Bone breaks around the knee :

shattered patella queries - - Posted by Peter_B (Peter_B), 14 January 2004

Hey everyone, this is my first post.  Well, I've spent 15 mins on this site and found out more about knees than I have been able to get from all my doctors.

I took a fall before xmas (12/12) and broke my patella into 15 pieces.  I had surgery the next day, they took the odd piece out and put in two straightish wires and some sort of figure of 8 tension thing.  I got a full leg cast and they let me out of hospital.  I got the staples out on 22/12 and the doctor said I could go partial WB. I've had not pain, which seems lucky given what some others seem to experience.  I am due to get the cast off on 27/01, I expect I will have to get an x-ray before this.  I am back to work (mostly sitting at a desk), daytime TV was too much for me.  I am am exercising the leg a bit (lifting forward, sideways and backward), but am not sure if this is bad or good.

So, I've got a few queries, if any of you can help?

Does my treatment thus far sound ok?
Should I be getting physio at the moment?
What sort/how much physio should I get once cast is off?
Is it worth going private for anything rather than NHS?
Anyone have any experience of Glasgow NHS and this type of injury?
Should I be partial WB?
Sometimes I take a few steps without my crutches, is this a problem?

I've been told that the bone will heal and I'll get my muscle back, but the problem will be the muscle moving over the roungh surface of the bone.  How bad/good could this all turn out?

So, thanks in advance for any help, and good luck to all fellow sufferers out there.  I am going mad from not being able to do anything, hopefully I will be able to go swimming when I get my cast off.

Peter
Posted by Peter_B (Peter B), 14 January 2004

Ah, one other thing.  I am taking homeopathic pills, symphytum.  A friend said she thought they helped her bone heal faster/better.  Does anyone know of anything else thatwould help?  Would drinking milk and eating steak help?
Posted by kgrosskurth (Kathy G), 14 January 2004

Hi and welcome to the club no one wanted to join

My situation with at tib plateau break is not quite the same as yours, but there are quite a few people with Knee cap breaks and problems - I am sure one or more of them will be able to provide you with advice.

One thing I can tell you is to obey your Drs orders and clear anything exercise wise you do with him or her, or you may be doing further damage and not know it until it's too late.

Feel free to read my diary if you have some free time - the link is in my signature block below (I am at about 90-95% recovered).

All the best to you in your recovery!  

PS: Milk and dairy products at this time are a good thing, eat and drink as many as you can stand while you have an excuse to indulge!  
Posted by JanieE (JanieE), 15 January 2004

Hi Peter,

Sorry you had to join us, but welcome aboard. I am one of your fellow patella fracturees.  There are several of us here currently.  It would be good for you to read the threads posted by some of those who had this injury during the last couple of yrs., they are full of usefull information.

I was not in a cast, so I am unable to answer those questions. I do know that anything you do to help keep your quads awake will help you in the long run. I was NWB for 2 months.  While in the hinged brace, I was able to do some isometric type exercises which did help, but my quad is still working the long road back to health.

You're not having pain is certainly a bonus for you. By the time the pain had pretty much subsided, I started PT which gave a whole new definition to the word.  You will probably start PT as soon as the cast is off and that would seem to be around the time most start.

It will probably take longer for this bone to heal then you realize. It is hard to visualize it being in 15 pieces. Mine was only in 2.   I just had X-Rays today and the bone is finally 100% healed. My 4 month post op is next week.  I hate to say it, but the name of the game is patience.  There is one bright spot, I don't know your age, but it seems the younger you are the faster you get better.

I have not heard of the natural item you are taking. It sounds like something we need to hear more about. I did choose to increase my intake of dairy products, including drinking a large glass of milk with dinner each night.

I wish you good luck in your rehab and healing. Be sure to keep in touch and let us know how you are doing.

Janie
Posted by lizl (lizl), 15 January 2004

OHMYGOSH! 15 may be our record, though most of the time, I don't think the OS actually says how many pieces. In my case, I had one half communited (multiple pieces) and the other half in one piece. Like you, part of my patella was discarded--though I don't think it was very much of it.

I think it is pretty normal to delay PT until after the brace (or immobilizer) is removed. I was partial weight bearing as tolerated from the start.

For the first few post-op visits to the OS, I had xrays every time to check on the fusion of the pieces. My understanding was that the PT gets kicked up a notch only when the healing is far enough along.

Speaking of the rough surface of the bone--smoothness on the backside of the patella is more critical than the front. The patella sort of moves with the muscle, more than the muscle moving over it.  For some of us, the roughness created by the presence of hardware has created problems which, eventually, necessitates a second surgery to "get the metal out."

LizL
Posted by Peter_B (Peter B), 15 January 2004

Thanks for the info and best wishes guys.  It is nice to speak to people who know how serious this is, everyone I know seems to think I will be back to my best in a few months.

I searched for info about the symphytum on the net, it was a bit patchy and all provided by sites that want to sell you the stuff.  Still, it's supposed to promote healing, including that of fractures.  It was pretty cheap (< £5 for 3 week's worth), so I thought why not?  As you guys also seem to think that calcium is a good thing, I'll keep knocking back the milk.  Low fat though, I normally eat loads but burn it off through sport, so am struggling to reduce my intake at the moment.

LizL, you mention post-op OS visits.  How soon was the first one and how often were they?  I've not seen mine since the op when I wasn't really in the right frame of mind to be asking loads of questions.  I am seeing him with a view to getting the cast off on 29/01 and will be giving him a grilling.  My main worry just now is that I am doing stuff that will shift the bits of bone around too much.  I suppose I should phone the hospital and hassle them for info.

Cheers

Peter


Posted by Christina (Christina), 15 January 2004

I had a tib. plat. break...its different from what you had...but I had the problem where I healed too fast and I'm young and stupid and started to walk a couple months too soon...The OS said that I "dodged a bullet with that one" So I warn you the hardware may not be able to withstand your weight if the bone is not healed completely and any shift even by millimeters can cause complications in the future.  If the doc says partial wb he means it.  
Like everyone else said calcium is the way to go...make sure it has vitimin D if its milk...I had the same problem as you being very active then when the knee broke I sat around doing nothing and gained tons of weight...if you want to avoid the milk take a calcium suppliment...even a multivitimin has enough calcium to help you out
I personally was at the OS less then two weeks after the surgery to get the staples out and check my ROM...Then to be x-rayed...Then I don't believe I saw him again for almost a month...I never had PT my doctor insists that it would be kinda pointless because I can do everything it would just be a waste of time on my part I guess...I think its really up to your OS what he feels you need comparitively with your healing
wish you the best of luck
Posted by caroline_f_98 (caroline_f_98), 15 January 2004

Hi Peter. I am also new and have similar concerns as you. Shattered tibial plateau and fibia in too many places to count! Surgery, 2 plates, 9 screws, 51 staples. You seem to be progressing very well. I've  a different injury but i only started PWB last week. I won't see my OS for another 6 weeks so that's at least 12 weeks until I weight bear. No mention of physio yet. To be honest I am seriously considering going private as I am very upset with my doctors. I am also curious to hear from anyone from Dublin to hear how they  got on??

I too am taking homeopatic remedies. Another good one is arnica if you have brusing or swelling. Re. supplements I take fish oil which has been proven to repair damages cartilage by a professor Bruce Caterson and I also take Glucosamine and Chondroitin.
Posted by lizl (lizl), 15 January 2004

Peter,

I think I saw the OS a couple of days after coming home from the hospital and then again on about day 10 to have the staples removed. Once I started PT, the insurance required a prescription every three weeks to continue PT, so I had to see the OS on that schedule. Also, once I was in the ROM (range of motion or hinged) brace, the doctor would re-evaluate how much to "open" the angle.

In regard to your visit on the 29th, I suspect that they will cut off the cast and do x-rays. If the bone is sufficiently healed, you may be able to graduate to a brace. Don't be too excited about the brace, though, as braces have their own issues. I cannot really compare a cast and a brace, though, since I had an immobilizer rather than a cast. I can tell you, however, that I actually put my immobilizer back on a few times at night--as I found it easier to sleep in than the brace. I had a TERRIBLE time keeping the brace in position, and it hurt like HECK when it shifted!

LizL
Posted by lizl (lizl), 15 January 2004

caroline_f_98,

Welcome to the board. I'm glad to see another mbl-er who found us, as well.

The whole weight-bearing restriction thing really stinks, doesn't it? I had a broken foot several years ago and was NWB for eight weeks. I did not have surgery, as my doctor felt the bones were well-aligned, but the lack of hardware meant that I had to stay off of the foot entirely to keep the bones that way. If I had had surgery, I might have been partial weight-bearing earlier; but the bone (broken in two places) eventually healed, and I don't have any hardware.

My mother-in-law is about eight weeks out from surgery for a broken hip, and she was told that too much weight too soon could retard forming of the calcification that is the start of bone healing. With as many different breaks as you have, I'm not surprised that you are restricted on weight bearing for so long. All of those breaks represent a lot of opportunity for something to get out of whack!

LizL
Posted by caroline_f_98 (caroline_f_98), 15 January 2004

Hi Liz

 

Yes, very frustrating! This whole thing is a real test of a person's patience, self motivation and strenght of character. Every doctor I speak to attempts to bring me back down telling me supplements don't work, arthritis is inevitable, no gurantee I'll walk.. etc etc. I feel so positive until I get into hospital. For example I have ROM of 100 without effort and am only in a brace a few days. I think that's impressive but they wouldn't comment. Instead they told me I should be more worried about the fact I'll need knee replacement eventually!
Posted by lizl (lizl), 16 January 2004

Oh, Caroline!

Do your best to ignore the nay-sayers. There will be enough time later on to accept dire predictions, if that does come to pass. Right now, keep concentrating on proving them wrong.

Before my second surgery I was trying to tell the OS what my goals were, and he just sort of snorted at me, "You know that knee is never going to be normal!"

Well, duh! That doesn't mean that I should stop trying to get a better result! The second surgery did help.

LizL
Posted by Peter_B (Peter B), 16 January 2004

Hi Caroline:

Welcome to the club!  12 weeks without bearing weight, that must be a right pain.  Still, it is good that you can still bend the leg.  I don't know much about your type of injury but I would agree that you seem to be doing well.  I have had the same issue with pessimistic doctors.  The guy who got me to sign the surgery consent form left me in tears with his dire prognosis.  I am being positive and not thinking about this not getting better and am brought down with a bump every time I see a doctor.

Liz: what is an mbl-er?  These brace thing sound like a barrel of laughs.  I had one in hospital before I got my cast, I used to wake up with a steam of profanities every time I moved my leg.  The worst thing about hospital though, were the plastic covers under the pillow cases and sheets.  I would wake up in the morning completely soaked with sweat.  Ugh.

Christina: cheers for the weight bearing advice.  I am going to force myself not to over do it.  It is a pain though, cause I can hobble around, cooking say, without any pain.  I called the PT at the hospital, he said that FWB woiuld prob be ok, but I'm not going to risk it till I've had another x-ray and seen the OS.

I got a wee bit drunk last night and fell of my (low) seat, should probably act more responsibly, but, hey, these are meant to be the best years of my life.

Peter
Posted by caroline_f_98 (caroline_f_98), 16 January 2004

Hi Peter

You had asked before about going private. I was also considering this. I went to my GP today and she agreed that I would get much better treatment. She is going to try to get me an appointment . I can only speak for Ireland here but I have to say I was v unhappy with the treatment I got in hospital. I saw different doctors each time , never saw my OS and got conflicting answers to my questions. I would be happier to pay and get a long consultation with one person who I can follow up with each time. I feel happier having discussed this with my GP. Maybe you could try taking to your GP and see if you could get better treatment elsewhere?

Posted by lizl (lizl), 17 January 2004

Peter,

mbl=www.mybrokenleg.com

I don't know of any broken patella-ites who hang out there, but it's a place where some of our tib-sufferers also post.

Early in my internet search, I found that site first. Of course, we have a lot in common--especially in terms of rehab and the need for positive mental attitude.

LizL
Posted by dcook (dcook), 19 January 2004

They had me up walking on my leg the day after surgery, with an immobilizer and crutches (and morphine). The doc said putting weight on the leg would cause the bones to rub together and start the healing process. (My patella was broken in two.)
Posted by Christina (Christina), 19 January 2004

Peter:  I have nothing to say except I too have had a bit too much to drink and woke up not knowing what I did but my stairs were involved and my knee really hurt for the next few days...Its just no fun...lol

Keep getting well...I hope everything works out for you.

Caroline:  Like Lizl said...God don't listen to people who tell you that you can't do it...I was back at work before they told me I would be able to walk...its all a matter of what you tell yourself you can do...Keep trying...keep getting well...And don't let anyone bring you down!  It will only get better hun
Posted by Joy (Joy), 1 February 2004

Hi all:

I've been reading these posts with interest.  My OS didn't tell me he wanted to see me again.  I had surgery in Nov. for a broken patella, visited the doctor twice after that, the second time because I wanted to.  He told me then that he didn't know if the swelling would ever go down completely. I never questioned him because I was so startled.  I'm finding it very difficult to remain positive and am frightened that I'll never have a normal knee or a normal walk. My injured knee is also bigger than the other knee.  According to surgeon, hardware won't be removed before a year.  I have good ROM and in in rehab.  Any comments?  I'm nervous.

Joy
Posted by lizl (lizl), 2 February 2004

Joy,

If you are still in physical therapy, you will probably still be seeing the OS from time to time. He/she has to authorize continued PT. For now, it might be helpful to have a heart-to-heart discussion with the therapist every two weeks.

You need some information and reassurance, and the therapist is probably going to be more knowledgeable about your actual progress than the OS, anyway. If you are feeling depressed about a lack of progress, maybe the therapist can change the routine a bit. During one of my lowest points, I found renewed hope from simply changing the sequence of my PT routine.

One day, I got teary-eyed in therapy, just trying to tell the therapist about my week; and he hugged me and told me that I was actually doing fine. I needed that dose of reality and show of faith from him, after what had been a physically draining week for me.

Good luck and keep in touch with us.

LizL
Posted by Joy (Joy), 2 February 2004

Hi Liz:

I had an awful day yesterday.  Feeling of tightness around my kneecap was absolutely debilitating and I couldn't walk.  My knee swells and I don't know if the tightness is due to the swelling, scar tissue or tension wire inside.  I never don't feel the knee.  I look forward to rehab 3x each week.  I am just upset because I can't walk stairs and haven't yet regained enuf strength in quads.  I'm 3 months after surgery.  Therapists always say I'm doing well.  I want to climb stairs with two legs and walk without a limp and I haven't a clue as to how long it will be until I can do this.  However, I will speak to the therapists......

Thanks.  I will keep in touch.  I find this board essential to my well-being.

Joy
Posted by Peter_B (Peter B), 4 February 2004

Hi Joy,

I hope you're doing better than a few days ago.  I am am relatively new to this, but I am happy as long as there is continual improvement, even a little.  I have not had any major setbacks so far though.  

You sound about a month further into rehab than me and I don't think I will be walking normally or doing stairs properly in 1 month.  So, I guess what I'm trying to say is that, although it sucks, you seem to being doing ok.  I have has the same experience with doctors, either being pessimistic or not offering an opinion.  This had been the most dispiriting bit of it all.  My physio is much better and I always leave with confidence.  Yours should be able to tell you how you are doing and how you will progress.

Good luck - Peter


Posted by Pat_A.E. (Pat_A.E.), 4 February 2004

Just stopped back to catch up and read this thread.  As you can see from my profile I am about 1 1/2 yrs out from the injury and 1st surgery and 1 year out from the hardware removal.  I can very clearly remember wondering if I would ever return to normal.  I can honestly say I have not, and probably never will be were I was prior to the injury.  That being said let me reassure you that you will regain your life, walk without a limp, do stairs, and many other things which seem impossible right now (this from a 56 year old women).  I will honestly tell you that there isn't a day that I don't realize that I had a serious injury to my right knee, but it doesn't keep me from doing most anything I want -- except running or kneeling.  I was really surprised at how long it took for me to stand for longer then a few minutes without discomfort!
Now a word of warning.  Don't try to push too hard to fast.  I thought I was doing the right thing by getting back to step aerobics and other strenuous exercise.  Instead I developed a very severe case of tendenosis.  This is a shredding of the tendon without inflammation, and it hurts like he***.  Even sitting down didn't relieve the pain and there is no good treatment except some PT and laying off any open chain and/or repetitive activities - like aerobics, jogging etc.  It's been about 2 months since I stopped the above and there is marked improvement, but not 100%.  This entire situation has been very humbling.
The good news is that within 8 months I had regained 100% of my quad strength which is critical to walking limp free, getting up from a seated position and doing stairs.  Granted I may have accomplished this at the expense of my tendon!  Maybe younger people don't have this trade off.
My OS told me that calcium supplements, milk, etc. take months to kick in and will serve you well in the future but have no effect on the present healing.
Best wishes to all of you in the healing process.  Do you leg lifts and all those other boring and seemingly stupid exercises.  They will pay off and you will get better.
Posted by Joy (Joy), 5 February 2004

Well, I've been discharged from rehab as of today.  PT said insurance ran out and there's nothing more they can do for me that I can't do for myself. I'm using 4lbs. on my ankles, walking 2.5 miles pace on the treadmill, using the stationary bike and I've not yet got full extension on knee extension.  Advice was to go back to the gym and work out there strengthening quads.  I still have this incredible feeling of tension inside my knee which bother the h-ll out of me and that nobody can explain to me.  Always feel as if my knee is taught elastic or that elastic is wrapped around it.  I haven't driven yet due to the pain in knee when I lift it.  What does scar tissue feel like?  Can you feel it?? Is all this due to the swelling?  I get different answers from OS and therapist.  My anxiety doesn't leave me.  Pat's post was encouraging, though.  

Joy


Posted by Joy (Joy), 5 February 2004

Have to edit:  taught elastic should be taut elastic.....
Posted by lizl (lizl), 5 February 2004

Joy,

That tight feeling is probably going to be with you for some time. Of course, I have no way of knowing how your tightness feels compared to mine, but you will have tightness to some degree even after you regain ROM. What is your ROM now?

That's a bummer about the insurance! I would think that the extension issue would be enough to warrant more PT, but some policies have a strict limit of number of visits, regardless of the condition. My PT told me that he has worked with stroke victims who are barely out of the wheelchair and have a limit of 20 visits.  I'm sure that your therapist told you to work on the extension. You'll never get rid of the limp, if you cannot get full extension.

I know you said that your OS did not schedule another appointment, but I think you need to see him/her again to discuss your progress. If he/she remains unconcerned, maybe you should seek a second opinion. And if you do get more PT authorized, you might even consider changing therapy locations, as well. I know nothing, other than my own experience, but it sounds like they have you working hard on strength, and I wonder if they have you doing much on flexibility?

I had pain in/under the patella when lifting my leg until after the hardware was removed.  Then again, you're only three months out and many of us still had lots of issues at that point--I know that is hard to believe, but three months is not enough time for complete recovery from your injury. I do believe, however, that not having full extension is a little unusual. Again, that's only unqualified opinion. . . How much off is your extension, by the way?

Three months is a little too soon, but you might be a candidate for hardware removal--so if nothing else, that's hope for the future.

LizL
Posted by Joy (Joy), 6 February 2004

Hi Liz and whoever else is reading:

To answer your question:

I am working diligently on regaining strength in quadriceps.  I was in rehab for 6 weeks, 3x each week.  The therapist said there's nothing more they can do for me and I would be fine continuing on my own.  She didn't want to request an extension. I have gone from barely lifting my leg to using 4lbs. on ankles.  Knee extension is probaly minus 5-10degrees.  Entire focus is on regaining strength in quadriceps.  PT assured me it would happen with patience.  My limp is very slight but it bothers me terribly.  I walk with a cane outside (lwhen I can walk) to maintain my gait.  My foot hits the floor differently now, which is probably because of the gait, and I get ankle pain.  I am told this will all disappear as soon as quads are back in action.  I am continually working on gaining full knee extension.  ROM is very good tho I couldn't give you any statistics; way past 90 degrees, can bend my leg back in bed almost as far as uninjured.  My knee is always slightly swollen,.  So, I don't want to be scared that I'm not where I should be.  I can visit OS anytime I want to really; I just want to wait a while and see how I progress.  I've been so anxious and even depressed that I have to rid myself of all that and believe that this will end soon and I will come back to normal.  Pat's post was very inspiring for me.  I need to have patience.  This is hard to deal with considering how this happened to me and decisions I've made.   Thank you all.  I need to have communication with others who are having a similar experience.

Joy
Posted by Pat_A.E. (Pat_A.E.), 6 February 2004

Joy, I can so vividly remember being where you are.  Believe it or not you are progressing well and no doubt will continue to do so.  I had only 3 months of PT twice a week so your therapist may be correct.  I worked out in my local park district gym between PT appts. and then at least 4 times per week when PT stopped.  
One word of warning.  I think my current situation with tendenosis may be a result of being too aggressive with getting ROM while the hardware was in place and then doing impact type of exercises (jogging, step aerobics) after the hardware removal.  I don't have a suggestion, just a heads up. For a time the tendenosis was as difficult to deal with as the injury - I could barely walk.  It is much better now but I just completed another 6 weeks in PT.
I know exactly that feeling of tightness in your knee.  I descriped it the same way - having a taut elastic band accross the knee.  I has only been the last month or so that it is almost totally gone.  I will deminish little by little but like everything else with this injury, it takes much longer then it should!
I think when the surgeons tell us we will be OK in 3 months they mean something totally different then our version of OK.  I recall asking my surgeon when I would be walking again.  His reply "With or without a limp?"  At the time I was willing to accept the limp just to be weight bearing and off crutchs.  Even now some of my friends who are doctors in or the medical profession are surprised I am still dealing with issues related to the injury.  I guess there are too few of us - thankfully  - for them to see alot of us in their practices.
Keep up the good work and hope you are driving again soon.  That made me feel independent and improved my outlook 1000%.
Posted by Joy (Joy), 6 February 2004

Hi Pat:

This is a trip and a half.  I never expected this to be so difficult.  My main focus in life is to get full knee extension.  I still have about an inch to go to have it level with my uninjured knee.  I think "okay" by the OS means the bone is healed.  They never warned of the aftermath.  Does your knee still swell?  I can't stand without getting discomfort.  On Monday I will begin my work at the gym.  I haven't used my membership in 3 months.  I work diligently at home using ankle weights on my leg and doing whatever leg lifts I've been doing at rehab.  I just feel as if I'm never going to acquire this last bit of strength in order to be able to do full knee extension and rid myself of the limp.  I don't plan to take any classes at the gym; I would hate to reinjure.  I will use the bike, treadmill, eliptical trainer and all the machines, especially the quad strengtheners.  I am really frustrated and emotionally upwrought from this entire "episode. " I can't believe how long the recovery is.  Pat, I like your posts; they offer information from experience.  I don't have that yet.  I can't even think of hardware removal yet.  I'm just hoping I'll be able to walk comfortably.  I'm going to try driving this weekend since I'm able to bend my knee now without pain when lifting.  

Joy
Posted by Pat_A.E. (Pat_A.E.), 7 February 2004

Standing was an issue for over 1 year!  My PT, who has been terrific and right on target, told me the standing pain comes from the tendon inflamation.  Do you still do icing.  I stopped after about 6 months and have started again.  It helps alot.    I have been fortunate not to have issue with swelling, but I know many others have posted this problem.  
Have you tried walking on the treadmill backwards?  If not, give it a try.  You will need to slow it down and probably hold on to the sides for balance.  It works a different set of muscles.  Look goofy, but works.
In order to gain full extension (which I have and then some) my PT would tell me to sit with the injured leg stretched out and then put the ankle weights just below or above the knee.  I would sit this way until I couldn't stand it anymore.  The extra weight causes the muscles to stretch.  I also would lay on my stomach at the end of the bed with a weight on my ankle and let the bad leg be pulled down by the weight.  
Again, I can remember feeling so depondent and at time angry.  To top it all off I was on vacation in Italy when I had my accident.  It was a fabulous holiday and it was cut short by 1 week.  So not only did I end up with the worse injury of my life,  lost a part of our trip,  the villa has refused to accept any responsibility for the accident, and I have lousy insurance which has resulted in some pretty substantial bills!  I sense you are similiar to me and you won't let this knee thing get you down for too long.  Just look at how far you have come.  This experience has given me respect for those who are permently disabled.   I am happy to share whatever I can with those going thru healing for this injury.
Posted by lizl (lizl), 7 February 2004

Joy and Pat,

For months, I did the walking backwards on the treadmill thing. I asked my PT today about it, and he confirmed that it helps with extension. He is also an advocate of the move Pat suggested of lying on your stomach and extending the leg over the edge of the bed. Add an ankle weight, when you can stand it and then start increasing the weight. By the way, send someone out this weekend to get you an ankle weight. The kind that has pockets for added weights is ideal. You can go from 1/2 pound up to 3 or 4 pounds, depending on the style you get.

Honest, Joy. This is going to get better. We are here to support you.  It is an excruciatingly slow process. Just try to believe that you, too, will make progress.

LizL
Posted by Joy (Joy), 7 February 2004

Hi Ladies:

Thanks to both of you.  I've been using ankle weights at home since I started outpatient PT. I'm going to try the exercises you suggest as well.  Walking backwards on the treadmill seems pretty dangerous, tho.  I have to accustom myself to being back in the gym first.  Thanks for your advice.  I'm just a hair short of full extension.  I keep trying.  Maybe today will be the day.  Pat:  I made my own problem with compensation for this injury which happened in my dentist's office.  I know him for years and we're pretty friendly so I have issues with compensation but I'm rethinking my decision.  That's also causing some emotional turmoil.  

I feel differences in strength every day.  There are new sensations in the knee every day. My PT told me to stop worrying, I'll be fine if I just keep working on regaining strength.  I have to believe her and you.

Thanks!!!!
Joy
Posted by Joy (Joy), 7 February 2004

Pat:

In answer to your question, yes, I do do icing but probably not as frequently I should.  The surgeon said there will probably be residual swelling from this injury.  The knees already look different from each other.  I don't seem to eliminate the swelling on the injured knee.  The knee feels best when I'm in bed.  Then I barely feel it at all.

Joy
Posted by Pat_A.E. (Pat_A.E.), 9 February 2004

Regarding the treadmill:  walk backwards very sloooowly!  Regarding compensation:  go for it.  Your dentist has insurance and is more then likely expecting a claim.  If someone fell in my office I would be on the phone with my insurance carrier before they where.  Unfortunately for me, insurance and claims in Italy are far different then in the States.  Recently I met an Italian attorney who was visiting friends in my town and she connected me with another attorney in Rome who thinks I do have a claim!!!! That's a whole different aspect of this ordeal.
Joy & Liz I can honestly say that there are times during the day this past week when I almost can't tell the difference  between knees  I think as long as I behave and stay away from impact exercises I will have longer and longer periods like that.  We are traveling to France for 3 weeks in June so my goal is to be 100% and walk and walk and walk. . . .
Joy, there are ups and downs.  The challenage is to focus on the ups!  3 months is not a good benchmark for your recovery.  Healing takes time and requires persistence.  You have both
Posted by Joy (Joy), 11 February 2004

Pat:

I sent you a personal e-mail.  Didyou receive it?Wanted to explain what happened with the dentist but didn't want to do it publicly.

Glad to say I'm making progress.  I have full knee extension finally,  but still have a slight limp.  I thought that goes away with full extension.  Am at the gym now, work very hard, but am not sure if what I am doing is correct.  I have hired a personal trainer to guide me. I also use ankle weights at home. I still have the band of tightness across my kneecap which is an impediment to walking.  I am unable to reduce the swelling for long periods of time.  Any suggestions anybody? I am determined to get through this as quickly as humanly possible.

Joy
Posted by Pat_A.E. (Pat_A.E.), 12 February 2004

The tight feeling was with me until recently.  At times it is still there but not nearly to the extent of even two months ago.  I think it has something to do with the tendon.  Neither the OS or PT could give me an explanation for the sensation.
I limped slightly for many months, especially when I was tired or walking at a faster pace.  When I stopped and thought about the proper foot placement for walking - which I learned in PT - I could actually make the limp go away.  I do remember, though, thinking that I wasn't limping only to have the therapist or a friend tell me I was.  I'll bet you it will be mostly gone soon and totally gone within the next 6 months.
The personal trainer is a great idea.  Not only will he/she help you with regaining quad strength but help with other area also.  Even at my age (55 at the time) I was able to regain 100% of my strength with 6 months.  It is very frustrating now to not be able to do any impact exercise due to the tendonosis.  However, it is actually getting so much better that in time I may be able to resume those activities too.
This morning on the treadmill I recalled thinking 1 year ago this time that I would never be able to do a 15 min. mile, and now I can!  So will you.
Posted by corylus80 (Corylus80), 17 February 2004

Um, Hi...  

Just joined your board, it looks fab!!!

Jumping in at the deep end (I wish!) my "story" starts way back in May last year (03).  

On the way to work (as a physio assistant would you believe it! hehehe), huge car crash - wrote my car & my legs off! Well, wrote the car off anyway - legs are getting better but soooo slowly!  I fractured my right femur in 2 places & thats only just started callousing but it HAS started now.  Uh, my left patella caught a stellate fracture & the chaps at Frenchay hospital (Bristol UK) decided to wire it & stick some screws in it.  

Long & the short being I'm now facing an arthroscopy combined with a lateral release.  OA has been detected & I'm really bothered about the best approach to this whole situation-should I just say "take the damn patella out"?  As my ROM in that leg is sadly lacking, angle of 110 on a good day, at 23 I'm just not prepared to leave it imperfect - I want "equal leg pain-free capability!!!"  So I have an appointment with a cranial osteopath to help with the pain and hopefully increase some movement; and with my Consultant in a couple of months. (I'll post after the apptmt with the Ost and  how it goes if anyone's interested.)

Thanks for any input as to the long term hints with the patella and OA?  

BB, Hazel  
Posted by lizl (lizl), 17 February 2004

Hi, Hazel!

My understanding, unqualified at best, is that keeping the patella is tremendously important. I have heard so many people on this board say that patella removal was a big mistake for them.

My patella fracture was in January of last year, and I was stuck with 95 to 100 degrees of ROM until I had the hardware removed in December. What I'm saying is that 100 degrees of ROM, at this point, may not be so hopeless for you, since you still have hardware in and around the patella. Of course, if you still have non-fusion issues with the other breaks, you are probably not ready for any additional surgery.

One other thought--it might be worth asking if you should wait on the LR until you've had the hardware removed. It seems to me that the whole mechanism might work differently in a hardware-less state. I think I'd want to see what impact that would have before going for the LR.

Welcome to the board!

LizL  

Posted by Xanthipe (xj), 19 February 2004

Welcome Hazel,

From what I have heard, taking the knee cap out CAN be a nightmare (my PT has said this should be avoided at all costs). Please get all the information you can, and as many opinions as you need, before deciding to do this at 23.

I too was in a terrible car accident and broke by kneecap (over a year ago). I am back in PT now (for the last 2 months) because even 8 months after my 1st surgery, I could not manage my standing job (10-16 hours/day) and the level of pain during simple water exercises was increasing.

At this point, I may need a third surgery, but I am going to make sure that I take a conservative approach before having anything else done again...at 30 I don't want to start going down the path of having a surgery after surgery to "fix" my knee.

Best of luck and please do take as much time to make a decision that you feel comfortable with. Patience is difficult, but essential is this long recovery process.

XJ


Posted by corylus80 (Corylus80), 19 February 2004

Thanks!

I've been wading my way through the zillions of messages on these 'boards and there are some great ideas but I wasn't sure how they'd relate to me so thanks for the reassurance!  

It sounds like I have a looooong way to go yet but I make a good tortoise! - just keep plodding along, albeit with a crutch!

It's wierd concentrating so much just on my legs!  It's refreshing to have a great reason not to do hideous January diets!!!  But all the walking is good!!!    Just gotta smile!

Thanks again,

Wazel

Nice to find this board.  I fell on some ice and fractured my patella on Feb. 3, trying to be an "essential employee" at my job.  Now we know how essential I am!



The top half of the patella was intact, but the bottom was in "several" pieces, according to my doctor.  The put in two screws and a wire around the kneecap.  I was just in this past week for x-rays (which look good), and to have my staples out.

Reading others' notes has been a wealth of information and encouragement, but I do have a question... I have this big brace (Bledsoe) on, from mid-thigh to ankle, and the doctor just gave me 30 degrees of movement.  I'm not sure if I should be moving it, though, since it hurts like the deuce when I do.

Of course, there is the continual battle of boredom, and I've read several novels recently... it's so good to find this group.  Hope to hear from you soon!

ByteSize

My OS has a great nurse and he will always call back on the same day so that is the best way I can get my questions answers. You might be able to ask him about range and brace and showering..Otherwise, you might want to wait on doing ANYTHING before your first PT visit!!!!

Yes a medical supply store might work, but for me, I could not get my leg over the wall of the bath tub with the types of seats that they provided.

In fact, I could barely get it over the lip of the shower after I got back from the hosptial...I put a HUGE garbage bag over the brace like a dress with the open side toward the shower's floor and cut out a hole in the bottom of the bag to fit the size of your upper thigh. It works very well, but takes a bit of time and help to get assembled. The H20 simply runs off the bag and down. Once I had a shower, I felt so much better because I was clean. You will need help getting in and out; i needed it, but it is worth very minute. I must have stayed in a long time, but at the hosptial the said to stay in for a short while until the stiches are removed...at that point I was  that for a ms the pain was completely forgotten.

Best,
XJ

Thanks for the information, everyone.  I guess I have all the equipment (a shower stall, a hand-held shower head, and a husband), except for the shower seat.  My main impediment is just courage, because I'm fearful of what could happen if I take the brace off of my leg.

My husband, in the meantime, is urging me to take a shower.  I don't think that I have BO, or anything like that, so I'm not sure what the deal is with that!  

At any rate, I find that the idea of certain things has now become intimidating, and I have to find the way to get over the "fear factor" and move on with my life.

Again, thanks for the suggestions.

ByteSize

LizL -- you are right, I broke my patella, surgery was on 2/3, and staples have been out for about 1 1/2 weeks.  I feel like a wimp, being so fearful, but I just don't want to hurt myself, or give myself a setback in any way.

Well, if Eric (my hubby) is up for helping me out, maybe I will suggest getting a shower chair.  While my mom was out, she actually shaved my legs for me (which made me feel like a new woman!) so I think I can endure for awhile.  It was just that they were starting to look like something that belonged to a gorilla, instead of a human female!  

I definitely should put details about my injury in my profile... still learning the ropes around here, so thanks for the suggestion!

ByteSize

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.

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