KNEEtalk

DIARIES => Post-op diaries (<50 posts) => Topic started by: kuiper138 on January 07, 2014, 05:02:50 AM

Title: Left Patella Fracture and Recovery
Post by: kuiper138 on January 07, 2014, 05:02:50 AM
Hi everyone! Since I fractured my patella a little over two weeks ago, I have been reading though this site. It can be hard to find information on patella fractures, and it seems like everyone's recovery is different, so I thought that I would post my story here.

About me- I am a 25 year old male in pretty good health. I'm not really athletic, but I work out from time to time and try to stay active. Before this, I haven't had any major health issues. I'm a grad student, and fortunately can do most of my work anywhere using a computer.

On 12/20/13, I was on my out to do some Christmas shopping when I slipped on a patch of ice in my parking lot, landing smack on my left kneecap. When I landed, there was an audible crack. There was a moderate amount of pain, and when I looked, it was clear (through my jeans, mind you) that the knee was convex rather than concave. My first thought was that I had just displaced it- oh, how wrong I was!

I tried to stand up, but as soon as I put weight on my left leg, I toppled over onto the wet pavement. I managed to pull myself up and hopped over to my car, which fortunately was only a few feet away. After levering my bad leg in, I drove myself to an urgent care center about a mile from my apartment. I called the center from my car and persuaded them to bring me a wheelchair (at first they only offered to bring it to the door!) and was wheeled inside.

Luckily for me, the pain in my knee wasn't too bad while I was waiting. I even felt a little guilty, since the others who were waiting seemed like they were in pretty bad shape, while I was having fun rolling around in the wheelchair. After two hours, I got called back. The doctor looked at my knee and sent me back for x-rays. As I watched the technician in the control booth, I saw his eyebrows go up and him mouth 'wow'! This is when I knew that something was wrong!

Long story short, my left patella was fractured into three pieces, which were clearly in different parts of my knee. I was taken to the hospital and scheduled for surgery two days later.

The surgery went smoothly, though it apparently took a half hour longer than expected, due to the break being worse than thought. I now have three pins and a wire in my knee. I didn't have anyone in town to take care of me, but luckily my parents were able to come up for the surgery. I was kept overnight for observation and released the next day in a leg immobilizer.

Although I live in Michigan, I wanted to do the first part of my recovery at my parent's house on the east coast. Due to a power outage, we left MI as soon as I was out of the hospital. Over the next two days, we spent about 14 hours driving to my parents house. The ride was bearable (I didn't drive, obviously), mainly due to frequent doses of percocet. Now I am safe and sound on the east coast, waiting for my leg to heal.

Two weeks later, I am feeling a lot better than I did at first, and am able to hobble around pretty well. The last time that I took pain meds was a week after surgery, and I have been ok since. I am wearing the immobilizer all of the time. Today was my first followup appointment, and the bone seems to be staying together. I start physical therapy later in the week, which promises to be fun/painful.

A few observations on post-op life:

Pain: I was in moderate pain for a few days following surgery, but at no time during this have I been above a 4 on a 1-10 scale. At no point have I been screaming, so that's good. For a bone break, this seems like a low pain injury.

Getting around: I am on crutches, mainly for stability. A few days after surgery, I was able to put full weight on my leg. I can shuffle around without the crutches, but don't feel very steady.

Sleeping: Uncomfortable for the first few days, but I am getting used to sleeping in the immobilizer.

Driving: I did go out driving a week ago and didn't have any major issues. I needed to move the seat all the way back in order to fit my leg in the car.

I think that's about it for now! I am trying to play it safe with bending the knee, since I am afraid that I will re-injure the knee if I push it too hard. That's what physical therapy is for! I'll try to post further bulletins as events warrant.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 08, 2014, 07:42:20 PM
Had my first physical therapy session this morning! Today's session was partly an evaluation, so I was not in much pain afterwards. I can currently manage about a 35 degree ROM in my knee. Looking at my left leg next to my right, it is clear how much the muscles have atrophied. The therapist gave me a few exercises-just simple muscle contraction at this point- to help get the muscles going again. I also had 15 minutes of electrostimulation in my leg to help get the muscles working.

I'm feeling pretty well today. After therapy I went out for a drive and managed to pump gas by myself. Since I am planning to go back to my apartment in a few weeks, I want to see how much I am able to do on my own.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 10, 2014, 11:44:42 PM
Today marks three weeks since my injury. The leg looks a lot worse than it feels. The surgeon wanted me to have a few physical therapy sessions before getting the staples out, so hopefully that will happen next Wednesday. The left leg has definitely lost muscle, and still has a lot of bruising from the surgery. It is getting better though. I'm not really in any pain, other than some stiffness from having my leg extended all the time.

My PT is focusing on getting my quad muscles to reactivate and strengthen. A good chunk of therapy today was doing electro-stim to get the muscles to flex. Aside from that, I was able to get a 50 degree ROM today on my own. The PT says that for the first few weeks, we will be working in the 0-30 range, so I am not expecting too much pain.

Outside of therapy, life is pretty good. I am hobbling around without my crutches some of the time, which makes it easier to carry things. I do my exercises and icing regularly. Otherwise, I have just been working and relaxing!
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 13, 2014, 03:35:20 AM
So far so good, three weeks post surgery. I hope that the patella is on the way to being healed. From what I have been reading, it takes the bone itself about 6-8 weeks to mend, but there is a lot of variation. Even after the bone is knit, it will be several weeks before I am likely to be back to full mobility. What this injury lacks in pain it is making up for in rehab!

I was out and about today without any problems. In the morning, my parents and I went over to visit some relatives. I still haven't found a good way to sit in a non-reclining chair while wearing my immobilizer. If I try to sit normally, the back support digs into my thigh. More comfortable is to sit on the front of the chair and lean back, but of course this looks funny. Every chair is different, it seems.

After that, we stopped by the grocery store. This was my first time walking around a big store on crutches, although I could have done so before now if I had wanted. I was happy to find that I could get around the store with no problem, and was even able to carry things in one hand while holding the crutches under the other arm. I figure that when I go back to my apt, I will rope someone into going shopping with me and will buy a month or two worth of non-perishables, then will make the occasional trip out when I need milk or something.

Speaking of crutches, I have pretty much ditched them for moving around the house. I am getting good at shuffling around while carrying things. The only time that I need to use the crutches is when I am going down the stairs. I also still use them when I am walking outside.

I have been icing my knee 3-4 times per day to try to get the swelling to go down. The knee isn't that swollen, but is still worse than the other knee. Part of the top of the knee has felt numb ever since the surgery. I am not sure whether that is from the swelling or the fracture. I mentioned it to the surgeon at my last appointment as well as the PT, but they don't seem too worried about it. I am still doing muscles flexes in order to get my quads going again. Looking forward to getting the staples out later in the week!
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 15, 2014, 11:58:26 PM
I had my staples out today! The procedure was painless and took less than a minute. I have some thin bandages on right now, but I am sure that the leg is going to look much better once they come off.

X-rays show that the bone is staying together.There is still some swelling, but that seems to be going down with icing. The bruising on my leg is slowly getting better. I still have some numbness around the top of my knee, but the doctor doesn't think that it is anything to worry about. I'm guessing it is a nerve problem that came about during the surgery.

After my appointment, I stopped at the grocery store to try doing a load of shopping on my own. I was able to hobble around the store without any pain, using the cart as a sort of walker. I am pretty much limited to the amount of food that I can fit in my backpack, since that is how I need to get it upstairs while I am on crutches.

At this point, I feel like I am almost ready to live independently again. I am tentatively planning to go back to my apartment in a week and a half, assuming that I still feel good. My job is flexible enough that I can probably work from home for three days a week and just go in for meetings/seminars. Here's hoping! I'll let everyone know how it goes.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 20, 2014, 11:07:41 PM
Four weeks post op update:

My quad is noticeably stronger after a week and a half of therapy. Once my doctors figured out who had what prescription, I finally got my own home electro-stimulator unit! Now, I am at the point where I can flex my quad at will and can just barely lift my leg up straight. So far, I have only tried lifting it a few inches, since it hurts a lot, but once the muscle is a little stronger I will probably start doing straight leg raises in PT.

My leg is looking a little better now that the staples are out. There is still some swelling, but not as much as before. The hair on my legs is growing back. Normally, my legs are pretty hairy, so it looked pretty weird when the surgeons shaved the middle third of my left leg. The bruising is getting better, and should be gone soon.

I had thought that since I am relatively inactive that I would be gaining weight, but instead I have lost a few pounds. Probably most of it is from my leg muscles wasting away.

No real pain to speak of these days. I am able to get around on my own and should be fine to go back to my apartment soon. I will still be wearing the immobilizer for a month or two, at least when I am walking.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 22, 2014, 11:42:42 PM
"Phase II"of therapy has begun, and it is not as easy as Phase 1! The first phase of my program focused on quad contraction and <30 degree ROM. The second phase focuses on strength, walking, and getting my ROM up to 90. Today, my ROM was around 65 and the therapist spent a lot of time bending the leg. Of course, if the leg wanted to bend, I wouldn't be in PT! It is an odd feeling when I bend my leg- not exactly painful, but when it reaches a certain point, it just doesn't  want to bend anymore.

Feeling good afterwards. More icing and exercises later tonight.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on January 28, 2014, 12:46:06 AM
Five weeks post surgery! I had my final appointment with my surgeon on the East Coast today. Next week, I am going back to my apartment.

Everything is still going well with my knee. The surgeon seemed a bit disappointed that my ROM is still only around 65 degrees. He bent it to around 80, which hurt! I think that my PT is being too gentle with me- one drawback of going to a university PT clinic is that most of the PTs are college students who want to coddle you when you are hurt, rather than causing you pain. I'm trying to do some more aggressive bending at home. The bone is held together by titanium screws, so I'm not in danger of pulling it apart.

My quad is strong enough to do straight leg lifts now. They still hurt, but I don't feel like I am going to pull a muscle like I did before.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on February 04, 2014, 03:45:30 AM
I'm now six weeks post surgery. My knee is healing. I'm back in my apartment now! My mother helped me to move everything in and get myself situated. While she was here, I bought a big load of non-perishable groceries, so hopefully I won't need to make too many trips to the store for the next month or two. I was also able to get a handicapped parking placard, so I shouldn't need to walk to far in any case. Inside, I don't have a problem getting around, but the roads and parking lots are often icy or snowy here, so I worry about falling whenever I go out.

My range of motion is at about 80 degrees now. In PT, I was going back and fourth on a stationary bike, even though I can't do a full rotation. The protocol that my PT was following had me working in the 0-90 range for weeks 5-8, so for now the goal is just getting comfortable going to 90.  My quad is getting stronger. I am doing straight leg raises every day. I am trying to get my leg to move more naturally- right now whenever I want to move it, I first need to consciously tell my quad to flex, then move my leg.
Title: Re: Left Patella Fracture and Recovery
Post by: rbfd19 on February 05, 2014, 01:49:24 AM
Just read your diary.  Man you've had a hell of a journey.  Sounds like you're going in the right direction.  Best of luck.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on February 09, 2014, 08:23:37 PM
Thanks for the well wishes rbfd19! It has been tough, but I think that I have been pretty lucky overall. Between being fairly healthy overall, having a flexible job, and a supportive family, this process has been a lot better than I was afraid that it was going to be.

That being said, I am now seven weeks post surgery and am still working on my recovery. I have been back in my own apartment for a week without any problems. Everything in MI is cold and covered in snow, but I have not had as many problems as I thought that I would in getting to my car and back. As long as I go slowly and use crutches, even the slushy parking lots aren't too bad. Before I came up here, I bought a new pair of hiking shoes which give me better traction on the snow.

I went into my office for the first time this week. It was good to see everyone and get back in the swing of things. I mostly sit at a desk all day, so my leg doesn't bother me that much. Other than using the elevator to go from the 2nd to the 3rd floor, I am back to my old routine.

My doctor (the guy who actually did the surgery) thinks that the bone is healing well. He seemed surprised that I was full weight bearing on my leg six weeks after the surgery. He asked if my other doctor had cleared me for this, and I said that I had just started putting weight on it on my own as soon as it wasn't painful. He seems to think that putting full weight on prematurely can potentially cause the pieces of the bone to separate, but in my case everything is holding together. My old doctor and PT hadn't said anything about it. So I guess if you are reading this with a patella fracture of your own, the best bet is to talk with your doctor and get their advice! My next appointment with him is in 8 weeks for a final checkup, after which he thinks that he will be able to certify my knee as healed, barring any unforeseen circumstances between now and then.

One upshot of the appointment was that the doctor said that I could start walking around my apartment without the brace as long as I use crutches and am careful. This is really convenient, since I live in a 1 bd place. Putting on the brace to walk 10 feet to the couch is no fun! I can also now sit on the toilette like a normal person and take a shower. Getting in an out of the shower feels risky, but it is worth it to be able to wash the left half of my body again.

Still working in the 0-90 range of flexion. I am going to restart PT up here this coming week! Otherwise, I'm taking it easy and hoping to be better by spring!
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on February 16, 2014, 09:14:43 PM
Eight weeks post-op. I feel like I have made a lot of progress this week. I restarted PT at a clinic near my apartment. When I am at home, I am walking around without the brace, using one crutch for stability. I occasionally walk without any support, but I am sure that this increases the chance that I will fall and hurt myself again. Outside of my apartment, I am still wearing the immobilizer and using crutches. I have been taking the brace off at work a bit.

My range of motion in my leg as increased to over 100 degrees. Moreover, I no longer feel any pain or stiffness when I am at 90 degrees, which means that I can sit at a chair with my leg bent. I have been doing wall slides in PT (lying on my back with my leg up on the wall, then bending it to the point that it is uncomfortable and holding it), which I feel are more effective than bending the leg while sitting.My quads are getting stronger as well- I am up to 50 leg lifts per session, and don't have much pain while doing them.

I haven't had any big problems getting around or doing my normal activities this week. Everything is still covered in snow and slush, but I just walk slowly, use my crutch, and make use of handicapped spaces. Taking the trash out is difficult, but I have managed so far.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on February 23, 2014, 09:11:33 PM
Today is nine weeks since my surgery. It is hard to believe that it has been two months! I finally feel like my life is getting back to normal. This week, I have been walking around without a brace or crutches except when I am outside, where there is still alot of ice. One upside of the cold weather that we have been having (no sign that we will be getting above freezing for the next two weeks) is that I haven't missed out on many outdoor activities. Between the walking and a getting a haircut (I had been avoiding that while I was in the brace) I finally look like my old self.

Walking without the brace and crutches is getting easier. I feel pretty steady, but my left leg is still not as strong as my right and my reflexes are not quite as quick. I am still using a crutch in parking lots and in crowded areas, where I feel that I might get jostled. I have found that I can go up stairs normally (alternating steps), but am still slow. I am not in any hurry to try running or carrying heavy objects. Still, it is nice to be able to get around.

Speaking of doing normal activities, I went on a date on Thursday! I debated wearing my brace, but decided to just use a crutch. I was honestly more nervous about the ice outside of the bar than meeting the girl! I had told her before hand that I would be using a crutch, so that didn't come as a suprise. The date was fun. I don't know if we will be seeing each other again, but if not, I can at least say that the knee wasn't an issue.

Physical therapy is going smoothly. I have been doing my leg lifts with ankle weights and doing 10 minute sessions on an exercise bike. My flexion is up to 120 degrees and getting better every day. I'm hoping that by the time that spring comes, I will be back to normal!
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on March 03, 2014, 04:53:24 PM
Ten weeks post op! I am guessing that as long as I don't fall directly on my knee, I am out of the woods in terms of re-fracturing my patella. I feel like I am walking with a normal gait. There is still some tightness around my knee when I walk- like I am pulling against a rubber band- but nothing painful. The tightness may well be from the wire going around my patella rather than the injury. While my left leg is still gaining strength, it feels strong enough to keep me steady when I am walking. I am still using a crutch when I am on icy/snowy/slushy pavement. If the temperature would ever get above freezing, I think that I would be done with the crutch entirely!

Physical therapy is going smoothly. In addition to several sets of exercises for my quads, we have added some activities to work other leg muscles, including the calf and hips. Each session is basically an hour and a half of me working out. I am pretty sure that I am getting more exercise now than I did before my injury! I bought a set of ankle weights for when I do my exercises at home.

My maximum flexion in my left leg is around 130 degrees, which is only a few degrees less than the right leg. I still can't sit cross legged, but my range of motion doesn't impede me from any of my usual activities at this point.

One more week of therapy to go! They can get an extension from the doctor if they think that I need it. For now, I'm just trying to get the strength back and am enjoying walking around again!
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on March 10, 2014, 08:10:57 PM
Not much new to report 11 weeks out. I have been on spring break, which mostly meant sitting around my apartment and going to PT. There is still a lot of snow around here, so I haven't been doing much outdoors.

My range of motion is now the same in both legs! It is still a little uncomfortable to sit cross legged, but my range of motion lo longer impedes any of my activity. I'm not running or going down stairs yet, but otherwise I am back to my usual level of activity.

The only time that I still use a crutch is if there is ice on the ground between my apartment and my car. For the most part, I have been walking around without any support. I have done laps around the mall and the grocery store without any problems, so I think that in terms of walking I am good!

I'm still doing PT to get my strength back in my left leg. They decreased it to twice a week from now on. In four weeks, I have my last appointment, after which I should be fully healed!
Title: Re: Left Patella Fracture and Recovery
Post by: sprsnow on March 16, 2014, 03:58:15 PM
Hi, thanks for sharing and glad to hear youre back to normal and healthy again.  Have you get a chance to discuss with your doctor about removing your hardware?  It seems did not bother you at all from reading your post.  As matter fact, I am starting the 12th week post-op (broke left kneecap on 12/21 and surgery 12/27 with two hooks and wire for 2 pieces of kneecap).  I started my PT 1/27 and increased ROM 15 degree every week and now its about 130.  I had less than 6 weeks twice per wk PT and now I felt and even earlier I could do most exercises at home and health club, and I have been worked very hard at home to progress my goal.  Just wondering what type of exercises do you do to get your ROM?  Mostly I have done are heal slides.  I have gotten 80% ROM and 60% strength back and worked on yoga and aquatic fitness besides heal slides and little stationary bike.  BTW, do you have any aches or pains now?  I have lots of aches at night and almost waking up at night on hourly basis but my doctor said its normal due to the hooks/wire or never pain plus I feel the knots of wire bothering me when the heal slides or knee bending.  How about you and appreciate your info?
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on March 16, 2014, 08:18:01 PM
Hardware removal has been mentioned a few times, but there are no plans so far. The only problem I have with it right now is a tightness around me knee when I walk, almost like I am pulling against a rubber band. This isn't that painful though, and if I don't have more discomfort than this, I probably wouldn't choose to have the hardware removed. Of course, my left knee is still a different shape than the right knee, so as everything readjusts I can imagine that things might change. I'll also have to see what it feels like once I start hiking or walking long distances again.

I did heel slides against the wall to get my range of motion back once I hit 100 degrees. For the last few degrees, I had to press down on my left leg with my right leg. I also did the stationary bike at PT, which helped me to get more comfortable with bending past 90.

I have been pretty lucky in terms of aches and pains. There is still some discomfort, but nothing that really bothers me. The only thing that does get uncomfortable is sitting with my leg bent for a long time like in a movie theater or during a long drive. As long as I can stretch every so often though, I am ok. I only have the one wire circling my patella, and that hasn't bothered me very much.
Title: Re: Left Patella Fracture and Recovery
Post by: Bricks1974 on March 19, 2014, 12:10:25 AM
im 6 weeks post op on left patella fracture and torn tendon repair. im bending at 60 and still take pain meds for pt and sleep. my question is....how long did it take your swelling to subside and do you still feel heat comeing from your knee?
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on March 20, 2014, 06:55:10 PM
I would say that most of the swelling went away after 5-6 weeks. It is hard to say though- my left knee still looks different from my right knee, but I am not sure if that is swelling or just from the surgery. The knee is rounder and the kneecap doesn't stick up as much as the right one. It still feels a little warmer than the right one.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on March 24, 2014, 08:04:55 PM
I'm now about 13 weeks out. Not much is changing these days. There is still a bit of tightness in my knee when I walk around, but nothing too painful. I have discovered that sitting with my leg bent for long periods of time (for example, in a movie theatre) can cause stiffness, but if I get up and stretch it goes away. I can go down stairs (alternating steps) without too much difficulty, though I do need to be holding onto the railing and to go slowly.

I still can't do any running. It feels like the point where the quad attaches to the patella is still painful- maybe because it hasn't had much stress over the past few months? From reading other people's stories, it could be a few more months (at least) before I am able to do any kind of running or jogging.
Title: Re: Left Patella Fracture and Recovery
Post by: kuiper138 on April 03, 2014, 09:37:33 PM
I had my last physical therapy session today! The PT recommended that I continue to do leg raises (with an ankle weight) at home for a few months. She said that if I think about it, I can do some of the other ones, but the only thing that I really need to work on is strengthening the quad. The muscle is pretty strong already, but still not nearly as strong as the good leg.

No other changes to report. Still no running. Still no problems with the hardware, then some occasional stiffness around the kneecap. I have my last appointment with the surgeon next week, after which I should  (hopefully) be declared better!
Title: Re: Left Patella Fracture and Recovery
Post by: sprsnow on April 03, 2014, 10:57:34 PM
Glad to hear you're done your PT and continue with quad strengthening. You're very young and hope you'll have your full recovery much sooner.
Same here I stopped mine PT last month and workout at a health club.  The fitness yoga is helping me physically and mentally.  Appreciate the ROM exercises you suggested.
Title: Re: Left Patella Fracture and Recovery
Post by: caseam on May 18, 2018, 04:26:09 PM
You made some serious progress in recovery. I'm at 12 weeks 70'ish degree's.
Title: Re: Left Patella Fracture and Recovery
Post by: bsorge on June 09, 2018, 08:37:36 PM
I am 10 weeks post op on a commutative right knee fracture. I am a 70 year old that is 63 and was in exceptional condition. I had conventional surgery on March 26,2018 with 2 pins and wire. I stayed in the hospital overnight
And discharged with a mobilizer. On April 7, 2018 the Doctor removed the dressing and surgical staples and left the mobilizer on. Using crutches, but always afraid of falling. Problem with constipation and sleep. Used Kirkland (Costco) Sleep Aid which over the counter and works. Also Miralax for constipation. On May 10,2017 started to go to gym to use weights while sitting down every day on upper body. On April 16, 2018 (3 Week ps) took off mobilizer at night (85 rom). April 19,2018;started walking around house with mobilizer, but no crutches. April 30, 2018 (5 weeks) started PT and no mobilizer for 3 times a week. May 21,2018 walked 2 1/2 miles and 3 miles the following day. Working out in gym and PT 3/4 hours per day plus stretching. May 24,  2018 up to 131 ROM.  Ay 31, 2018 PT ended as have good gym. June 3, 2018 walked 9 holes golf. No driver used.
June 5,  2018 walked 18 holes golf 6.5 miles.

Now pretty much recovered and back to all normal activites just prior 11 weeks. Knee is still swollen and tell me might take 6 months. My Doctor does not want to remove screws ever which I expect due to age. No pain in knee, but some discomfort when full bending my knee. I can walk up and down stairs without holding on. They have changed my walking gait to make sure I bend my knee and land in my heel. Also doing a great deal if work on improving my balance so that this will not happen again. Between walking gait and balance I expect these are two most important things to work on after recovery. ROM at 135. Tell me this best I will get which ok with me.