in the clear yet (and probably won't be for a *long* time), but it was nice to hear some encouraging news for once. I just hope the news gets better and better with each day.

Patricia

Patricia, the news you've given us makes us ;Your whole attitude seems one of hope instead of dread and this is great stuff.  Of all the posters on this thread your case was by far the most difficult and we all felt diminished by your troubles and emphatic that you get better with everyone offering their experience and hope.  It worked!!!!  You are getting better and despite the worst efforts of your physicians you kept at em until they came around to your struggle and made it their own business to think harder to solve your needs, and now you can rest your nerves a little.  Keep up the good work!  John C.

Hi Manxman..
The pain u are having, could come from the wire "around" the kneecap..I just recently found out that the wire is going around it cause i was having the same pain as you..a little massage around the kneecap will help you a little bit, but remember to keep it elevated.
Sonshyne

Hey folks.  Got room for another?

My story - I ruptured my left patella tendon playing in a yearly flag football game for charity.  Was in the last couple minutes of the game.  "And there I was ..." running a deep route, trying to adjust for the ball and suddenly felt like I got kicked below the kneecap.  Took a spill (head over heels apparently) and that was pretty much it.  Ambulence ride, ER, etc ...  Admitted that evening and had surgery the next morning.

Just over 2 weeks post op.   IN the STUPID imobilizer of course.  Having the stitches taken out tomorrow.  Would love to start PT ASAP, just to break up the boredom.   Wonder what the OS is going to say ...

Quick question - from what I've read so far in this thread, it seems like I was "weight-bearing" somewhat early.  The day after surgery, they showed me how to use crutches, puting some weight on the bad leg.  Unusual?

Some many more questions.  And so much more frustration (summed up by saying "THIS IS SUCH BS!").  However, reading this thread already has me optimistic.  Thx folks.

D

Welcome aboard, bigbadd. Not the best club to join, but I suppose it's better than nothing, eh?

I'm not sure I'm the best person to answer your questions, seeing as my case is a lot different than everyone else's in this thread, but I'll give it a shot anyways.

After my surgery, I was placed in a full leg cast for six weeks. I was given crutches as well, and told that I could do partial weightbearing AS TOLERATED, after the first 72 hours (which were to be spent in bed or on the couch with two pillows beneath my ankle). Hope that helps somewhat

Feel free to ask any questions, that's what we're here for! This thread is a great tool as well, sometimes you'll find the answers to most (or even all!) of you questions without having to even ask them!

Good luck with your recovery and rehab and PLEASE keep us updated on your progress!

Patricia

Okay, now for a little update on me...

I'm back in PT daily, and I'm slowly progressing. I'm seeing a "team" of physical therapists, my doctor wants me to have the best care possible.

Unfortunately, two of my therapists argreed that I'd need to have my knee cleaned out again because there's just too much scar tissue inside. The PTs can get SOME ROM, but not nearly as much as they'd hope. I should be able to get about 90 degrees by now, but I'm nowhere close. Sure I'm at 90 in my CPM, but that translates to about 60-65 on the goneometer. Ahh well.

I'm also using all of the different machines to help decrease the scar tissue buildup and hopefully promote healing of the tissue. One of them  looks like a computer mouse with a laser on the end. Weird!

Seeing the doctor today, I'm hopefully getting the stitches removed. We'll see, though. I have yet to be on target with anything

I'll keep you updated, thanks for the well wishes! Hope you're all doing well!

Patricia

Welcome a board bigbadd! These people are a great source of encouragement an advice. Help and support is at the tips of your fingers.. These guys are great!

Pat- to be so young, your are very strong!! Man, you go girl! Keep your head up. .. I'm sure by next summer those legs will be kickin! Later! Post a picture then.

Thanks Sonshyne - saw the doc today and he said the same, so that's fine. Thanks for he advice

Don't worry, Bigbadd (and welcome to the club). It's usually weightbearing as tolerated. My doc was quite happy for me to weightbear as long as the leg was not flexed...

Good luck. You're in good company here

Guys and Gals-

I just got back from the doctor. Feeling pretty good, I must say. I DID have my stitches removed! I was actually really excited to get them taken out merely for the fact that that was the FIRST time something actually happened when it was SUPPOSED to! Gives me hope that things are finally looking up! Hoorah for me

My doc also opened up the brace to 90 degress, says it'll make me work harder. Although the next few weeks are going to be extremely painful, at least it's the "good" type of pain.

We discussed the possibility of having to go back in to clean out the scar tissue. He told me that he couldn't really give me a definite answer as to if I'd need another surgery or not because he didn't want to inevitably disappoint me in the end. That basically told me that he thinks chances are pretty decent I *will* need another operation. Ahh well.

He gave me scripts for both percocet and ultracet, says to use the percs when I'm in extreme pain and before/after PT. Otherwise, use the ultracet for "everyday pain". Sounds good to me!

Other than that, I'm to continue with PT daily and really work the knee at home. He says I can start driving a little, too!

I'll be seeing him in a week, so that's when I'll post my next update.

Again, hope everyone is doing well and is having a pain-free day!

Patricia

Hi BigBadD

One suggestion was to sit on a chair with caster wheels and put your injured leg up on another chair.

Six weeks in a cast is normal and then the rehab commences........ugh.

Which part of the world do you live in

Best wishes
JohnK/Manchester UK

Hi Tom

Welcome to the RPT club --- You are  number 34 to have registered on two |RPT message boards since December 2002.  Very rare to do in both legs - albeit 4 years apart - Did your OS put this down to any weakness i.e. on steroids etc?.  At least you know that you are in for a long haul.

As for BigBadD - a few further tips as you are the new boy!!!!!

Have a look at the following web pages - they will give you lots of knowledge of your injury and importantly, read all the threads on this message board.



www.emedicine.com/orthoped/topic246.htm

www.arthroscopy.com/patendrep.htm

www.sma.org/smj1999/junesmj/enad.pdf

www.medscape.com
You must register first - suggest ""nurse""

www.Knee.1.com

You should also start looking for a pedal exerciser - not expensive - have a look at

www.physio-med.com
for ideas

Sleep with a pillow/cushion between your legs - takes the weight of the tendon. This was one of the best tips given to me by my Consultant surgeon.  (A young blonde would be a good substitute !!!!

Best wishes  JohnK/ Manchester UK  

Hi tburgoyne,

As another double tendon rupturer - mine also several years apart - you have my sympathies

In my case, the rupture happened both times while playing sport - but was put down to excessive sport (athletics, steeplechase) years ago that gave me jumpers knee. No steroids in my case. Like you, after the first, I got back to full fitness and even jogged again and played tennis, although I stopped ski-ing. Now, like you, I'm planning to cut back to things where I don't stress the knee - cycling and swimming - especially as I also have had operations on both Achilles tendons...

From what you've said, you have exactly the right attitude and the right approach. I was very aggressive in my physio after the first one but am taking it carefully now. There's no reason, though, for not getting back to fitness... and improving my fly fishing!

Welcome aboard... just mind the step

Hi all,

Its been a while since my last update. First off, welcome to all the other single leg newbies, and Tom as a repeater   Patricia, great news, progress at last, keep it going  

I am still going to PT twice a week, in a knee group class. I had a bit of a hiccup a couple of weeks ago where I was putting in just that little bit too much effort with some of the high knee exercises, and ended up straining my quad tendon on the bad leg. I have been easing off the exercises to help it heal a bit, and it was better at the PT yesterday.

I've still been riding my bike everyday to and from work, but I have also extended this to riding in and out of hospital for PT as well for the last 3 weeks or so. As others have said, its a great low impact exercise. I would recommend it on a static bike, or pedal machine, as soon as you all have enough bend. And ride home from physio is down hill, which helps  

Last week, for the very first time since my injury, I actually knelt down on both knees. It was the weirdest feeling. I knew I'd lost a lot of feeling in the knee, but when it was fully bent when kneeling, it was very numb. No pain at all, which was great, just a strange feeling.  

Keep up the good work all,

Cheers

Andy
(Portsmouth,UK)

Good to hear from everyone and just lovin the board ... Everyone have a great weekend!
Onward and upward, your getting better everyday!! Believe it!

Hey folks,

Just thought I'd put up a quick post to see how all are doing.  Nothing new to report really.  I got cleared to go back to work next Monday (finally).  Not really sure how I'm going to manage everything.  I'm still pretty dependent for a lot of things.  But nothing to do but give it a shot.

Tom I guess we had surgery on almost the same day (Oct 17th for me).  I completely hear what you're saying about thinking hard about giving up hoops, etc.  I've been really athletic my whole life too.  Hoops and football - neither of which seem like great sports to do after recovering from this injury.  I kept thinking my sports career is over.  Buti n the back of my mind I know that when it comes to it, I'll try again.  It'll be a cautious try, and who knows if i'll ever be explosive again (even if my leg allows, mentally who knows) .... but bottom line is I'm gonna take my time to heal but I will play again.  Might not be like before, but in the back of my mind I know I'll play again.  (Maybe I'll play the old man game .... good set shot and lots of fouls instead of good D ... )

Some of the other stuff you mentioned kinda hit home too.  I've had knee problems for a while too.  Tendonitis in both knees.  I always though it was also an inflamation type issue, that you just learned to deal with via ice and advil.  I've got to revist that.  My OS things that previous degeneration (tendinosis he called it) led to this.  

On the subject of treatment, early this year, I went to see my regular MD about my left knee (the one that ruptured).  It was bothering me after activity, especially after leg workouts.  One specific spot on my knee cap (a bump) was the center of pain.  I got referred to physio.  The treatment helped, but I have no idea EXACTLY what they did.  Basically it was some sort of active diffusion treatment where a medicated pad was placed on my knee, using electrical potential to get the substance to transfer through the skin.  At the time, and based on what my PT told me, I thought it was someting to help reduce significant inflammation.  I had this treatmetn for 2-3 weeks, along with backing off of the weights and hoops.  Things were pretty much normal after.  But in light of the fact that I ruptured a tendon in that knee months later - I'm going to have to find out exactly what it was that I was treated with.   Did it lead to weakening the tendon?

Well, thats my two cents for today.

Best to all,

Onwards,

D  

I'm with you EngKnee. I've noticed since my injury that a large number of people have had prior tendon problems. Tendonitis seems to be the common factor in most cases. I had Tendonitis prior to my rupture. I just made the mistake of not taking Ibprofen prior to physical activities and here I am. I just wonder If anyone has even bothered to put together a study of these cases

Hi Corey

Welcome to the RPT club - I make you member 35 worldwide since I started the count on two message boards since December 2002.

However, both knees  

Thats going to be a very long - long haul to recovery.

My first suggestion to you is to read as many posts as possible on this board - got lots of valuable input - keep us informed of your progress and dont hesitate to ask questions.  You will find that you have fellow sufferers on both sides of the pond.

Best wishes for a speedy recovery

JohnK/Manchester UK

Hey guys -

Went to the doctor yesterday. He was a little disappointed with my ROM (which is hovering around 90, I can get about 75-84 on my own), but otherwise was happy with my progress.

I gave him an update of what I was doing at PT, and he told me NOT to use weights during straight leg raises. I was surprised, seeing as my physical therapists all had me using weights, but oh well. He said that it would put too much pressure on the tendon and he doesn't want to take ANY risks, even with one pound weights.  

He's starting to open up the brace more, but still requires me to stay on the crutches. I'm growing more and more tired of the crutches every day (I've been on and off of them for nearly a year and a half now). Ugh!

I'm starting to worry that I'll need a sixth surgery to clean out the knee again, but I guess I shouldn't get too ahead of myself. I'm working the knee as hard as possible without putting too much stress on the tendon, but it's difficult when it just feels like it won't budge. It's even painful trying to do patella-mobilization, which is a concern for not only myself, but my therapists as well.

I am continuing laser therapy as well, hopefully it continues to do its job. My therapists say hopefully by the end of December the holes in my knee will have fully closed. I guess that would be a nice Christmas present, eh?

BTW -- it seems like I'm the hot topic at my PT facility. News has spread about my "story" and everyone is always telling me how awful they feel for me. I'm one of the youngest patients (I'm 19, most of the people there are in their 20s-50s). Their jaws literally drop when they hear about everything I've gone through (five surgeries, having my knee wrecked by my phyiscal therapist and original OS, etc). I even brought one of my therapists to tears telling her how brutal I was treated at my previous facility.  

Well I'd go on, but I'm sure I'm boring you all by now. I hope you're all having pain-free days. I know with the cold weather coming it must be difficult for a lot of you guys (it is for me!).

Patricia

corey -

Welcome to the club, eh? I guess it's not the best club to be involved with, but at least it's something! hehe

Definitely look through this thread, there's 27 pages of a LOT of good material. I'm sure you might even find the answers to a lot of your questions without having to answer them!

As for your question regarding weightlifting, I'm not really sure if that's down the toilet, but I would think that unfortunately with your situation things have been jeopordized. I'd think it would depend on your OS and what s/he thought, since they would be the ultimate deciding factor there. I wish I had an answer for you, but I probably wouldn't be the best person to answer seeing as I'm currently rehabbing a ruptured patellar tendon as well. You'll definitely receive a lot of replies though, so don't fret. I'm sure a few of the posters here who are further along in their rehab would be better suited to help you out, but like I said, definitely talk with your doctor about this.

And if you have any further questions, don't hestitate! It's going to be a long recovery, but you can do it! Heck, if I can do it, anyone can!

Hope you're feeling well!

Patricia

Hi all..
Im 2 weeks away from gettin the wire out..and that scares me a little bit..Can anybody tell me about the procedure??
Im now almost 8 months post Op and im feelin great..they call me 6"8 ballerina on trampoline at the pt clinic 118 Rom (best ever)so my mood is going up for the first time in months..even though the weather in Copenhagen,Denmark does make life a bit sad these days..(Cold,rainy,windy)..

To all the Bball heads..u guys are on a risky track..i retired at age 26 with chronical tendinitis in both knees addicted to iboprofen and diclon..(i took 800mg a day)

Well, I just got back from PT with a bit of discouraging news. My therapist says that she thinks I'll most likely need to have my knee cleaned out (a manipulation is out of the question). Told me that when I see my doc that I should definitely bring that up with him and take it from there. She is pretty much convinced that I'll need another surgery, though. Says that there's just too much scar tissue to break up and it would be absolute torture for me to endure that much pain (again), while it would also be difficult for her and my other therapist to try to stretch me because it's like trying to break a thick piece of wood.

Ugh.

Patricia  

Hey folks -

Discussed my latest dilemma with my other therapist tonight at PT, he said he would call my doctor tomorrow and see what's going.

Basically, the problem is that I'm stuck at 90 degrees. If I'm lucky, I'll hit 92-3, but that's with a lot of pushing and extreme pain. My other PT agrees that it does seem I'm stuck and probably won't get very much further, but he also says that my doctor probably won't want to operate until my other "holes" are fully closed. One of them looks pretty decent, but the main hole (the big incision that opened up initially) won't fully close for another month or two, even more (according to one of my therapists).

This is where we have a problem. I want to go back to school in January, and if *that's* when my doctor would want to operate, there's a big problem. I need to have more ROM by January, I need to be able to somewhat walk around the campus and be able to drive to the school (which is about a half hour away) as well. I'm basically told that I won't get more ROM because of the scar tissue and the walking is an issue because I *am* still on crutches, and will be for a while it seems. The worst part, however, is that if I don't go back to school in January then I will be dropped from my mother's insurance and I will no longer have any form of healthcare, meaning I'd lose everything. So, I simply cannot wait until January for the surgery.

So, as I said, my therapist is going to call my doctor tomorrow and tell him my situation. My therapist agrees that I shouldn't have to wait, because I need to get my life back on track again. I have therapy at 10:30am on Friday, so hopefully by then I'll find out a little more as to what's going on. Maybe I'll even get to talk to my doctor as well (seeing as my doctor is in the same building as my PT facility.

Keep your fingers crossed for me, I really need to get this surgery ASAP. Of course I'd rather not have to be operated on for a sixth time, but it needs to be done and I simply cannot wait.

I'll be back with an update after PT tomorrow. Hopefully I'll have some (good) news.

Patricia  

UGH. Well, that did not go how I had hoped for it to go.

My therapist said he spent last night writing up everything he wanted to say, and actually went over it in preparation. Cute, eh?

Well anyways, he called my doctor this morning, and left a message for him. Says he left a good long message, basically reciting his entire speech. However, he hadn't received a call back from the doctor by the time I was in the office for PT (I went in at 10:30 this morning). I was a little disappointed, but hoped that he would receive a call sometime during my appointment.

Unfortunately, he still didn't receive a call. He told me that after I left (I was his last patient for the day), he'd run over to the office and personally talk to my doctor and then give me a call with an update on everything.

And unfortunately (again, heh), I never received a call today. Now I have to wait until Monday to find out what's going on. UGH, I hate having to go through a weekend with important things on my mind. I'll try not to worry or think about it, but that's just not going to happen.  

Soo0o, I'll be calling the office first thing Monday morning to find out what's going on. Hopefully I'll find out more then. If not, then I'll call the doctor's office myself and try to get in for an appointment ASAP.

BTW -- now I'm just not progressing much at all at PT. I've been stuck in the low 90s for almost three weeks now. Hell, that's with being pushed hard, too. I can only get in the mid-eighties by myself. I don't think I'll be able to get much further without another surgery.  

Hope you guys and gals are doing well. The weather is really taking its toll on my knee today, my tendon is KILLING me. Stupid rain!

I'll give an update as soon as I find out what's going on.

Patricia  

Saw the doctor today. I am now scheduled for surgery two weeks from tomorrow. Ugh. It will be my sixth surgery since August.

I would have the surgery sooner but my doctor wants to have my opened incisions close up a little more before he goes back in. Plus, having surgeries less than six weeks apart isn't the best idea.

I'll be having a manipulation and my knee will be cleaned out through means of scope. I'm not so much nervous about the scope (I've had my knee scoped five times now), but I'm nervous about the MUA. Having an MUA on a reconstructed patellar tendon (only three months out from the reconstruction) is VERY risky. I had an MUA last time as well...well, a GENTLE MUA, but even then I was very nervous. At least I have one of the best knee specialists in the tri-state area working on my knee. I completely trust him.

He said for the time being to focus on strength rather than range. The ROM will be fixed with the surgery, but I *will* lose a little strength after the surgery so it's better to try to gain as much strength now. Makes sense.

I'll keep you guys updated on everything.

Patricia  

Hey got a question for you folks.  I spent 6 weeks immobilized, was not prescribed a cpm mach. so this whole bending thing has really just started about a week and a half ago.  I just started P.T. and the braces have come off.  Ive got between 60 and 65 degrees range of motion but Im not sure if thats considered good since Ive only had about two weeks of "freedom" and only one dose of PT, or is this average or below average.  Beleave it or not my therapist has never worked with someone who has ruptured both tendons at once and kind of gave me a puzzled look when I asked her the above question. Sooo it looks like Im going to have to turn to you folks for some real world advice!  Appreciate the help.  
Corey
P.S.  There is considerable pain in my right knee, but almost none in my left. Whats up with that?    

I have a question for those of you with single patellar tendon ruptures. Have you guys experienced a lot of pain in your "good" knee? Ever since July (before I even knew I had a RPT), my left knee(good knee) has been KILLING me. I tried talking to my ex-physical therapist about it, but she just disregarded my concerns. I guess I shouldn't worry about her too much, she was a Devil-woman all on her own...

Anyways, after I tried talking to my PT, I talked to my chiropractor about it. After examining the knee, she said it was very likely I tore my meniscus. I've torn my menisci in my right knee, I know what that feels like and this certainly DOESN'T feel like that. So...I just let it go and chalked it up to run of the mill patellofemoral pain.

However, most recently the pain has gotten worse and I'm starting to feel/hear a lot of clicking at the spot of the pain, at its worst when I'm going up/down the stairs and getting up/sitting down from/in a chair. Maybe it IS my meniscus?

I spoke with one of my PTs about it last week, showed her where the pain was, and she said it was likely I had severe tendonitis in my good knee! Said the clicking could very well be from a torn meniscus or just some loose cartilage in general, but is fairly certain that I have tendonitis. UGH! I'm nervous to mention it to my OS, I don't know why, but am. I've been wearing a tendonitis knee band the past few days, it only seems to help when I'm walking. I still have pretty bad pain on stairs and getting up/sitting down (and the clicking sensation remains as well).

I'm rambling now, I know...but do you guys think its possible that I will rupture my left patellar tendon? Are my chances increased because of my right PTR? And finally, is there anything I can do to maybe prevent such an injury? I guess I really should talk to my doctor about it...I just don't want to find out I'll need my left knee scoped because of torn/loose cartilage or a torn meniscus.

Sorry for the long post...I tend to get a little wordy sometimes, eh?

Otherwise, I'm doing pretty well at PT. Working on strengthening the knee, not focusing on ROM at all. I'll still stretch the knee and take a crack at the stationary bike, but I'm not being measured or anything. I wouldn't be surprised if my ROM has dipped below 80 at this point. Ahh well. If I'm going to be having a scope anyways, I might as well focus on other areas. My only problem seems to be that some of the exersices hurt my back. Yeah, thanks to my ex-PT, I also have a damaged back (I have a herniated disk, degenerative disk disease, and disks that are nearly fused together). Ehh...I'll worry about THAT later...I have enough on my plate as it is!


Hope you're all feeling well!
Patricia

Hi Patricia

Although I am currently on holiday in sunny Israel, I have been looking at the postings during the past 14 days.  I see that you must undergo another operation and we all hope that this does the trick and bring you on the final road to 100% recovery.

For myself, I have to see a vascular Consultant next week, to establish why I am getting hardly any circulation in my leg, which my doctor states is a possible side effect of the RPT some two years ago.

Meanwhile, off to the beach for a long walk - about 32C or 86Fr and very peaceful.

Best wishes to all members of the RPT club

JohnK/ Manchester UK

Hey guys -

Saw the doctor today, everything's looking good for Tuesday. He initially said he was thinking about changing the date to Thursday, but I didn't want to put the surgery off any longer. About midway through his thought process, he also changed his mind and agreed with me. *whew!*

He was a little concerned that my shin was VERY swollen and painful. I had noticed that the past few days it was painful to the touch, but never thought anything of it. He told me to make sure I spend the week until the surgery elevating and icing not only the knee, but the leg as well because he'd like the swelling down for the surgery. He put another ace wrap on my shin to compress the swelling, so now my whole leg is practically wrapped up!

At least I don't have to go to PT every day until after the surgery, that was a load off of my shoulders. I had been going every day for a little while now, but he said I could go today, Wednesday, and Friday; not to worry about Tuesday and Thursday(Thanksgiving) because I should rest up for the surgery itself. Good deal.

Had a bit of a scare at the office today though, when I was getting off the table my brace managed to hook itself on the corner and I went crashing to the floor. Had my doctor not rushed over to catch me I would have slammed into the floor face first. We had a good laugh about it afterwards, but it was definitely a little scary there for a minute, hehe.

Hope you're all doing well, and again, thanks for all the well-wishes. Hopefully this WILL be my last surgery for a while, I'd rather not keep up at the pace I'm at right now!

JohnK, I hope your vascular doctor can solve your circulation problem! I know from experience, having poor circulation in a bad leg to begin with is NO fun. I already have poor circulation in my right leg thanks to a sickness I had when I was younger. Had some nasty nerve damage in the leg and to this day the circulation is crummy. Doc thinks that contributed to my incisions healing VERY slowly. Ugh! Can't catch a break, can we?! Anyways, good luck JohnK. I'll be thinking of you!

Patricia  

Hi Corey

Firstly no two knees are the same and in reading all the posts on this message board, you will realise that no two RPT have the same problem - however in your case with two RPT which is very rare, nobody can give you a positive reply because we are not Surgeons, Consultants, Doctors etc.  

I am of the view that you will have to go back and see your Consultant/Surgeon, and if he cannot give you a positive response, then try and see an Orthopaedic Consultant/Knee Surgeon.    Dont sit back and wait for the world come to you.

Best wishes and keep us posted

JohnK/Manchester UK

Hi all,

Not much to update on myself. My physio is still going well, and I reckon I am at full bend. The biggest problem I have is the lack of thigh muscle which means I can't really put a lot of power through the leg. And when I try, the quad tendon tells me about it!!  

Corey, as per the other comments, get back onto the OS, and hopefully they will find the solution to your right knee problems.

D, when I started physio, I went twice a week with a physio working with me one-on-one, each session being 30 mins long. After about 6 weeks of this, I got put into the knee therepy group sessions, working with 8-14 other people in the gym at the same time, with the one physiotherepist, but this is also twice a week, and lasting 1 hour each session. I would say twice a week is your bare minimum you should go to PT, 3 times even better if you can get it. But regardless of how many times you go, when you get given a set of exercises from the physio, making sure you stick to them in your own time at home it the real trick to improving your knees. There were a couple of specialist machines that helped me in the PT gym, but my best improvements came with me sitting on the floor at home doing my exercises.

Patricia, good luck in your next, and hopefully last, surgury!!

Sonshyne, sorry I can't advise on your problem, as I didn't have a wire, mines just sutured up, and they will be staying indefinately.

I celebrate 6 months since injury in a couple of weeks. Its been a 6 months to remember      

Cheers

Andy
(Portsmouth,UK)

Just lovely.

I don't think I can handle much more of this.

Not only is surgery postponed by a WEEK, I'm also not allowed to walk, drive, go to PT, go out, do anything at all. Basically confined to my bed for the next week. Brace has been locked again as well.

My OS is having me get an MRI because he fears I may have done more damage to the knee. I told him my problem with not being able to straighten the leg the past few days (along with my hyperextension problem), and after feeling around he said he's concerned there might be some damage inside the knee again. I'm praying REALLY hard that the tendon didn't snap again, or even tore a bit. I can't deal with something like that.

The worst part though is that the surgery is scheduled for FIVE PM!!! And then my doc's secretary tells me that the time could "fluctuate"...great, just great. I told her that I NEED a set time for the surgery because of my lack of options for a ride, she says there's nothing she can really do about it. UGH...no one will work with me, will they!? The best I got out of her was to call her the Friday before and see if there has been any changes...but of course, call no later than 12pm because she won't be there. d**nit why can't she just call me?!

I'm so tired of all of this. I really can't take much more...I was supposed to go to Philly on the 11th, now that's obviously out. I can't even live my life anymore. I'm so tired of false hope. Maybe I should set my expectations incredibly low so I won't continue to be disappointed....


Patricia    

Hi Brothers and Sisters of the RPT club, I hope all is going nicely for all, even sister Patricia who seems to be getting the brunt of all the negative energy lately, hang in there girl, listen to auntie Kim who always has good advice, or just say the Serenity Prayer a few times a day and that should help you get through the tough times.  I'm about seven months post-op and life has gotten alot better for me but still have a ways to go yet.  My problem has been my lack of exercise regime on a daily basis as my PT sessions have been curtailed by insurance rules until the beginning of the year.  I have been walking a couple miles/day but not much else.  When faced with the prospect of running late for an appointment/train and I have to hot step it some I find that my knee lets me know that I'm still in rehab, you know what I mean, the sharp pain returns , and I wonder if I've been doing all I can to get the knee back  to close to it's original strength, the short answer is NO!  I need to do much more and starting today I plan on getting it together and get back to the exercise regime that was suggested months ago for me to get back my strength.  Nigel, are you experiencing this same difficulty?  I challenge you to do the same thing and we can both feel like we have done all that we can do to rehab, what do you think man?  Let's get busy. John C.

Hi Folks

Am reporting to one and all, still suffering from a circulation problem.

Been to see the Vascular Consultant today   ...

Nothing can be done to relieve the problem - this can happen whilst repairing the Ruptured Patella Tendon after it gets mashed up.....

Informed to wear a very compact elastic bandage and keep the leg elevated  

Getting very cheesed up and frustated.... told to get walking, but the Consultant does not have a leg with 110deg bend

Reminding everybody - sleeping with a pillow between the legs keeps the weight of the damage