DIARIES => Post-op diaries (<50 posts) => Topic started by: sabasc3 on October 17, 2009, 02:13:49 AM

Title: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on October 17, 2009, 02:13:49 AM
Hi everyone, I figured I'd join the diary writing club, so I can provide more detail than my signature allows.

Fell and broke kneecap on sidewalk - lateral displaced fracture of the right patella into two pieces.
My daughter's friend's mother recognized me as she was driving by and with the help of a kindly passerby and a shop clerk, carefully loaded me into her minivan.
At Urgent Care clinic, received morphine shot and had x-rays.  Attending OS reviewed x-rays and confirmed diagnosis of triage MD.  Fitted with immobilizer and discharged.

Appointment with attending OS,  He was really great at answering my questions.  He arranged to perform my surgery on 09.18.09.

Admitted to hospital for surgery: 2 pins 2 wires, small fix to (right?) retinaculum

Hospital stay -- OS visited and said repair went very well, and that my patella cartilage felt smooth and continuous when he palpated it.
Great bedside manner :)

OS visited again and gave my discharge instructions.  He also helped me change the dressing on my incision as it seemed a bit tight and I couldn't feel my right foot. 
Hospital discharge

Feeling in right foot is restoring.

Feeling in foot is almost completely restored.
First post-op OS visit:
- staples out
- fitted for brace, w/ROM set to 40
- Rx for PT 12 weeks, 2 times a week.

Scheduled my 12 weeks PT.
First PT appointment w/ice&TENS target ROM 30
My primary physical therapist is very gentle and careful. 
I will visit her and another PT who will fill in when my primary PT is unavailable.

Feeling in foot is back to normal. 
Observed redness at the last inch or so at the thigh-end of the incision; I suspected minor infection & made appointment to see OS later the same day.
Tried to go to work.  Not too painful at first but very achy and fatigued at end of the day.  Got green light from manager to apply for short term disability.
Second post-op OS visit:
Redness was due to rubbing of the brace, not infection -- whew :)
OS observed my ROM and updated target ROM to 50

Got my own portable battery powered TENS unit (also does EMS).  Name of the unit is "Twin Stim".

PT appointment - the other PT got 63 ROM, with no pain, just tighness! :D

10.16.09 - 4 weeks after surgery.  Knee is much stronger.  I can contract my quads with no pain at all.  Looking forward to strength training at the PT clinic on the bike etc.  In the meantime I'm lying on my side and gently using my leg muscles to slowly extend and bend my leg ( pain free :) ), contracting my quads, doing heel slides, and RICE (rest, ice, compression, elevation).  Walking with a rollator almost everyday too.

Stay tuned ;D
Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on October 20, 2009, 10:23:29 PM
10.19.2009 - just used up the battery that came with my TENS unit.  On to rechargeable NiMH batteries.  Hopefully they'll last at least as long between charges.
10.21.2009 - PT apppointment in the AM.  Expecting PT to try for 60 ROM but I think I already have that ROM now :-).  Next week I should be able to start strength training at PT. 
Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on October 22, 2009, 07:34:30 AM
Today's PT session confirmed 60 ROM flexion. 

Rode the bus to and from PT appt. and spent a few hours at playground with daughter.  This walking etc. was good for strength but wore me out.  I was very fatigued around 5 PM.  I put shoes on (running shoes with laces) for the first time since the accident.  That made a big difference in stability and comfort.  I was wearing sandals (simple plastic foam with strap over the metatarsals) at first because they were easy to get on and off.

Sleep: Lunesta worked well for me, I noticed only one minor side effect: slightly altered sense of taste.

Started strength training of hip area and hamstrings at PT office.  Waiting for clearance from OS next week prior to quadriceps strength training. 
Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on October 26, 2009, 06:59:49 PM
I just got a great result on X-ray today.  My fracture is barely visible!
OS gave me the green light to start light quad strengthening and to walk in my brace set at 40 degrees flexion. 
That made a BIG difference in my ability to walk smoothly. 
My flexion estimated today by OS is around 80-90 degrees.
My next OS appointment is Nov 23 and he thinks I may be able to come out of the brace then. 
Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on October 30, 2009, 05:47:13 AM
Started strength training at PT office Wednesday.
Pain was significant but quite tolerable.  I couldn't lift my straight leg off the table yet, but pretty close.
I got to do some rocking motion on the bike (actually went over the top but then PT advised me to wait until next visit to do more full circle pedaling)

Today I tried lifting my leg at the knee-end of the femur (with my hands) and was able to hold it straight. 
It was kind of painful but I could hold it, so I hope that between more PT visits and my home excercises that soon I'll be lifting without my hands helping. 

09-09-09 - Broken! (
09-10-29 - 5 weeks after surgery (pic 1) (
09-10-29 - 5 weeks after surgery (pic 2) (

Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on October 31, 2009, 07:48:32 PM
;D Woo-hoo! ;D
I finally did a straight leg raise (10 of them actually)!!!
I first tried it with my brace on while standing and made it to 45 degrees or so.
Then I took the brace off and tried it in bed.  It feels a little sore but very doable. 
Previous attempts (at the beginning of the week) would result in a quivering quad and moderate pain. 
I'm so happy to reach this milestone!
Title: Dead air (radio silence)
Post by: sabasc3 on March 12, 2010, 03:46:08 AM
Where in the world is Scott????

Hey folks, pardon my extended absence. 
I was laid off at the end of Dec and my family decided to finally act on a plan we've had in mind for quite some time.  Relocate back to New England.  We are now in central Massachusetts, and I have pretty much recovered from my patella fracture except for residual atrophy of the right quad.  I have a surgery date to pull out the hardware (new OS - Dr Paul Pongor in Marlborough) on April 2. 
The hardware makes my right knee warmer to the touch (after a full day's activities) than my left, and there's a persistent pain around the periphery of my patella.  I'm looking forward to getting the pins and wires out. 

My latest two x-rays visits show that I broke the wire where it passes through my quadriceps tendon (imagine a break like this / \ at the midpoint of the uppermost part of the wire in the image below - I don't have a file with the broken wire x-ray). 
09-10-29 - 5 weeks after surgery (pic 2 - front) (

Speaking of unemployment - if anyone has any leads on software QA positions in central MA (or toward Boston metro area) please let me know via personal message.


Title: Re: Diary of Scott's right patella fracture recovery
Post by: jackiek on March 20, 2010, 09:25:11 PM
Hi Scott,
Glad to hear you've moved to my old stomping ground. Lived in Brookline Ma between 1993-7. Lovely state. Hope you find work there. Plenty of computer businesses so you should be ok.

As regards the injury, I have been off Knee Geeks for some weeks now. Trying to wean myself off obsessing over my knee and getting on with my life. But your email to me sparked my curiousity. Yes my knee is always hot when I have done excess exercise. I have just returned from a trip to Sri Lanka to get over the last six months of pain and no sleep. After a yoga session, it got very hot and the long flight also got it going as well. It still hurts to climb high stairs (think the quad is still too weak and I have got very lazy with exercising) and sometimes the patella gets off-track so there is pain...explained by the VSO ???? muscle on the side (can't remember its name). Also sometimes the knee gets quite stiff. But I did an 11 kilometre walk with my walking group a month ago so I am quite proud of myself for that.

I see a OS in about two weeks (last appt three months ago). Here, they don't take out the hardware unless its causing problems. But I guess in your case, its necessary. Anyway best of luck for the next op. Keep us updated.
Title: Hardware out tomorrow (2010 Apr 2)
Post by: sabasc3 on April 01, 2010, 06:33:27 PM
Hi folks,
I am going in for ORIF hardware removal tomorrow morning.
I'm searching the 'geeks postings here for clues as to how long people were out of commission after removal of pins and wire from patella.
If you care to reply here, thank you.  I will post excerpts of, or links to, posts I find regarding the subject.

Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on April 03, 2010, 11:54:36 PM
I had a really easy time with my hardware removal so far.
Yesterday, my OS (in Massachusetts) took out the hardware (put in by OS in California).

I had the best experience I've ever had under general anesthesia. 
I received a scopalomine patch and an oral anti nausea medicine sometimes given to cancer patients, prior to surgery.  I didn't feel the least bit nauseous during recovery at the hospital or after.

I also had a femoral nerve block which helped me stay pain-free until around 24 hours later.
My hardware removal incision is shorter (along the original scar) and covered with a waterproof clear dressing.  I'm delighted to be able to bear weight, do a straight leg raise and move it (albeit with limited ROM while the incision is fresh) and shower with it.

The only unfortunate thing about the femoral nerve block is that it also prevented me from being able to contract my quads until the block wore off.  I absent-mindedly forgot this just long enough to have it buckle under me.  Fortunately I had something to grab onto to break my fall. 

Quads are working fine now. 

I'm hoping my ROM and strength will return fully to pre-op levels and beyond very soon.

Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on April 05, 2010, 03:54:46 PM
I'm off the pain meds!  Just ICE (Ice Compression Elevation) periodically.  Slept ok last night.
Pain is really mild now, more of a tightness.  I did a slow walk up a flight of stairs with no pain, but not a fully normal gait since I'm still trying to avoid bending beyond about 70-90 degrees while the incision continues to heal.   
Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on April 05, 2010, 04:19:28 PM
I forgot to mention that I have stitches instead of staples this time around.  They are the kind that dissolve, so my follow up appointment with OS should just involve checking my incision health, ROM, (lack of) pain etc. 
Title: Re: Diary of Scott's right patella fracture recovery
Post by: grandmalinda on June 23, 2010, 05:31:45 AM
Have been reading your diary  Scott, and am particularly interested in your hardware removal. I , too, fractured my patella in Sept of 2009.  It was my left one, but that's really beside the point. My OS told me in December, that he absolutely would not remove any hardware until it had been at least a year, so don't even ask. He also told me that if I felt that I needed to have the hardware taken out, to schedule a visit a couple months in advance. To make a long story short,,that time is almost here,,I have some swelling and lumps on my knee, and of course, the constant dull ache, so I am very anxious to try getting the hardware removed. Thank you for posting your experience with this part of the recovery. Wish me luck in trying to convince my OS to do  my surgery a little early.
Title: Re: Diary of Scott's right patella fracture recovery
Post by: Greta on June 23, 2010, 12:35:43 PM
If you are experiencing problems with your hardware - persuade them to remove it!
Read my other posts and you will see what I have been through, and how - as LostPirate put it - having it removed is like the difference between night and day.
We are all different, and all OSs are different, but I was making no progress in my ROM, and it had to go. It was scheduled to be removed in February (6 months after it was put in) and even though I am 70, they must have considered the healing had been sufficient. In fact, due to a persistent (UT) infection it wasn't removed until May - 9 months after.
But I've not looked back since - so I hope you can persuade him to remove it
Keep us informed and good luck ;D
Title: Re: Diary of Scott's right patella fracture recovery
Post by: sabasc3 on July 13, 2010, 06:00:33 AM
...interested in your hardware removal ... trying to convince my OS to do  my surgery a little early.

Hi GrandmaLinda,
Sorry for the delay posting a reply.  I am sooo glad I got the hardware out.  ;D

I healed and continued to increase ROM without any further PT appointments, and now I'm back to my full range of activities, including walking, hustling to keep up with my 6 year old daughter, biking, and swimming.  Climbing stairs, biking and other full flexion activities don't bother my knee anymore.  The swelling's gone too.  As some have observed in their own knees (and my original OS mentioned), my repaired patella is larger than before but not drastically so.   

One interesting artifact: when I press and gently rub my R patella I can feel the tracks where the figure 8 wire was, so I assume bone grew around the hardware (kind of like how a tree grows around a foreign object like a fence -- see below).   

Another artifact I noticed is that the stapled section of my incision has a different scar than the sutured part.  The second OS (hardware removal) closed with dissolving sutures after retracing a part of the original incision closed by staples.  The sutured part left kind of a wide scar, whereas the stapled section left a very narrow scar. 

My OS here in MA was fine with taking the hardware out as long as I didn't do any intense sports (no basketball for example) after he removed the hardware.  Sometimes my post-surgery knee actually feels better than my other knee :-).

Right/Left ROM difference is negligible, with only a bit of tightness in full flexion of R knee.

All in all I am so grateful to have had access to modern medicine to fix this fracture, as I expect I'd be partially crippled without the fix.

Like Greta said, I hope you can get approved for hardware removal! 
Let us know how things go for you, GrandmaLinda!
Title: Re: Diary of Scott's right patella fracture recovery
Post by: Greta on July 19, 2010, 04:51:22 PM
Scott - interesting what you say about the scar.

First time round I didn't have staples, I had one continuous stitch which was removed about 2 weeks after the operation. The incision ended up a slightly prominent but narrow white scar.

With the hardware removal, they did the same as with you, went down the side of the original incision. I had soluble stiches, and I until you mentioned it, I hadn't noticed it was a wider scar. All is healed well, though it is very pink still. No doubt this will fade. I have noticed over the last few days it has been quite tender,  but the PT did some quite aggressive massage last week and manipulated my patella a lot side to side and up and down, so this has probably been the cause. Fortunately it is very free, which has to be good news. 

 I thought your tree simile was marvellous! They told me that the wire I had although was 'protrusive' was also very firmly embedded, so I think they had to dig around a lot to get it out. Glad I was asleep and knew nothing about it. I think I also have ridges, but this is nothing compared to the ends of the wire which were sticking out just under the skin.

My ROM is now 95 - my PT measured my other leg last week and the ROM there is only 117, so it would seem I don't have all that far to go to match the two legs. However, I appreciate that this last bit will probably be a long time coming. Being nearly a year since the fracture, I am resigned to not trying to rush things. My project is to stretch my hamstrings and quad tendons, this I am finding quite hard work, and a bit painful but they have been 'unstretched' for so long, it is not surprising that they are tight.

My OS didn't seem to think I needed a lot of PT as I knew all that had to be done, but the patella manipulation is something I would rather someone else did, so it is worth going for that, and the stationary bike (which I can only rock - couldn't possibly go all the way round). I am lucky in that I don't have to pay for PT (UK - NHS) and I do have a PT I trust and have confidence in.

Getting there; slowly and surely is the nature of the game as we all know!

Title: Re: Diary of Scott's right patella fracture recovery
Post by: Mrs.W on August 12, 2010, 06:06:04 AM
Hi Im Cris.. I fractured my left patella in 2002- Fell down a flight of concrete stairs- though still managed to drive myself to the ER in
 my 5 speed GTI... with my then 5 year old daughter in tow, convinced I had only dislocated it- only to be told that all I had was a hematoma.  After making a big fuss, I got an xray to confirm a horizontal fracture. Fought for 3 days with insurance company for surgery which was finally approved. Had surgery,  wires & screws, and 8 years later, all I can say is that I have been in PAIN. I also believe my left quad is atrophied (sp?) I went to PT 3 times  but when the freaky woman decided that the result of my accidents (I also fell off a horse in 91 and shattered my left ankle requiring surgery) was 'weak stomach muscles' and began deep tissue masage of my abdomen, my young and stubborn mentality took me running out of that place determined to do it on my own.

Now I am 34 year old stay at home mom of 3, & I have no insurance. I NEED to do something about this I can't live like this anymore. I am in constant pain. I m reasonably active working out at a gym 3-4 times a week... I have a pretty wide range of motion considering ... & I don't limp anymore... up & down stairs just fine. (down took a while to master) but pain sometimes keeps me up at night & Im NOT a pill popper so I try to stretch it out to no avail.

I am pretty sure the hardware removal would really help because I had the hardware in my ankle removed the year prior to the patella fracture and the pain there is now minimal... only when it rains ;)

I suppose I'm just needing some emotional support from those who understand my predicament...

Oh & does anyone's knee sometimes buckle out of nowhere?!!
Title: Re: Diary of Scott's right patella fracture recovery
Post by: grandmalinda on September 19, 2010, 06:04:13 AM
Okay, I am scheduled to have my hardware removed on the 22nd of Oct. I hope it helps my knee feel better. It would be so great to be able to get up and down stairs again with little or no pain, it would be great to not have that constant ache. I am also wondering,,,if I happen to put any weight on my knee,,as I used to normally do when making my bed and spreading the sheets, it feels like I am kneeling on a dozen stinging nettle plants. Do you think the hardware is causing that? ( or am I just being a wimp? ) Anyway, I think I could really use some encouraging words about this. Thanks so much.
Title: Re: Diary of Scott's right patella fracture recovery
Post by: Greta on September 19, 2010, 08:20:57 AM
Hi Grandmalinda
Yes I am sure the stinging nettle feeling is your hardware. If you look at my other posts you will see I described the feeling as exactly that, and I have not experienced it again since I had all the metalwork out in May.
Also the continual ache will go - I hadn't realised this was there all the time and it was only afterwards that I realised it had been there but my body had accepted this as normal so I didn't notice it.
I don't thing you should - or any of us for that matter - ever think of yourself as a wimp. What we have had is a very serious injury, so rare that you are unlikely to meet anyone else who has had it, and there is no doubt that it is lifechanging. Thank goodness for this site where you find you are not the only one to go through it.
As you will see if you read my posts, after nearly 14 months I am still not out of the woods yet but we are all different and I seem to have been unluckier than most. But I do think that the best thing that has happened so far is the hardware removal!
I was very encouraged yesterday when my daughter, who hadn't seen me for about 3 weeks said "Mum, you're walking like a normal person"  I know it may seem silly to be pleased to hear something like that but every day a milestone seems to be passed.
Good luck with your op - it's nothing compared with the first and you just won't look back after it!
Title: Re: Diary of Scott's right patella fracture recovery
Post by: Ops on November 15, 2011, 09:28:32 PM

i went through the exact same thing except im from such a small island and the physio at the hospital is not very helpful and does not have any equipment for me to work on my leg also the other only pt here cost 60 dollars nz for half hour could you please send me info on the exsercises you did to strengthen my knee and quads its been 6 weeks after my surgery and i had the same pins and wires put in how long did the whole thing go for?

please reply im begging you