Bone breaks around the knee :

new fractured patella patient - - Posted by RAM (RAM), 31 October 2002

Just fouind your site today. Looks like a lot of support from people with real experience with knee injuries.

I simply want to know what's next?!

I had my patella reconstructed 10 days ago after a collission while playing soccer. Full length cast with my f/u appointment with the ortho surgeon in five days.

He said the patella is back in place with wire and pins (which have to come out) but the cast stays on for a total of six weeks.

Before I see him, I'm hoping

1) I don't need the cast for that long - trouble sleeping at night. Is a brace possible?

2) P/T, he said, could be from 12-18 months to get back to 100%.

3) Can I expect to get back to full strength, flex? I'm 45, active and athletic. Road race and play soccer.

What really happens? And how bad is p/t - reading the boards here it seems frighteningly painful.

Thanks for your input.

RAM  
Posted by dre (dre), 31 October 2002

well, pt is painful at times. after surgery & starting pt, you usually have a lot of restrictions. & the things you can do don't really seem like much, or at least not much that would really help you, but they DO! even if it seems like nothing it does help. the little nothing things get you to the big important things. it's very important to push yourself, but not rush it. rushing things will only set you back. i know for experience. don't worry about pt, it's rough at times & encouraging at times. esp when you accomplish something you couldn't do the last time you were at pt. so hang in there & just take it for a ride. hope things go well, dre
Posted by Ross (Ross), 1 November 2002

RAM, I'm giving you five years' start but at a pretty fit fifty I tried to drive my right patella through a ceramic tile bathroom floor.  Bathroom floor 1, patella nil!  After about five months of pretty conservative non intervention we finally bit the bullet and accepted that my three piece patella was not going to fuse and it was time to get on with the pins and wire routine.

Remember that my patella was the only busted bit in the deal by this as I was back to running and all the stuff that blokes our age do to avoid admitting that the easy way out is via an armchair!  You still with me?  The day of the operation, performed under a general I walked back out of the hospital on my immobiliser and a stick.  Day procedure stuff, big cut, single filament stitch that came out dead easy on day ten.  

Gotta say it was a bl##dy miserable two days after but day three I walked two miles on the immobiliser and day four I took the bl##dy thing off for good.  I've been using a neoprene compression sleeve thing but more as a buffer to soften the inevitable knocks that you give any injury.  

I'm not the most cooperative patient (as my mate the cutter would tell you) and I believe that the faster you get working on mobility the faster you will recover.  BAD example!  Negative JUJU!  Still I've pretty much managed to work right through all but the really bad days and, although a change in the weather or kneeling too long makes it very stingy, I reckon the move it or lose it philosophy works for me.  The rotten thing still tends to fill up with fluid at the end of the day but I am hardly a brand new fresh out of the box item, yagotta make some allowances for fair (and UN) wear and tear!

I have enormous difficulty with the concept of immobilising a joint that HAS to be free and able to move.  Maybe you damaged more than just your patella, maybe your knee had some pre-existing problems, mine didn't, all I had was a busted sesamoid bone that just plain would not fuse without a push!

Hope it works out fine for you, do ten times the exercise the physio suggests, and keep smiling!  Happy folks heal fastest!
Posted by Rhonda (Rhonda), 1 November 2002

Hi,

I'm 6.5 months post-op patella reconstruction (after slamming it against a tree).  You should most definitely get a brace instead of a cast! NOW!  You need to be able to bend it while non-weight-bearing in order to get a good Range of Motion (ROM)- otherwise, you'll find it will be excruciatingly difficult to bend it after six weeks in lockup.
I wore a Bledsoe brace for 3 months.  The first two months, I wore it locked straight  anytime I was walking on it, and unlocked to do ROM work (I actually rented a CPM for this- it's a machine that bends your leg up and down to keep it from stiffening too much).  For the third month, I could walk on it unlocked.  I was NEVER in a cast, and my fracture was really bad.
I think you should ask your OS if you can get a Bledsoe Brace instead of the cast- just lock it straight while weightbearing.  I'm not saying its all that comfy, but it's better than plaster! (Plus you can open the brace to scratch once in a while! very key!)
Just for the backstory- my fracture was particularly bad (shattered- they wouldnt' even give me a number on how many pieces) .. but the upside is that the younger docs and residents woudlnt' touch it- so I got the best trauma surgeon at Mass General (#3 nationwide for ortho).  SO it healed well, and I was really kicking butt in rehab.  I had even started running for 10 minutes at a time on the treadmill at PT .. but after a month of that, I was getting some pain, so backing off a bit.  But hopefully I can get back to sports in a couple more months!
And hopefully you'll be back on the soccer field in less than a year!  (Pre-injury, I played hockey and skied- I feel your pain!)
Yes, Patella Fx can be a very debilitating injury in some cases, but for some people, they are back in a year.  (I guess it's never 100%, but close!).  It's very important to keep up ROM (so ditch the cast for a brace!).  Also, make sure you get lots of e-stim in rehab.  Once the bone is healed, keep up the rehab and push harder.

Let us know how it goes with the OS!  See if your insurance will pay for a CPM machine (if not, there are thign you can do on your own, CPM just makes it easier)

-Rhonda


Posted by RAM (RAM), 1 November 2002

Thanks to Rhonda, Ross and Dre for your input.

Lots of good information, and everyone is so positive, which I really appreciate.

I am going to shoot for the brace. I won't be too optimistic - doctor's need to cover their butts, but getting some very minor flex has to be better than staying frozen for six weeks.

My knees never gave me probs, so I expect my patella is the only problem I have.

Starting at the beginning, where you guys haven't been for sometime, it just seems like one year from now is a very, very long time.

With a stiff upper lip, and a little luck cajoling the OS, maybe I'll have good news next week.

Thanks again to each of you. Take care. RAM
Posted by buzzy (Robin W.), 4 November 2002

Hi RAM - I am also somewhat new to this fractured patella stuff. On September 6, 2002 I fell and fractured my patella.  It broke completely in half horizontally and the two halves of my knee cap separated by about two inches with the bottom half fracturing into a number of other sections. Post operatively, my surgeon stated that the lower half looked like a road map due to the number of fratures it contained.    
 
I had surgery that same day, which included two screws to hold the two halves together and wire to hold the bottom pieces together (my hardware will also be removed in about a year).  I was never in a hard cast.  When I woke up from surgery, I had a full leg brace, which I continue to wear and I have adjusted the hinges to allow for 40 degrees of flexion (I have muscle weakness and can not walk without the brace for support).
 
I began PT on October 15th.  At that time I had about 33 degrees of flexion.  I have made great progress and I now have about 98 degrees, but my progress has slowed down a bit (I am told that this is not abnormal).
 
I am 44, and also in really good physical shape due to years of weight training mixed in with some aerobic exercises (particulary spinning). My surgeon tells me that he is unsure whether or not I will be able to spin again and he also won't predict on my future ability to due squats with heavy weight.

Since beginning PT, my pain has increased significantly and I am not sleeping through the night.  I am told that this is also not unusual.  Beside the pain from PT and the limited range of motion, I am experiencing some muscle weakness which prevents me from doing straight leg raises or walking without the brace (I can actually walk straight legged without the brace, but I can't support myself with a bent leg walk).

I am not trying to sound all negative though - I have made wonderful progress since the injury and although I get frustrated, overall my attitude is pretty good.  The thing that I was not prepared for is the length of time that it takes to get my life back to "normal".

I wish you the best of luck!
Posted by RAM (RAM), 4 November 2002

Thanks for your input Robin. Your break sounds very much like my own.

My first appointment to see the OS is tomorrow evening, so I'm going with hat in hand begging to take this cast off.

I see that you started PT roughly 40 days later - so you were laid up for that time, or did you do "at home" PT at the direction of your surgeon?

What time frame has your doctor given you re PT?

Have you considered taking meds for sleep or pain? Not many like to take it, I agree, but eight hours sleep sounds good.

Lastly, are you using a Bledsoe Brace, or another type/style?

Thanks again for your input. Take care.



Posted by Rhonda (Rhonda), 4 November 2002

Hey RAM,

By the way, what part of the world are you in?  I' in Boston, Ross is in Australia.
Really push the issue about the brace, because they had me bending the knee the day after surgery in the hospital.  Just that one day after surgery, it was VERY hard to bend.  I can't imagine how hard it would be after begin in a cast for six weeks! (I was probably at about 75 degrees of flexion at about the 6 week point) I had to use the CPM machine 6-8 hours per day thereafter, until I went back to work.   It was the only exercise for me, until I started PT about a month and a half postop Then it was all about the quad strength there, and I continued ROM work at home...  (BTW:  At this point I can get about 140ish degrees easily, then if I stretch and push a few minutes, I can get my foot all the way back to  my butt)

When did they say you could start PT?   Mine had to be pretty gentle until OS proclaimed the bone was healed.  ANd in that first phase, I did a lot of quad sets while hooked up the stim machine (as well as a lot of combo stim and therband exercises), and gradully added in light weights.  Once doc said bone was healed- I started in with much heavier weights on the leg press, and stairmaster and elliptical machines, and increased activty rapidly.  I imagine you'll probably do much the same thing.  
Since my OS was a trauma surgeon, I'm going to see a knee specialist this week, to address whatever issues are left over.  In my case, seems although I have decent overall quad strength considering my injury, my VMO is still not firing before my outer quad.   I believe this caused me issues when I tried to start running again.   The other issue is that my right leg ballooned up in muscle strength from early favoritism ( I affectionately call it my "Thunder Thigh from Hell").  SO I have a pretty noticeable imbalance between the two legs, which made the running very uneven, with significant pounding to the good leg. Even started to cause an old achilles tendon injury to flare up in that leg.  
Insurance for PT ran out on Halloween Day, but my PT gave me a couple of freebie visits until I can get to the knee specialist (Arthur Boland of Mass General) on thursday.

Anyway, post the outcome of your doc's visit tomorrow! There are only a few of us patella break victims- so it's good to share info!  I had a hard time finding other's  stories when I first broke mine, then finally Ross found the site!   I dont' spend tons of time on this site like I used to, but I check back every so often to see if there's  another patella break vic!  

Good Luck!

Rhonda
Posted by RAM (RAM), 4 November 2002

Rhonda-

Thanks for the note.

Can't you tell I'm from Long Guyland? Ross - that's just outside of Manhattan.

I'm really putting all my eggs in the one basket that my doctor cuts this cast off. He has  "God" complex, I'm told by others, so maybe it's a good thing I'm in a form of sales (specialty chems for pharma and cosmetic mostly.)

If he turns me down, I'll be really bummed out. And I think the good people at work are expecting me about now. Trouble is, I start to get a burn in my hip sitting upright for more than 60-75 minutes, so I can't sit in a chair all day.

Another 24 hours and I'll know - and I'll let you guys know too.

Thanks again for all of the good info - and ammo - and for the moral support, which has come in real handy this last week.

All the best to you.  

Posted by RAM (RAM), 8 November 2002

Rhonda/Ross

I know I said I'd get back to you after my OS visit, but he's very busy and I had my appt resched twice.

The short of it: Took out the staples,  leave the cast. Too much effort and time went into rebuilding the cap to risk injury with a brace.

I was able to negotiate a week off the sentence, so the cast is off on the 25th. Update you then.

I see there are a few more entries to the site. This patella stuff is really frightening. I wish I'd said more prayers, but it looks like it's going to be up to me to get back to 99%.

All the best to everyone.
Posted by Rhonda (Rhonda), 8 November 2002

Hey RAM,

Well, great to hear you have one less week in the cast.  Just make sure you start bending it as soon as it's out!

Probably not much you can do right now - except collects all  kinds of knowledge, so when the cast is off, you're ready to go!

What are you doing about work?  I couldn't  sit upright for long periods of time, either.  I ended up being out 5 weeks (thank God for ST disability!).  When I did go back, I brought  in a sturdy laundry basket, flipped it over, and stacked a couple of bed pillows on top, and put it under my desk.  So I could have the whole leg supported out straight.  (It's still there- dont' need it as much as I did, but it's still nice to have when I have a cranky knee day)

I just saw a Sports Med Guy yesterday- Said patella fractures are awful- because it's tough to predict/assess the damage to the articular cartilage at the back of the kneecap.  Since I was feeling better when I saw him, he just said take the running slow (and I can try skating!)..  but if it hurts, he wants me back in there do to a CT Scan. (an MRI would be wasted on us, because the metal in our knees would make the magnets go nuts, and the image would show nothing).  He's an Asst. team physician for the Boston Bruins, so I guess he knows his stuff.  
Speaking of Bruins, my boys play your Islanders (of Long Guyland) next Thrusday! (Can you tell I'm a hockey freak?  It'll be even better when I can PLAY again!)

Good Luck!


Posted by RAM (RAM), 9 November 2002

Hi Rhonda. Thanks for your reply. You seem to bne in the inner circle of experts - I like my guy and he has a good rep, but I'll move on if I feel like I'm getting treated like "next."

I went back to work on the 7th for about six hours. Stayed behind the desk with the leg elevated. The back of my knee does hurt as well - keeping the leg extended, then it gets a little stiff in the hip.

My boss told me to stay home, but I've worked for our small company for 22 years and feel so guilty - my counterpart is doing near double work and it's wearing on him.

By three o'clock I'm ready to go home. I can't fit into my car (I was told not to drive, but I wouldv'e anyway) so the inconvenience factors are multiplying all around me. I owe people big time, and it's not nearly over.

I love gardening, so today I was out there trying to make a difference. There's always next year.

I was once a die-hard Islander fan - it was easy back then. My sister had access to awesome seats and I'd go a few times each month. Then the fighting got to bother me, but I've come back to it in the last two years. BBall is my favorite, but these days I find it hard to go out wearing anything that mentions the Knicks - they are really awful. As much as I'd like to root for the Nets, they're from Jersey and, well, you know a NYer can't cross the river.  

Feeling better having sat and written. I hurt myseld going up the stairs last night and just misplaced my bad leg. A twinge and then dull pain. Nothing worth shouting over, so it's probably just a warning to take it easy. Hard to do.

Rambling, but lastly, it's interesting theat the doc would let you skate. You have pretty good ROM by now, but whats happens if? Will you skate with a brace? I'd like to roller blade asap, that'll get the quad burning, but would've thought you'd take it slow. Let me know how you make out.

Have a real nice weekend.

RAM

Posted by dre (dre), 11 November 2002

ram,
glad to here that you got a week cut off you cast wearing. that will seem like a world of difference. you'll be out of it for thanksgiving! enjoy your turkey day!keep praying never too late for prayers. keep things slow, & don't push it too hard at first. that will only set ya back. but your knee will let ya know when to stop, you just have to listen. that was my problem. i found out thursday that i have to have another surgery on the 27th. i'm trying to see if there's anyway the os can take my staple out while he's in there, so it can all be said & done. but haven't heard back from him about it yet. well, hope things continue to go good for you! have a wonderful week! dre
Posted by Ross (Ross), 11 November 2002

RAM, I suspect the reason my OS pretty well lets me run my own race is that he's confident a halfway competent and to all external appearances sane engineer will have the sense to back off if he starts hurting himself (how little he actually knows!).  Either that or he's given up all hope that I'll take him too seriously!

My knee was immobilised in a removeable splint for a couple of days post-op and then I got stuck back into building up my quads and working on rotation.  It has been pretty good so far and really only lets me know it hurts if I do something of significant stupidity.  The muscles were pretty good pre-op and post op recovery was pretty quick.  Even the scar tissue is fading so it looks more like a four inch scratch rather than some of the horrors that I've seen.

That having been said, it now makes arcade quality noises until it has warmed up and wanders off to the lateral side when I sleep, that first step out of bed can be very noisy and some of it is me yelling!  Summer is coming down this way and a surfeit of sun, sand and surf should fix it (I hope!).

Plaster casts have a habit of becoming broken around me, especially if x-rays indicate fusion and they happen to be interfering with my life.  OSs as a group are a particularly pessimistic bunch, it's your knee, you'll know before he does when it's time to shed the ornamental plasterwork.  I'm a bad influence!

Make your own judgement based upon how you feel, the OS's prognosis is invariably based on the worst case.
Posted by dwalsh (dwalsh), 12 November 2002

Hi. Just found this site and it's been very helpful.

I fractured my patella into 2 pieces (and lots of cracks) when i fell ice skating.  Had surgery 9/24/02 at which point they put it back together with wire and screws. I'm 41 and very active. I run, bike, skate ..or used to! It's been 7 weeks and I'm becoming very frustrated and depressed with the lack of progress. I was in a knee immobilizer for 15 days and told not to move anything. When that came off I was given a brace and began PT. I can finally do straight leg lifts but not without a lot of pain. (been using a stim machine twice a day to help the quad fire).  When I told my doctor this he said I shoudn't be feeling any pain in the kneecap when raising my leg. Also I'm only at about 65-70 degrees rom and feel like I'm stuck here. The knee is so tight it just will not bend much further. A week ago my doctor told me to take off the brace because I was relying too much on it. Since then I've been attempting walking on crutches. I am allowed to put 50% body weight on the leg. Since I have very little rom it's a very uneven gait.

Here are some questions I have.

Should I push the rom? Will I do any damage? Should I have one of those machines at home? (right now I'm on the machine at PT 3 times a week for a half an hour)

Some of the wire is visible through the knee and sometimes feels very sore? Has anyone experience this? My doctor didn't seem too concerned.

Should I work through the pain in the straight leg raises? I can barely do them...but at least i can finally do them!

To make matters worse I have been out of work and staying at my sisters in upstate new york since the accident. I live in nyc on the 5th floor...5 flights of stairs and no elevator plus all the stairs in the subway etc. I'm starting to panic that this is not going to get better. I'm used to being very active and independent...now I've seen every episode of law and order at least 3 times!

Any feedback woudl be appreciated.

Posted by Rhonda (Rhonda), 12 November 2002

RAM:

I dont' think I'll be rollerblading yet- too many things to hit..  I think I'll try  on ice first- maybe a public skating session.  I'll pad the knee up of course, but the worst is that I'll fall down- no danger of entering moving traffic!   Ran just under a mile on  the treadmill yesterday anf felt okay.  One of the PT assts told me that my running limp is getting milder- so I guess that's good news!  How are you doing?

DWalsh:  You are doing fine for only 7 weeks out!  Took my 13 weeks to do a straight leg raise AT ALL!  Probably another couple of weeks where I could do them without pain and shaking.  My PT always told me not to hurt msyelf once I found I could lift my leg.  He said to "try it" periodically, but if it was painfull, stop and try again later.  Eventually it got pain free and I then did them on a more regualr shcedule.
You're probalby on the same schedule for ROM as I was.  My ROM came back a bit slowly, but I've got it back for the most part, around the five month mark.   If I really want to touch my foot to my butt, I have to stretch it (how often do you really need to do this?).  But I have easy ROM to just a couple of inches of that point.  But for a while  I was worried about it since I felt "stuck", but both my OS and my PT's said "Don't worry, it'll come.." and they were right!    You may not want to push too hard right now, because there is risk of refracturing the kneecap- putting you back where you were at the time of accident- YIKES! It's just  not worth it.   Once your OS can look at your XRay and tell you that the bone is FULLY healed (In my case, around the 3 months mark), then you can push it harder- both ROM and strength.
Seems you doc has a different approach than mine. My OS told me that when I felt ready, I could ditch the crutches and fully bear weight (about 3 weeks in my case) BUT, the brace was on for 3 months (the first 2, locked straight)...  Once the brace was off and the bone healed, I went crazy at PT, and lost my walking limp in 2-3 weeks (mainly due to the elliptical trainer)!  At 6 months out, I was allowed to try running on the treadmill - a few minutes at a time at PT (I do limp when I run, but that is getting better too).    I look at how far I've come, and you seem to be farther along than I was at 7 weeks- so hopefully that gives you hope!
As far as the metal- at 6-12 months, you can have that taken out if it bugs you.  I'm trying to decide on mine.  It's not painful at all, but sometimes I'm aware of it.  If it was painful, or visible, I'd have them yank it definitely.

I was lucky that I live on the first floor and have elevators at work.   I was out on disability for 5 weeks, and my company paid for cabs for the first month back.  But the second month, I had to deal with stairs in the subway, or stinky elevators, which the homeless people  use as their bathrooms! (I work in downtown Boston).    Maybe see if you could keep the brace and get rid of the crutches-  instead of the other way around)  That's would make stairs a tiny bit easier than having to deal with crutches!  You can just give yourself more time to get down the stairs on the "little kid" way- one stair at a time. (which I still resort to on occassion myself- stairs are still a little rough for me sometimes).

I can relate to the Law and Order- but thank God- The only other options would have been be Judge Judy and Jerry Springer!


Good Luck!

Rhonda

Posted by RAM (RAM), 12 November 2002

Dre, Ross and Rhonda:

Thanks for the added input. Hey Ross, I bet I know what your OS says about you. You're a doctor's worst patient - maybe he's one of your pals by now!

I can just imagine going into my OS's office (after waiting the customary 2 hours) without my cast. I think he'd just sign off and send me on my way.

Dre - didn't know you had to go back in. Sorry to hear that. I never want to have another knee operation again. And I just got here.

Rhonda - Public ice skating sounds more dangerous than roller blading on your own. You have to watch those little crazy kids who taunt you and cover you with shaved ice. (I'm a bad ice skater.) Look what happened to dWalsh!

To DWalsh - Feel bad for you but, just listening and reading other aspects of this site, it does sound like you're doing okay. Did they tell you 12-18 months of PT, like my guy? Man, laying in that hospital that seemed like a completely unimaginable time frame. Now that I'm getting more accustomed, and getting to know others who help share the pain, it's doable. Actually, I can't wait to get to PT - Next Spring, I'll be kicking soccer balls again.

The wire thing would bother me - don't listen to Ross if he tells you to get a pair of pliers and pull hard and fast!

Best to all -

RAM

Posted by dwalsh (dwalsh), 13 November 2002

thanks for all the input. It's a relief to know I'm not the only one who had a freak accident and ended up like this. There is very little about fractured patellas on the web in comparison to other knee injuries.

It's interesting how many different approaches are had by the doctors as far as rehabilitation. RAM has a full cast on and Rhonda was bending the day after surgery (can't imagine that!) and they let her bear full weight wearing the brace. My doctor (bedside manner leaves a lot to be desired) said I'd be at 90% in 6 to 8 weeks and then in another 12 weeks I'd be back at 100%. ha! My PT says a 6 months to a year and most probably never be 100%. Both doctors who saw me said a patella fracture is preferrable over ligament damage. (I know ACL patients who now snowboard so I'm not sure about that)

If you're really active I think the initial few months of downtime is very hard. Sports has always been a great stress reliever for me. What I wouldn't give to just run around the block. I'm not quite as brave as Ross!

Anyway I'm going to try the brace idea and see if i can ditch the crutches and keep plugging away at PT. Eventually I'll return to nyc and perhaps even get a new apartment with less stairs. I'll get a new os and pt down there. It will be interesting to see what they have to say. I look forward to returning to a semi-normal life!

Feeling better about all  of this. I'll check back and see how everyone is progressing.

Doreen

Posted by Ross (Ross), 13 November 2002

dwalsh, first suggestion, change the TV channel!  Second suggestion, the wire is supposed to lie flat after it has been twitched up.  A bit of a lump is no real big deal but I reckon I'd be concerned enough to phone or email the OS in the event that you have sharp bits digging into you.  Take it from a bloke who has had his share of hardware inserted over a forty year motorcycling career, the wire SHOULD lay flat, the heads of the screws are countersunk so that they don't dig into you.  

That having been said, you can get some pretty icky feeling adhesions following a fracture, the sensation you're experiencing may have more to do with adhesion or scar tissue rather than a wire end left adrift.  Have you any post operation x-rays?  

DRE you're a cheeky b*gger, and I'm an impatient one, pulling at trailing bits of wire with a pair of pliers without knowing what they're attached to is not good engineering practice.  If an end was poking out I'd be more inclined to reach for a pair of sidecutters , you could poke a hole in your suit pants otherwise!
Posted by Rhonda (Rhonda), 13 November 2002

OK RAM,

Very funny visual about ROss and the pliers..  But why it is so easy to picture?  

I would ice skate over rollerbalding, because I feel I have more control over the blades- they have these little things called edges, which wheels dont' have! SO that's why I would go that route first- but after hearing Doreen's story, I'll put a big fat protector pad  over it.  And those little kids better get out of my way! (God, I sound like ROss! )

Doreen, I felt the same way when I broke my kneecap- I was like "Who does this?".  Apparently another patella fracture came in to Mass General the day before I was released, but I'd never heard of anyone else...   And when I got access to a computer again, I didnt' see much info on it.  Now that this site has a "Fracture" section, it makes it much easier!  You are sitll in the early stages- rent some new releases- or get some books magazines.  Daytime TV can get to be a worse form of torture than a broken knee!  Get out and have dinner with friends (2 friends, use the extra chair for your knee at a table for four), or have them visit- that's the BEST thing, I think!  ONce I started being social again, the mobility issues didnt' seem as bad...
I totally understand about the sports thing.  I actually tried to play floor hockey last night (3 very brief shifts- my team was nice enough to let me try it- just wanted to get an idea how far off I was).  But no dice.  I walk fine, but still have a major limp when running (I'm thinking it's partially psychological).  But the other team didnt' score when I was out there, which is amazing.  But I think it will be a while before I can do that regularly.  Bummer!  Well, there was  time it seemed that I'd never walk normally again, and I did- so I have hope that I'll run normally again- hopefully fairly soon!

And Doreen will skate again, RAM will play soccer again, and Ross will keep baffling the OS's!

Good Luck to all!  
Posted by Pat_A.E. (Pat_A.E.), 13 November 2002

Thank goodness I found this site and people with similiar experiences.  I'm so sick of people telling me to "enjoy" this time off!  I'm a 54 yr.old very active women.  Worked out 6 times a week with step aeobics, weightlifting, distance walking, etc.  I'm counting on being in good shape to get me through this.

I fell on 9/25 while vacationing in Italy.  The OS there diagnosed the facture and wanted to schedule surgery immediately.  My spouse and I choose to return to the USA (home near Chicago).  They gave me an immobilizer and crutchs and sent me on my way.  When I returned home the OS here said the fracture had stayed together and said no surgery needed.  The next week I went back for a followup and more X-rays.  You guessed it, after the swelling went down the bone seperated and required surgery. . . pins and wire for the mulitple pieces.
The surgery was 10/11.  I used the CPM for a few days following surgery, but my doc. discontinued it's use after four days.  
I started pt 11/11, twice a week.  I've had three sessions and of course do exercises on my own, all non-weight bearing. I'm also putting 50% weight on the repaired knee.  Up to that time I was in the immobilizer with no weight-bearing at all.  In pt we are working on ROM which started at about 30 and within a week has improved to 75.  I'm happy about that but I'm still in the immobilizer so I don't experience the improvement just yet.  PT also involves leg raises (getting easier all the time), pressing the knee into the floor, calf raises, and other exercises to strengthen the calf.  It has all been pretty mild and will remain that way until the bones fuse.  PT ends with ice and stimulation.  I can't say I've had a great deal of pain, more like discomfort.
I'm learning that this injury is rare.  I think that is why there doesn't seem to be a routine protecal, so it is wonderful to have others to share with and to get ideas to suggest or question with the OS and pt.
   
Posted by RAM (RAM), 14 November 2002



Pat AE: You're well on your way. Sounds great (read I'm jealous). I seem to be the onjly one with an OS taking the very low risk route. 12 days to go and I too. can see my leg again.

Great to see evryone contributing their tales. And the international flavor is excellent. They grow them very tough in Ross' neck of the woods.

Take it easy Rhonda. We don't want to read any bad news about you. Must've felt good though to be back on the floor, swinging a stick. (I think we play you tonight.)

Doreen (dWalsh) - I hope my guy is giving me the couch potato's PT sched: 12-18 mos. Your 6 sounds more like what I had in mind and, if true, I'll really be happy.

Have a good day everyone.

RAM

Posted by Rhonda (Rhonda), 14 November 2002

RAM: You wait- Islanders going DOWN! (hope I didnt' just jinx my Bruin Boys! They are in first place in the NHL right now...  Of course, starting off in first place never helps the Red SOx, but that's a whole different topic...)
Bet you can't wait to get that pillar of plaster off you leg!

Pat: Welcome to our little broken kneecap world!

As far as healing times- it's hard to pin that down.
Everyone heals differently..
- Natural healing ability of individuals and previous shape they were in
- some breaks more severe than others
- drastically different prototcols for post op (cast vs braces, frequency of ROM work, etc)

Also, when med professionals tell you a time frame for healing, it depends on what they consider "healed"
I heard every thing from 3 months to 2 years...  I think it depends on the person's point of view.
The OS that put my patella back together considers  me all healed.  THis is because he is a trauma surgeon and is usually dealing with very grisly drunk driving accident victims.  It the bone is healed and the person can walk with little or no limp- they are cured, compared to a lot of his patients who are much worse off.  He'd not involved with the "sports medicine" side of it.  (And because he's the best surgeon, he gets the really bad cases- lets the residents do the easy ones)
On the other hand, a new OS I have seen is a knee sports med specialist.  He is much more concerned about what I'm doing now (future  cartilage issues from running, etc), because that's his line of work.

So basically I'll see my trauma surgeon if and when I need the metal taken out.  But if I need further stuff done- it's the sports med guys all the way!



Posted by Pat_A.E. (Pat_A.E.), 14 November 2002

I am curious about the hardware.  Some of you say that it will be removed.  My OS says that it will stay.  I can see in the x-rays the ends of the pins are bent around the bone.  He says that prevents the pins from loosening and the wire is flexible.

I think the whole issue of depression should be discussed with patients when an injury like this is so limiting.  It sounds like all of us led really active lives including sports.  All of a sudden we're in the position of needing people to wait on us and sitting still.  The  things I hate most are not driving, not exercising, and not carrying anything because my hands are on the crutches; and I watch my garden (my pride & joy) decline by the day  .  I do find attending social events, getting out with friends, attending church etc. is very helpful.  I own my own accounting firm, so I have been able to work throughout most of this ordeal.  I don't know what I would have done if I had a job which I could no longer perform!  Actually this site is helpful, and thanks for all the sharing.  Don't you get sick of people telling you about their knee replacement or broken bone in the foot as though it's the same!?

Posted by dwalsh (dwalsh), 14 November 2002

wow things are really picking up on the "fractured patella" board.

PAT: I agree, talking to other people who are going through the same experience has really helped my state of mind. Also like RAM I'm jealous! We injured our knees right around the same time and I'm quite a time with the ROM...doesn't want to budge more than 65. I'm not in a brace or an immobilzer anymore so when walking with my crutches I'm trying to exagerate the bend with every step (I'm also at 50% weight) but I've been in pt for 4-5 weeks now!

RAM: I get the feeling we might get a lot accomplished in 6 months and be fairly mobile (fingers crossed) but then it will take 6 more months to really get fully mobile....I'm thinking postive thoughts...just look at Rhonda playing floor hockey!


Rhonda: took your advice and got out of the house last  night. Dinner at a mexican restaurant with friends...much fun but i learned 2 margaritas + crutches= an unstable gal!

Ross: ok ok...i'm changing the tv channel. Yes i have had to post op x-rays. One was scheduled and the other was when i called in panic after seeing small lump moving around under the skin of my knee. I was convinced I had fractured the thing again. The OS looked at the x-ray, felt the knee, said it was wire, berated me for not being able to do a leg lift and sent me on my merry way. He also said I was a textbook case of healing. As the swelling continues to go down I'm now seeing (and feeling) wire on the other side of the knee. Part of the problem is I have REALLY boney protruding kneecaps but I'm still worried...don't like it and want it out as soon as possible. Other than that I am feeling all kinds of weird pains ...perhaps scar tissue/lesions like you mention. Does that get better?

off to do my exercises
doreen

Posted by Ross (Ross), 15 November 2002

dwalsh, the adhesions thing is with you to a greater or lesser degree for life I'd think.  

Having broken a bunch more bones than most folks I can assure you that each break has its own private means of letting you know it remembers exactly who broke it!  My right femur copped a savage hiding three times (once while it still had a K-nail in it!) they tell me surgical use of bolt cutters was pioneered that day! The adhesions around the break give a fair bit of trouble when the weather turns sour or if I get a chill.  The good news is that you always know when to take a coat!

That lumpy bit must be a rogue bend in the wire not an end, MY OS is a much better bush-carpenter than yours by the sound of things!  Possibly the fact that your knee was swollen may have something to do with the appearance of odd lumps and bumps once it returned to "normal".    

As to the removal of hardware, I have a self tapping screw in my thumb that has been there for nearly thirty-five years, and a plate on my left humerus that is only three years younger, if they don't hurt I can't see much point in exposing myself unduly to the possibility of infection which is inherent in any intrusive procedure.  If I have to go into hospital anyway, I have on occasion requested removal of odd bits of wire, stainless steel and screws.  I wouldn't be too fussed unless I was in there anyway, hospital food just isn't that attractive a prospect!
Posted by Pat_A.E. (Pat_A.E.), 25 November 2002

Thought I check in with an update.  Saw the OS today for the 6 week post op visit and x-ray.  Seems all but one of the fractures has fused, but he one that hasn't still has a fair amount of filling in to do.  So it crutches, imobilizer and 50% weight bearing for another 3 weeks.  I had hoped for better.
PT remains at twice a week plus all the work I do on my own.  I hope to get all the way around on the stationary bike within the next 3 weeks.  Mostly I do strength training with a 3# ankle weight and work on ROM.  Got up to 80 degrees, but I sure have a long way to go.  Is it true that once I start full weight bearing the pt will progress much faster?  
The OS said I should be done with everything, except a limp by Feb.  Gosh that's a long time, and from what many of you write, may not even be realistic.
Anyone taking pain meds?  Some days are definetly worse then others, some being really bad.  I've used Darvocet prior to going to PT, but it isn't very helpful.  OS has me trying Zoloft.  What are your experiences? I'm not anxious to take meds, but if it helps pt which helps healing, I'll do it.
Posted by buzzy (Robin W.), 26 November 2002

Hello RAM - I haven't been on this site lately so I just saw your posting.  I fractured my patella on September 6th and my surgery also consisted of screws and wire.  I was never in a hard cast (I woke up post-op with a brace.  I also had to have my dressing changed daily about three weeks (my staples were removed after two weeks).

I began PT at week 6 post-op and at that time I had 33 degrees of flexion.  I continue with PY going three days a week for about 2 hours per visit.  PT has been extremely painful for me but I have made such good progress that I am motivated to work past the pain. I now have about 120 degrees of motion and I seem to pick up a few degrees each week.  In addition to PT, I spend a good deal of my days working on my flexibility which I believe has helped with my quick progress.

Currently, my day time pain is pretty tolerable, but I have severe night pain that does interfer with sleep.

I will also have my hardware removed in about a year I am told.
Posted by Ross (Ross), 9 January 2003

...... and then at the end of November we lost the thread?  How are we all progressing?  

I for one had a bit of a reversal and it rather looks like a bit of lateral plica in my damaged right knee is my penance for berating others about their progress.  The left knee has been making crunching, banging noises since I played football in high school so I figure I can live with it.

My OS is keen to do an MRI and probably to retrieve his flash screws and the bit of wire I thought he'd given me, but only if he sees a meniscus he reckons would be worth fixing.  Other than that, life barrels along at a megagazillion miles an hour!

I hope you're all well and that your progress has been relatively incident free.
Posted by dwalsh (dwalsh), 9 January 2003

yes how is everyone progressing?? Whater happened to RAM? Rhonda and Ross I've been keeping up with you  both through your posts. Ross: sorry to hear about your slight setback...but  if anyone has the right attitude to perservere you do! and Rhonda you're incredible. ..floor hockey and running?


I'm finally back in nyc...been back about a week. Challenging to say the least. I've been walking to and from work about 16 blocks each way and to PT (about 8 blocks). The subway is tough ...so many stairs. (I'm just starting to be able to go up stairs...down is a whole different story). Waliking with quite a limp and a cane.  Found a good PT (am riding the bike, treadmill, some weight machines) trying to get an appointment with a new OS ...have to wait weeks but made 2 appointments (2 opinions!)

Main problems rom and pain. Have about 90-100 degrees of rom no matter what i do can't seem to get any further. Pain when walking under my patella and along the outside of the knee with lumpy hard swelling. My OS from home feels my problems stem from the wire and it should come out in the next 2 months rather than 9 months from now. ugh...feeling a little defeated lately. Never imagined it would be such a long recovery.

How about everyone else??

doreen



Posted by Pat_A.E. (Pat_A.E.), 9 January 2003

Sorry to hear about your setback, Ross.  DWalsh, I don't envy dealing the all the walking in a major city.  
I'm pleased to report that mid Dec. the OS gave the go-ahead with full weight bearing and no imobilizer.  PT was a huge help in getting me walking,first with one crutch.  Two weeks ago I ditched the crutch and mostly walk with very little limping.  I went back to the gym about Christmas to use the stationary bike and treadmill.  Have graduated up to the eliptical machine ( I read somewhere on the board that it help with gait.)  Also went back to a 2-day per week strength training class.  We did alot of leg work this morning and I think those quads are going to talking back tonight!  I find the more I use the knee the more ROM and flexibility returns.  Most days there is a noticable improvement with pain.  Mainly I am dealing with stiffness.
I'll be interested to hear about having wiring removed. I asked about it and the OS said he would go thru the same incision.  Don't know if I want to deal with all that again.  The pins are definitly going a.s.a.p because one of the has turned and is very sensitive.
Glad this thread started up again, it's kind of where I started and got so much info.
Posted by Ross (Ross), 12 January 2003

Doreen, I suspect a bit of depression will lodge in the bravest heart dealing with a busted knee!  I have never had an injury that has taken so long to show a significant indication of a return to normal, and I can count a couple of fractured vertabrae among my collection of life experiences!

If somebody had just said "this is going to take at least six months, why don't you just take a month's holiday about now and see if just taking some sun and a bit of surf type therapy is the answer?" a bloke would probably have done just that.  Instead there's been untold doctor's, OS's and radiographer's appointments to consume the little spare time I had anyway.

It's enough to drive a man to drink (were it not a mere putt in my case!)

Ah well, I'm off to see a rheumatologist about my overworked shoulders that are starting to show signs of bursitis on Tuesday.  There is nothing like the opportunity to catch up with folks from earlier incarnations who get their income (and jollies!) from sticking large needles filled with steroids into other people's joints!

I'll play you a few tunes from my shortly to be released album "Screams to Saw your Leg off By!" on Tuesday afternoon I reckon.  I'm beginning to think there may be something in steering well clear of the medical fraternity, the whole bunch seem just a bit too keen to do things to me for my own good at the moment!

Keep smiling all! nilo carborundum illegitimos!
Posted by RAM (RAM), 13 January 2003

Hi everyone. I can't say how many times I wanted to take the few moments to login - we're all back to work or our usual grinds, and who has time? We must find time.

Thanks to you guys, I didn't go nuts and become a Gilligans Island regular.

Today is 12 weeks post op. Finished 5+ weeks of 3/week PT. Up to about 125 degrees of flex and working hard on all the machines they'll let me on.

Just started doing modest weight bearing squats and leg presses. Soaked after the aerobic end.

The PT folks don't want me back in my regular gym yet. I wonder why?

Up and down the stairs (and my office chair) without much pain at all. It's funny how I can't remember what I would normally walk down the stairs like - did I always take a millisecond break between left and right? I always start with a baby step though.

Ten weeks ago I thought I'd be on crutches all my life. I'm so glad I had you guys around.  

Now it's up to the insurance company and battling for more PT than they're willing to give me. So your quad is half it's normal size, and your knee buckles on ocassion? Fight, fight, fight I will.

Haven't done any treadmill running - run across the gym floor with my soccer boys' team, and it feels very wierd. Just something to get used to.

The OS wants me on 3X/week, but I was thinking of going 2X, just to be sure it lasts a little longer (insurance.) Any opinions?

I hope everyone is making their own progress - I'm kind of proud of where I am right now. Really, I was very depressed at first, but after the cast came off and I could get around, I made improvement nearly each day.

I'm me again! (Not everyone is happy.)

Cheers to the real survivors.

RAM
Posted by Pat_A.E. (Pat_A.E.), 13 January 2003

Great news, Ram.  I am also just short of 3 months post-op (15 weeks since the fracture) and I am also back to doing much of what I was before the fracture.  Two months ago it seemed I would never drive again let alone use the stairs.  Two weeks ago I went back to my strength training class which is really tough and I could do most of the workout.  I've been going to the gym for about a month to work on the stuff we do in PT.  Gradually have worked up to a full 1-1/2 hr. workout on the threadmill, bike, eliptical machine and weight machines.   Just being able to workout again has improved my life greatly and I have less pain and more movement  almost daily.  
I saw the OS today and there is still an area that isn't totally fused, but he said go ahead with whatever is tolerated.  He said the pin that is turned and causing small pain, and a big bump, can come out anytime.  I' will continue with the same 2 times per week PT that I have been on since mid Nov.  I may cut them back to once a week because of insurance.  As it is the PT appt. are only about 25 min. because my insurance won't pay more then $30 per sesssion for 12 sessions.  In other words most of this is out of pocket.  
I feel so blessed to have gotten excellent results from a bad situation.  I pray that so many of you that suffer so greatly will find relief soon.
Posted by dwalsh (dwalsh), 14 January 2003

Ross thanks for the encouragement and as always the humor...laughter truly is the best medicine and believe me I"ve been very comical lately! I wish you good luck with your shoulder appointment and I agree with you...if i never had to see another doctor again i would be so happy. I went out with my friends sunday night and had a few glasses of wine and just tried to forget about the dang knee for a few hours (it worked)

Tomorrow i see an new OS here in the city. I've scheduled 3 appointments with 3 different doctors and then using intution and intelligence shall choose one...ha ha. At least i have a choice, when i broke the knee i was whisked away and operated on before i even had a chance to think.

RAM: so glad to hear you doing well. I would think 2 times a week is enough if you do a lot of excercise on your own (which you seem to do). I'm also going 3 times a week and was wondering the same thing. Though lately the PT has been really pushing the rom (actually laying on top of my leg and pushing it down to my butt....hurts!!!) and i think it's been  helping. So impressed you can actually walk  up and down stairs, I can't yet and I have five flights of them at my apartment.

Pat: I'm  going to try and get back to the gym. It seems to have helped you a lot. I'm a little nervous though! Have you tried the ellptical trainer?

doreen
Posted by Ross (Ross), 14 January 2003

Suffice it to say my situation is painful but not serious, ya gotta laugh at the situations that life feeds you up!  There am I catching up on about thirty years of shared history with the rheumatologist.   Me putting the squeeze on him to crew with him next time he takes his boat out and we go through all the tests and stuff then he absolutely floors me with the concept that there is no medical miracle to fix my shoulders that is worth contemplating.

I trust this bloke implicitly, his judgement in regard to rheumatics and orthopaedics has always been smack on the money.  I have never known him to miss and he is a very straight forward sort of a bloke who can communicate well.  If he reckons I'm behaving like a brat he'll tell me without a moment's hesitation.  This time he just said, "mate, this will take time to clear, maybe six months maybe a year".

So what could have triggered it?  Simple, infection!  Nailed by some miniscule virus in mid flight, geeze I hate that!  So it rather looks like I'll be taking cortisone for a while yet.

Knee-wise, it is looking more and more likely that the start of February will see the hardware removed from my patella and a bit of an internal tidy up of my knee.   It had been looking pretty good to be left alone but sometimes things just don't follow the plan!

Glad to hear that you are all well and taking charge of your own recovery!  There is nothing like putting a stakeholder in charge to make sure things get completed!


Posted by Pat_A.E. (Pat_A.E.), 15 January 2003

I do use the ellipical trainer.  The first time was only about 5 min.(that was 2 wks ago).  Now do 20 min.  My routine has been the bike- 20 min., treadmill - 10 min., ellip. - 20 min, and then some leg work using weights.  I use very low resistance/incline, between 1 to 3 on the machines, and light weights.  I always follow exercise with ice.
ROM seems stuck at 115 for the past 2 wks.  I am calling the OS today to schedule surgery to remove one of the pins that dislodge from the bone and pointing outward and causing pain.  I think this is keeping me from getting better ROM.
Posted by ckrostek (ckrostek), 23 January 2003

I fell of a horse while taking a jumping lesson on 10/29/02.  I also had a tibia plateau fracture in my right leg and had surgery on 10/31/02.  I somehow managed to put a 2 inch hole in my tibia with my femur and had to have a plate and five screws put in, which I hear are permanent.  Also bone grafting was done from bone taken from my hip to fill in the hole.  I was in the hospital 4 days and am still recovering as of today, 1/23/03.  I have 80% weight on my leg now and have been going to physical therapy (which was luckily covered by insurance) 3 times a week since 3 days after the surgery.  They start quick these days.  It was painful in the beginning but it's pretty routine now.  I'm still not driving though and get stiff in cold weather.  My orthopedic surgeon told me that if without surgery, if I could even walk, I would need a full knee replacement within 6 months.  From my understanding, I need no further surgery and can go back to doing sports.  I asked if I could ride horses again.  He said "Could you, yes, Should you?"  No answer.  Just had my 44th birthday in December and feel too young to stop doing things I love.  I called the doctor this morning and asked if I could play volleyball when it starts up the first week in March.  I am awaiting a call back so I don't have the answer yet.
Posted by Pat_A.E. (Pat_A.E.), 23 January 2003

We can only relay to one another our experiences . . .once the bones are fused and healing takes place I see no reason to not at least try to do the things we used to do.  Our bodies will let us know when we've pushed the envelope.  I started back to the gym about 1 month ago and went back to my weight lifting sessions 3 weeks ago.  I have adapted some exercises to accomodate my knee.  For instance this morning we did an exercise that required kneeling so I used a theri-ball and got the same result.  Also found out that I can't skip or even jog yet, but I can walk a mile in 15 minutes which no one could have convinced me was possible even two weeks ago.  In other words, once you know you won't do any damage go for it.  Get back on your horse for a gentle short ride, but don't give up what you love without trying first.  Good luck.
Posted by lizl (lizl), 14 February 2003

I've been searching the web for days now and have found almost nothing helpful in regard to a broken kneecap! I sure hope some of you are still reading this board!

I slipped on a wet floor and broke my knee Jan. 28. I had surgery on Jan. 29 (you know, the wires and screw routine). I have had the staples removed and the first post-op x-rays which showed proper alignment. The dr. sent me home for two more weeks of just waiting.

I am in sales and my job involves driving from 100 to 300 miles on most days. So far, my customers know that I have had knee surgery and am out for a while, but they really don't know for how long (nor do I, for that matter). I think most of them believe I will be back on the job soon. I'm very worried about how this will affect my business. The injury happened on the job--so Workman's Comp is supposed to pay the medical bills.

I guess my biggest worry, besides how far I can come back, is how long it will be before I can be back on the road visiting my customers. My customer base will probably disappear, if it takes more than a few weeks. The wolves are out there looking for my current business. New business is the name of the game in sales, and that is definitely on hold!  I just hope it is awhile before the competition figures out what has happened to me.

I'm trying to be positive, but it looks kind of grim?

Anyway, I have been wondering what to expect, in terms of physical therapy, and reading this board has been helpful.
Posted by Rhonda (Rhonda), 14 February 2003

Hey Liz!

Sorry to hear about your knee.  I was out of work for 5 weeks (probably could have gone bcak after 4, but had trouble getting thru to doc to get the "return to work" form (his secretary was pretty incompetent.)  I also had a really bad break.
I would say that you could probably expect the same, assuming you sit down and talk to your customers, rather than be on your feet all day.  I assume you have to drive a lot.  THat shouldn't  be a problem if it is your left leg that is injured...  By that time, you should be able to unclock the brace while sitting to get it out of the way. (also, you need to be dirving an automatic, not a stick)
However, if it is your right leg, then that is more of a problem, obviously.  But I hear there are "left foot pedal" attatchments you can put on your car.  You might want to look into that.  Even if you own a standard, perhaps you can rent or borrow an automatic car for a few weeks.   I am not sure how long it takes to be able to drive and automatic with a bad right leg.. or to be able to drive a stick with either leg injured.  (I was lucky- broke my left knee and drive automatic)  But I think some of the other folks can elaborate on that.

You'll feel better when you're in PT.  You won't be able to do real strenous stuff at first- too much danger of the wires snapping and the whole thing coming apart.   But just getting back  into a "gymlike" environment worked wonders for me psychologically.  THen, when the bone heals and you can ditch your brace- the recovery goes into high gear.  You can  lose the limp and start building back all the atrophied muscle.

Keep in touch and good luck!


Posted by lizl (lizl), 14 February 2003

Thanks, Rhonda. It IS my left leg and my car has an automatic transmission, so I'm hoping that driving will not be too problematic. It's the amount of driving I do that is a concern, once I can bend the knee a bit. The ortho said "at least eight weeks," because a typical day often involves 300 miles of driving and nearly always at least 200 miles. It is so reassuring that you returned to work after six weeks!

My other concern is what kind of work day can I put in, during physical therapy? If I have to carve time out during the business day for PT, that leaves me too little time to drive to, and then service, anything like a normal number of customers during the rest of the day. If my customers were local, rather than up to 160 miles away, it would be possible to do PT and then drive to see them. As it is, the local customers will see me, but the distant ones may be lost accounts.

I know I'm getting ahead of myself, since I'm only a little over two weeks into this thing. I try not to dwell on the business aspect, but now that the pain has lessened, the job implications wear on my mind.  By day 2 after surgery, I had developed some sort of medicine reaction, and that and the pain cornered my concentration. Then, when they changed all meds, leaving me with only Ibuprofen for pain, the pain took most of my waking hours. The Prednisone and heavy antihistimine made me sleep lots, thankfully.

How long was it before you were able to drive?

How much time (per day or per week) goes into PT sessions? I'm guessing that you dress one way for PT and then sort of redress for a business day.  

By the way, my break was pretty bad. The ortho said he did not know if he could save the kneecap, but he said the x-rays one week post-op looked good. I had a jagged horizontal break with the two pieces separated by about two inches and some additional damage to the two pieces.

Geez, do I just have too much time to think right now?  
Posted by Pat_A.E. (Pat_A.E.), 15 February 2003

Sorry about the break. You're right, there is very little out there regarding patella fracture, and what I did find was totally discouraging!  Glad you found this board because Rhonda and I have both made good recoveries and that can be an encouragement to you.  What you must accept, and this is tough, it takes a long time.  Can't be hurried.  I had my 1st surgery 10/11 and a 2nd surger to remove the hardware 1/31.  Today I feel like I'm back almost 100%, but last Nov. I felt like I would never lead a normal life again.
My break is on the right knee so I couldn't drive until the immobilizer was off which was mid Dec.  I was fortunate to have employees who picked me up daily and my husband brought me home.  I'm an accountant  so I was able to stay in one place and elevate my leg at times.  It was very inconvenient but manageable.
PT started mid Nov., ahead of schedule because my leg was so locked the OS was concerned about regaining ROM and thought the risk of injury wasn't as great as not regaining ROM.   PT takes one hour two times per week.  I was actually there longer because I had to change clothes.  They want  to see the knee so you wear shorts or pants that you can pull up to expose the knee.  The facility I go to schedules from  6a.m. thru 8p.m.  Mon - Fri. They try to accomodate all work scheduled.  It's a big committment of time because you also need to do lots of work at home, but it is absolutely critical to follow the program.  After 2 1/2 months I'm down to once a week but I work out almost daily on my own.  I'll probably quit at the end of the month because my ROM should be close to 133 and I'm currently doing just about everything I want.
I guess I've been lucky, but except in the beginning I haven't needed much in the way of pain relief.  Nights were the worst time and the OS prescribed a mild sleep aid which worked better then any pain pills.  I took Toradol and Darvacet northing stronger.  Initially it helped to take a Darvacet before PT to take the edge off.
Please contact me, I'll be happy to share my experiences and coping methods, but most of all to offer encouragment!
Posted by lizl (lizl), 15 February 2003

Yes, Pat, I am encouraged by your story and Rhonda's. I'll keep visiting this board and let you know how I'm progressing.

Thanks for the info on PT.  Maybe I can schedule it around my work, at least after a few weeks.  

Right now, I'm pleased to have finally found something I can wear out in public--men's warm up pants. I want to go to church on Sunday, and I may end up going in the warm-up bottoms, perhaps coupled with something nicer on the top.
Posted by Pat_A.E. (Pat_A.E.), 15 February 2003

Lizl, maybe you want to start your own post, saves time reviewing old posts to get to yours (I have a slow modem connection ).
I found wearing skirts and dresses the easiest form of dressing.  Bought some knit dresses from Land's End and wrap skirts from local Marshall's.  I wore knee high socks which I tucked under the immobilizer.  After the incision wasn't so tender  I would remove the immobilizer and put it on over my pant leg.  Doesn't look great but expanded my wardrobe greatly and keep warm in this cold northern climate.
Have you been using a wheelchair and gotten a handicap parking permit?  Both were a absolute necessity.  I used the wheelchair at home and whenever I went out shopping, dining, movies, etc.  As you have found out, it's pretty tight sitting in most places with your leg straight out in front.
Check with your doctor, but it's probably not to soon to start doing straight leg raises and ankle exercises.  They seem impossible to do initially, but they help with keeping the quads from totally disappearing.  There is a page on this website with good description of how to do leg raises.  Also passes the time and makes you feel like you are doing something positive for your recovery.  Also may want to consider taking glucosomine supplement.
Posted by lizl (lizl), 17 February 2003

Thanks, Pat, for the advice.  Yes, I do have a wheelchair. I plan to use it, when I go out--so I'll have an appropriate place to sit with the leg straight out. I use it at home sometimes.

I tried to get a parking permit during my first post op doctor visit, but the Dept. of Motor Vehicles would not accept the form from the doctor, because the form had been photocopied (the office has dr. signature on a blank form, which they photocopy and then fill out). This practice is the biggest orthopaedic practice in town, so I can't believe I'm the first to present the photocopied form. The site of me in full leg brace, with crutches and a driver to drive me around was not enough! By the time we got back to the Dr. office, he was already gone to the hospital and not expected back for the day. So, I'll deal with that again tomorrow at my next appointment. Truthfully, though, I have not left the house since that appointment.

I'll create my own post after I get back from the doctor tomorrow (if the appointment is not cancelled due to weather). Church was cancelled yesterday, and I was really looking forward to it. I would not have gone anyway, as there is ice on the ground, and I am terrified of falling.

Thanks for the advice on clothes, as well. I honestly do not have any of those long, full skirts or dresses. I usually wear slacks, suits, or straight skirts. I'm short, and the long things just emphasize it. For now, though, they sure seem like a good idea. The doctor specifically warned me NOT to wear the stabilizer over slacks, not that I could just yet, as the wound is still a bit new.
Posted by lbdeharak (Linda), 17 February 2003

Hello Lizl,

I found that the mens basketball tear away pants were even better than the warm up pants. They have snaps that go down the entire lenghth of the pant leg, so you can put your pants on and off much easier, and you can get at the brace throughout the day without having to pull your pants down.

Good luck!
Linda
Posted by lizl (lizl), 18 February 2003

Actually, those are the type I have--I just didn't know what they were called. My daughter went to town in search of large sweats or something like that and came back with the men's basketball warm-ups with snaps down the side. They are great! Before that, I was wearing only moo-moo type dresses that are actually bedroom/house dresses. When I went to the first doctor appointment, I wore shorts under my winter coat.

Tomorrow, I'll wear the basketball pants and a sweater and feel more dressed.  It's amazing how good it feels to make just a little progress!

Thanks for the encouragement and suggestions!
Posted by mabdegonian (mabdegonian), 18 February 2003

In answer to the previous question.  In my case I was in the hospital for 5 days and then home for 4 days before I started driving.  I injured my right leg and with my height I couldnt sit in any of my cars comfortably with the brace locked anyway.  So I would climb in the passenger door, slide across to the drivers seat and leave my right leg on the passenger seat.  Then I would drive with my left foot.  Perhaps not the best idea but with my work schedule I couldnt have my wife driving me.  We didnt want her getting the kids up to come and get me at 3am when I get off work.  So I had to drive to work as soon as possible.  Since I sit at work and had the wheelchair it all actually worked out pretty well for me.  Now we joke about 5 days in the hospital and then 4 days of work.  Not to mention 2 of those days I did some work from home.  I am just glad that we could rework things so my wife could take the kids to school and a neighbor would pick them up for me.

Anyway good luck on getting back going lizl.

Posted by lizl (lizl), 19 February 2003

Mabdegonian,

I don't know how in the world you did it! Weren't you in pain, not to even mention discomfort? OK, I feel like a real baby, feeling sorry for myself.  

I'm on temporary disability, but I'm doing quite a bit of work from home, via phone and laptop computer.

Lizl
Posted by mabdegonian (mabdegonian), 20 February 2003

The Cryo-cuff and just not really having any choice.  Oh and lots of motrin.  After I fell and broke my knee the first thing I did, after lying on the ground in agony was to try and stand up on my good leg.  That went ok but when I tentatively tried to take a step with my bad leg I learned whole new categories for the word pain.  Lying on the ground at that point is when I realized how badly I was hurt.  I managed to get back up, hop across the parking lot to grandmas old apartment, find some ice in the freezer, and slide down the wall to wait for help.  So it wasnt fun but since work could be done in a wheel chair with my leg elevated and hooked into a cryo cuff I could cope.  Hurt like hell but I did it.  Paid the mortgage.

 So no dont feel bad.  My pain tolerance is obviously somewhere in the stupid range.  You know the saying "no brain, no pain."  It took me all day to decide I had to go to the doctor for my broken hand.  I apparantly walked on a broken leg for 2 weeks just because the ER doc didnt see the lipohemarthrosis or know that it signified a break he could not see well from that angle.  He told me it was just sprained and to put the brace on and take it easy.  The really stupid thing was when the pain would twinge and wake me up screaming in the middle of the night to ease and then do it again in 15 minutes or so I just dealt with it.

Everyone deals with pain differently and I truely believe everyone feels it differently.  There is no way I can understand how much pain anyone else here is in.  I read some of these posts and wonder how they deal with it.  I think we each do what we have to.  Hang in there.  The pain passes.


Posted by lizl (lizl), 20 February 2003

Mabdegonian,

It sure sounds to me like you cannot trust your own reaction to pain as a measure of how injured you are!

When I broke my knee, I wouldn't even TRY to get up (then again, I had touched the knee and felt joint instead of kneecap, so I had that as reinforcement that something was really wrong). I just started yelling for help. Sometimes you gotta trust the pain. It's your body talking, man! Hopping across the parking lot? I cannot even imagine that.

Everyone here has pain, and I agree that I don't know how those people with chronic problems cope. I do know that they are an inspiration to me.

Lizl
Posted by Analee (Analee), 20 February 2003

Can you please tell me how to find the page on how to do the leg raises that you mentioned ?
Thanks,
Analee
Posted by Pat_A.E. (Pat_A.E.), 20 February 2003

The leg raises and other exercises can be found on the home page for Kneeguru: www.kneeguru.co.uk/ under the exercise section.  If I recall correctly the exercises are listed in three segements based on how strenuous they are.  Turns out they are the same ones the PT gave me initially.
Posted by Analee (Analee), 24 February 2003

I can relate to "wolves at the door" as well as much of your other message.
I fell at the grocery store on a green bean in the produce dept. They sent me to the hospital in an ambulance, paid for that, talked with witnesses, confirmed the accident, and sent me a letter saying how sorry they were that I had sustained a serious bodily injury, HOWEVER, they carry NO medical payments liability ins. SOOOOOO they can't help with the bills !!

Surgery was on Dec.6,2002. Presently, I can be up and around for a couple of hours at the most before lapsing into heavy pain. PT for the last 3 weeks has helped a lot.
But like you, I am wondering how it is going to work out with "$$ survival"...since this is not something that happened in a work setting. My ins. is covering a part of the medical bills but only a portion. The balance is mine to pay!!! NOT RIGHT !! A business that invites me to come and spend my $$ there should have coverage for my well being. My savings is going quickly !!
Any comments welcome.
Posted by lizl (lizl), 24 February 2003

Analee--

Get yourself to a lawyer QUICKLY! Even if they do not have insurance, they do have assets. It was to their advantage to pay your medical bills. As it is, they will get to pay both your medical bills and your lawyer. The only way you should not pursue this is if you are convinced they have no assets (unlikely, since the business itself should be an asset). In any case, a lawyer will find out what attachable assets exist. Ask around a little to come up with the name of a good lawyer, or simply march into a law firm that has a pretty good reputation.  It will not cost you anything to have an initial consultation. If you doubt that, just phone them and ask what their policy is.

I'm betting that a letter from a lawyer will change the atmosphere a bit. Don't delay another minute!

What kind of injury do you have (I'm assuming broken patella, since you posted in this thread)?

If you want  info concerning your injury to appear at the bottom of each post (as is the case with many of the people who post), you can edit your profile to include that info.  Go to the main page of KNEEtalk and select Profile from the menu at the top of the page. Put the injury detail  at the very bottom of the form in the section titled "Signature." That way, all people who read your posts will be reminded of your circumstance. It really helps other readers to know the type of injury (broken kneecap--but did you have surgery, for instance) and the timeline (are you currently in physical therapy).

The little statement that shows up under your name is called "Personal text," and you can add that in the Profile, section, as well.

One other trick that I have found useful involves navigating to the end of a long thread, such as this one. When you see little numbers (Page 1 2 3 4) after the thread's title, you can click on the last number to go directly to the most recent posts. That way, you don't have to load all of the entries to get to the most recent ones.

And, hey, welcome aboard (though we all know that the admission price of being injured is pretty high)!

LizL

PS: Let us know what the lawyer said!
Posted by Rhonda (Rhonda), 25 February 2003

What Liz said..

Get a lawyer!  Send them  letters nicely but firmly saying  that if they don't step up to the plate, you plan to file for damages.  Since there are witnesses, plus they paid for an ambulance, PLUS sent you a letter of apology- it should be a slam dunk.   If they have more than a few functioning brain cells, they know this.   Right now they are hoping you will just go away... Assure them, that you are not.  In this case,  just the threat of a lawyer should get you somewhere..    If they refuse to help- then they run the risk of lawyers fees (as Liz said) plus the possiblity that you will be awarded punitive damages on top  of everything else- just to teach them a lesson.
First of all- I sincerely doubt they can legally run a business so publically populated without some form of medical liability insurance.
But, regardelss, Liability is NOT determined by insurance coverage.  It is determined by negligence. (IN this case, failure to keep floor free of slipping hazards).

Is it a big chain or little mom and pop store?

Actually, some people said that I could have possibly sued the place where I broke my kneecap- Killington...  I woulnd't because it was my own stupid fault (sledding at a ski resort)..  but just the fact that it was their property may have given them some liability (although, like I said- I never explored that since I didnt' feel that my accident was due to THEIR negligence. )
But if my friends are correct - then you should have no problem in your case.  Not only was it their property, but they were clearly negligent.  
THere was another woman on this board a few months back- she slipped on a grape at Wal Mart and broke her kneecap.  I wonder what happened with her case...

Anyway- keep us updated!  
Posted by Pat_A.E. (Pat_A.E.), 25 February 2003

Ah, insurance and liability!  Does anyone know how to deal with foreign, i.e. Italian, insurance?  One of my clients is an insurance arbitator for large companies.  He said that if my injury would have happened in the US my retirement would be guaranteed!  Anyway, since it happened in Italy none of the lawyers I have spoken with practice law outside the States.  I am finally getting my e-mails answered by the owners of the villa.  It took them three months to answer the first letter.  They claim they are turning the info I sent over to their insurance carrier . . . . .  I tripped on a step up to a patio at 10 p.m., obviously it was dark.  There were lights at the step but they either were not working or were not turned on.  I was informed by my traveling companions that the next day  while I was in the hospital there were electricians crawling all over the villa.  Guess what, the night following my accident all the lights were on
I'm certainly not looking to get rich on this, but my husband and I are self employed and our medical insurance (which costs us over $10,000 per year) is pretty much catastrophic coverage leaving us with high deductibles and high co-pay.  My PT coverage is $360 per year and in suburban Chicago PT is $180 per hour.

On a better topic, the weather has changed, it is  very cold (-6 this morning)and my knee doesn't hurt . It sure did Sunday before the weather change.  Maybe I can go into the weather forcasting business.
Posted by jab105 (jab105), 26 February 2003

I know what you guys mean!!

I hurt myself at an iceskating rink that didn't have a zamboni (the thing that cleans the ice) cause it was so small (about 1/4 the size of a normal iceskating rink), and it had big snow chunks and holes all over the place, and it had so many people that they had run out of rental skates.....I'm an ebay person and get all my money from selling on ebay, which means, I make enough to be comfortable(house, car, food), but not enough to have health insurance (I'm young never been injured before this)....

My husband wanted me to inquire about if the ice skating rink would have been liable, but I can't imagine that there would be any way to tell if they were too many people on the rink....and, I was dumb enough to get up and wimper my way off the ice to the car instead of letting them get me there.....my total (since I didn't need surgery) including PT is around $2000.....not nearly as much as some of you, but certainly a big chunk of change....I think if it had been too much more, I would have inquired further...but I just worry that the companies have so many barriers in place to keep people from winning damages for injuries, that  it would not be worth it, cause it would be more for lawyers fees...

So it goes, I think about it less and less as I get better......cause for a time I was worried about if I could get better....

Tonya
Posted by Rhonda (Rhonda), 26 February 2003

Wow, Pat..  I think the fact that they put all the lights on the day after your accident shows some fear on their part..  Definitely see what you can get out of them!  CAn you find an Italian lawyer?
But I read in a another poist that you are running without a limp now?  Wow- I still limp when running..  If you are still in PT, doesnt' sound liek you will need too much more- just keep up your workouts in a regular gym.  I'm going back to my old gym.  I can't take my PT's gym anymore.  He's got a whole bunch of people training for the Boston marathon in there these days!  
Yes, TOnya, skating on choppy ice can be hazardous..  When I was playing ice hockey, sometimes all the players would be falling all over the place (even the better skaters) because the kid driving the zamboni didnt' do a good job.  But I'm glad you didnt' need surgery!  Mine cost over $20K, for the 4 night stay and surgeon fees.  Add in Emergency room, ambulance, CPM machine rental, PT, etc.. I'm estimating roughly $30K.  I'm really lucky I work for a big company- had good medical coverage, and got disability coverage for the month I was off work.    I'm especially lucky, because, while in theory I certainly could sue the ski resort, but not only do I think I'd lose, but probably embarass myself further for my stupidity!  

Sounds like you guys are doing well!  Keep up the good work!
Posted by Pat_A.E. (Pat_A.E.), 26 February 2003

Rhonda, I have been running on a treadmill, but for short bursts - 1 to 2 min.  I was NEVER a runner so I never did too much more then that.  I prefer walking and this morning is was short 25 sec. of my 15 min. mile goal.  My limp is gone 98% of the time.  Some days when I push too hard at my workout by the end of the day I find myself limping a little.  Then I slow down and think about what the PT told me about planting my step correctly.
I think today will be my last PT visit for awhile.  I'm self-employed accountant and tax season puts a real strain on my time.  I figure as long as I can get to the gym 5 mornings a week I'll take a pass on the PT.  Once I get out in the spring and starting gardening and doing more outside activities I may find the PT will be beneficial.  I'll actually miss my therapist.  When we first met I got the impression he thought I would be a whinny middle aged women and since this was the first patella fracture he had ever worked on he was skeptical I would get this far.  We've worked well togther and I give him alot of credit for my progress.  Funny thing is - he's Italian!
Posted by dwalsh (dwalsh), 26 February 2003

Tonya
How coincidental we both fractured our patellas ice-skating. I don't even have the zamboni to blame ..tripped over my own foot! I'm sure ice rinks can't be sued-so many people must injure themselves there. Can't believe you hobbled to your car. I could not walk at all..ambulance came...big embarrasing scene. Loved your picture. So jealous of  the warm weather and swimming, I really can't take much more of this northeast snow and cold.

Pat and Rhonda
It's so amazing you both can run. I still cannot. I feel like the leg gets stronger everday and the pain gets less though. Still only have about 100 degress of ROM so I think that is the biggest problem. Hopefully after the wire removal this will improve. I'm on the fence about PT lately. Everything I do there (ride the bike, weights, balance exercises) I could do at my gym. My PT does do some deep tissue massage and trys to physically bend the knee further (hurts!) but I don't think it is all that helpful. Trying to decide whether to conitinue.

well back to work!
Doreen
Posted by Analee (Analee), 27 February 2003

Thanks to all of you for the support. Yes, this grocery is a large national chain with "deep pockets" and doesn't carry any liability because the burden of proof of NEGLIGENCE is on the person seeking help !! Proof is...they KNEW the green bean was in the floor and neglected to remove it.
I am certain most folks just turn around and go home and try to forget it, and pay the bills. I CAN'T !! Expenses are now at a level so high I will have to file bankruptcy. And I am still not well enough to be up on my leg for more that a short time.
Attorneys decline such cases UNLESS the $$ to recover are high. Perhaps mine will qualify. They cannot afford to spend so many hours on a case, filing fees, court costs, etc. and then not prove negligence. This is what I have been told about the state of Tenn. and that I should go home and get well before I get involved in this matter as it becomes "consuming"....That was told to me by a lawyer after Christmas, and I grabbed it ! I can see how "not worrying" has helped, but now comes the "wolves at the door" as the savings account is going down !! Stay posted in the coming weeks for what happens with my entire future !! Not kidding.....single, no family support......what does one do
I directly attribute any sanity I have to my faith in God. And NOT trying to understand any of this. Just dealing with TODAY. That's all I can handle.....

Thanks.
Posted by Pat_A.E. (Pat_A.E.), 27 February 2003

Analee, Have you talked to a legal aid group.  In our communities there are attorneys who volunteer their services for those who don't have the means to pay.  Also, if you are a member of a church, talk to your pastor because they often have resources that they can refer you to.  Seems hard to imagine you couldn't at least have your medical expenses covered.
Regarding the 1 year your doctor said it will take for recovery, don't dispair.  I was told the samething and what I think it actually means is 1 year for total recovery.  That means no pain, discomfort, etc. but the reality is you will probably be able to do most everyday activities (sometimes with modification)within 6 months or sooner.

Doreen: Getting better ROM is important for running but since you probably don't spend most of your time running just focus on walking without a limp.  I found once I started using the gym in addition to PT I started making real progress.  It is just way too expensive to ride the bike, etc in PT.   I now use PT to beef up my workout rather then the other way around.  I count on the PT to tell me the correct way to do an exercise and reassure me I'm not doing any damage.  I've been going weekly this month but backing off to every other week starting in March.
Getting the hardware out did improve my ROM but it was already at 123 before the removal. There is no easy way to improve ROM except to keep working at it.  I sit almost everynight and pull on my foot to keep forcing the knee to bend more.  The closer it gets to 133 the slower the progress seems.  I'm at 130.

Yesterday I almost broke down in tears of joy when I realized how frightened I was last Oct and then after surgery when it seemed I would never regain my life.  As hard as it was I keep asking God's guidance even though it didn't seem like the answers were coming.  The whole ordeal has been a lesson in humility and patience. I have a new found respect for those who are permently handicapped.  I am chair of the building committee at our church and believe me it will be accessible because if there is ever a time when people need to have access to their church it is a times like these.  
Posted by lizl (lizl), 28 February 2003

Analee,

Make some phone calls before you spend any more time worrying.  I think that the store is responsible for accidents that happen on their premises, even if they were not negligent. I'm not a lawyer, but I think even a homeowner is responsible for accidents that happen on their property. That's why such things are covered by homeowner's insurance.  

You need a lawyer to help brainstorm for things to investigate in terms of negligence. For instance, a lawyer may first ask for copies of work orders at the store to determine how often the floor is swept. Perhaps the store was short staffed that day, and some custodial chores suffered. You never know.

In any case, don't go to the lawyer who advised you to go home and heal. Find someone who is more aggressive than that.

Do you have any evidence that the store knew the bean was there and yet did not clean it up? I know that's a stretch, but that would go a long way toward proving negligence.

By the way, you don't have to actually prove they knew there was a problem with the floor, only that they should have known (the absence of regular sweeping of the floor might prove that they did not care if there were hazards).  Also, let's say that a produce worker restocked the fresh green beans an hour earlier and dropped some of them, which then were not swept up. Perhaps the display often has over-flowing beans and creates a hazard on a regular basis (this is probably the best case scenario). If this is the case, you might have someone take a camera with a time-date stamp function and snap a few photos to show to a lawyer. Be sure NOT to use the flash, however, as that will attract store security (they'll be watching through their secret camers, as always). No store wants you to be taking photos inside it, so your helper needs to be in and out quickly.  

Of course, the store has security cameras in place, and your accident was probably "caught on tape." (That's another reason to act soon.  Any such tape may not be available for long, and it may help prove your case.)

Please, please, talk to another lawyer--either a very good one or a very hungry one!

LizL
Posted by Analee (Analee), 9 March 2003

Thanks for reply. Yes, our homeowners ins. is for our protection if someone gets hurt on the property and so is our auto liability ins if there is injury in accidents. And if we DON'T carry these coverages people who try to collect from us have to take us to court and prove our negligence and obtain our assets. As I have been told recently by this atty. this is what MUST happen in my case. He said large companies like Kroger & Walmart choose not to carry the liability ins. and will make a small "nusance payment" offer to someone and hope they take that and just go away. And with a small injury it usually works. They KNOW how much $$ is involved in having to file a lawsuit and that burden is on people like me, NOT THEM.
Again, thanks.
Posted by wofford99 (wofford99), 13 April 2003

Hi everyone-
  I have had 12 knee surgeries including bilateral patella realignments.  I am in pain management on narcotics for chronic knee pain management.  About 3 nights ago (Thurs night), I was mopping my tile kitchen floor and fell right on top of my left kneecap(my worst knee).  I developed a huge red (very red) bruise all around my kneecap. I had a lot of pain, trouble straighening/bending my knee, and could barely walk.  Also, I fell on the top of my tibia where I had the screw removed from my realignment about a year ago.  That area is very tender.  
  My orthopedic surgeon was on vacation and they told me to go to the Emergency Room Friday morning.  I didn't want to deal with the wait there so I made the mistake of going to my general doctor.  I saw his physician assistant who x-rayed it, etc.  She was not experienced in complicated orthopedic x-rays- she did not have access to my old x-rays because she is in a different hospital. She took a sunrise x-ray where my knees were bent and on that one she saw either a "fracture" or "blood vessel" on the medial part of my kneecap.
    After showing it to my doctor, they agreed it probably was a fracture-looked like a zipper.  She told me to wear an immobilizer and crutches until I can see my orthopod on Tuesday.  
    I know that this is not a severe fracture;however, with my history it is concerning.  I have searched the internet and haven't found much about the symptoms/signs of a longitudinal patella fracture and the treatment.  I didn't think a blood vessel could show up on an x-ray but I could be very wrong.  I wonder if I should go to the emergency room and have an orthopedic surgeon look at it before Tuesday.  I am in a lot of pain.  Thank you to anyone with input! Margaret in North Carolina  
Posted by Pat_A.E. (Pat_A.E.), 14 April 2003

Since it is only two more days before you see an OS I would wait rather then take my chances at the emergency room.  I am assuming the OS is one of your choice, correct?  The treatment for a fractured patella always involves imobilization and non-weight bearing whether or not surgery is involved.  I found that once my knee was imobilized and I kept weight off of it the pain wasn't unbearable.  Since you already have pain meds I'm surprised they aren't helping somewhat.  Please try to keep your leg elevated, iced and non weight bearing until you get expert advice.

This old Forum was so valuable that we have kept it as an archive. It is just for reference. If you want to ask questions or offer advice, there is also a current Bulletin Board which you can access from our home page.