Bone breaks around the knee :
Pain after patella surgery - - Posted by Joy (Joy), 21 August 2004
For all you fractured patella-ites who are reading this: I have been living with pain that I have been ignoring thinking it was the quads gaining strength. I have pain when bending my knee, doing squats, climbing stairs, etc. It isn't severe pain so I thought it was just part of the healing process, assuming the muscles were weak and were gradually strengthening. Do any of you have similar pain? Also, and I've been posing this question often, do any of you have a feeling of tightness around the kneecap? I often think I can feel the quads adhering to the bone below the kneecap and sometimes I feel pain in my thigh. I've been attributing all this to healing. I haven't really discussed this with the OS who discharged me a while ago. Please describe whatever pain you've been feeling. I'm suddenly feeling very nervous and insecure about all this. My leg is gaining strength but the sensation remains with me.
Posted by HHB (MHB), 22 August 2004
Hello Joy,
My patella fracture is coming on 5 months post op. During this time period, had pain early on from screw impingement when the knee was swollen more than usual. Later, at 5 wks, had some discomfort for a couple of weeks while getting the bend back. Then at about 12 wks, when OS finally gave me the okay for normal stair climbing, descending the stairs was uncomfortable until I remembered how to do it -- took a few days.
Otherwise, no discomfort to speak of during activities -- oh, well, forgot -- sometimes a few stiff steps if I've sat working at the computer for a few hours.
Was reading these boards and saw your post on the rehab forum. The pain you describe there
Quote:
suggests pain when bearing weight on the bent knee, is that right? As you know, such movement presses the underside of the kneecap in against the femur channel there. If the underside contours of the patella fit the groove poorly and cannot glide smoothly, then bearing weight on bent knee could be uncomfortable, I suppose. walking stairs, doing squats or knee bends,lunges, rising from a chair.
If the patella is moving out of the groove during the bending, pressure on patella/femur contact points is no longer even, and pressure increases -- those surfaces rubbing together could hurt. (You mentioned a "popping" sound on extension, which could mean the patella was off track, and upon straightening, needed to move back into groove before stopping at full extension. )
Had about a week of same (wks seven to eight), which occurred only during ROM bending exercises performed from a certain position. Of course, I wasn't bearing weight on the bend with this exercise, so it didn't hurt. I couldn't feel the cap moving out of the groove at the start of the bend, but could feel it hopping back into the groove on extension.
Two of the simpler reasons for maltracking I know of are:
1) muscle imbalance (VMO gets out pulled by stronger lateral quad or doesn't fire first)
2) a bit of scar tissue adhered somewhere on the lateral side gives it extra leverage in the pull (my problem was this).
Both situations are fixable, most of the time with exercises. If you still have hardware and/or swelling, that could contribute to your discomfort, too, I suppose. Scar tissue, maybe, but with your full ROM, doesn't seem like that could be the pain source.
Have you tried to "feel" your knee while bending, i.e., while sitting in a chair, on a bed, something like that? When mine was maltracking that week, I could feel it with a hand placed lightly over the cap. I couldn't hear it pop, but could feel a slight kerplunk when it got back on track right before full extension.
Whatever the source, hope you'll check it out with your OS -- no need to suffer if something can be adjusted. Sure do wish you well in getting past what is maybe the last hurdle ....
-- MHB
Posted by Joy (Joy), 22 August 2004
Thanks. I was thinking this is a symptom of maltracking. I had hardware removal surgery at the end of June. I've been working my knee at the gym like crazy. When I extend my knee after flexion it also pops, which I can feel with my hand, and I was even able to see movement in the knee. What exercises repair this problem? I'll call my OS but perhaps I can get some suggestions for exercise here.
Posted by lizl (lizl), 28 August 2004
Joy,
Has your pain level decreased since the HW removal?
I felt so much better as soon as the incisions had healed, but I did have some slight problem with adheasions. My physical therapist was pretty aggressive in massaging the scar tissue and insisting that I keep doing the massage until the skin started to pull free of the kneecap.
The tightness of which you speak sounds much like I had. The good news is that it does get better. I'm about 8 months past my second surgery and 20 months post-break, and I still notice little improvements.
Hang in there!
LizL
Posted by Joy (Joy), 28 August 2004
Thanks, Liz. The leg is growing stronger and I have good movement but that tightness is extremely annoying. I saw a new OS and he said I'm doing remarkably well. I'm two months after second surgery so I guess I'll just hang in there. He couldn't tell me what the pain or tightness was due to, but said to wait at least a year and then if there's no improvement I'll have an MRI. I find this tightness very uncomfortable. I haven't yet regained total strength but am continually working on it.
Posted by booms (booms), 28 August 2004
I did not experience pain post op. And I was on my feet the third day.!
Now after about 8 months, the pain comes in... i read in the forum that sometimes screws come out or wires start moving.. i hope no such thing has happend.
Posted by Pat_A.E. (Pat_A.E.), 9 September 2004
The tightness you describe is common. None of the professionals (OS, PT) new what it is. In fact they acted like I was the only person who had experienced it! After almost 2 years I still have it but to a much lessor degree. Sometimes I think I have just gotten used to it. I have stopped worrying about it or trying to find a remedy because it doesn't prevent me from doing what I want to do!
Updated Mon Oct 6 2008