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Author Topic: Quad Tendon Rupture  (Read 13836 times)

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Offline ~*Heather*~

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Quad Tendon Rupture
« on: May 22, 2003, 06:45:25 AM »
I am not sure where this goes so I'm posting it here. I have it posted with all the other tendon issues, but someone mentioned here might be a better place in another person's post:

I am 26 years old. I had a surgery in Feb 2002 Lateral release and medial plication (incision in VMO to hold it) I took a fall in march of 2002, my doc didn't discover I ruptured my Quad tendon until July 2002. I had the Quad tendon repair in August 2002. I can't seem to recover from this! It's driving me nuts! I now have a huge bulge in my knee and I saw a new doc today.  He did x-rays and discovered that my kneecap is too far down, almost on the shin bone which is causing it to lock.  This is a BIG problem!  I still can't do a leg raise or leg extension without some lag and a lot of pain! He is not sure if it can be fixed and how he would even go about it!  I am getting an MRI on Jun 3rd and we will take it from there.   Anyone out there who has had this surgery or knows anything about it?? Please help me! Post here or email me directly [email protected] I AM SO DESPERATE!!!!! Thanks for reading : )  
I also just learned that I can put the description of injury under my posts!  ;D
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline Heather M.

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Re: Quad Tendon Rupture
« Reply #1 on: May 22, 2003, 08:16:52 AM »
Hi, Heather.  [I moved my response from down below to up here--there's more traffic on this thread.]

I saw your response to my post on the other page....you really need to talk with this new doctor about arthrofibrosis (excessive scar tissue) and patella baja.  According to your x-ray reports, that's what you have--patella baja is also called patella infera, and it happens when the patellar tendon contracts due to trauma or scar tissue.  This pulls the kneecap down out of place, causing it to impact the shin bone and the other bones that make up the knee joint.  This in turn causes a LOT of pain, swelling, cartilage damage to the back of the kneecap.  It also basically makes it impossible for your quad muscle to function right and causes a vicious cycle of pain and swelling.    

So while it might seem like your problem is from the quad tendon rupture, it sounds like now your problems are slightly different--patella baja etc.  Also, you don't really know if your lateral release/VMO advancement were effective, because you injured yourself post-op.  So it could be that you are having ongoing tracking problems (of the kind that made your doctor do the lateral release in the first place).  I guess what I'm saying is the quad tendon might not be the culprit, you could be having issues with cartilage damage and scar tissue, or some combination of all three....lucky you, eh?

You should do a lot of research and make sure your second opinion doctor is very, very good at what he does.  I had to hunt high and low to find someone willing to address my problems--patella baja is a frustrating condition and you really need a top notch surgeon to deal with it.  There are a couple of people on the web page here who have it, and one of them (Janet) also has had a lateral release, VMO advancement, and quad tendon rupture.  Only she did hers in the reverse order (quad tendon first, then the other stuff to treat the scar tissue problems).

For your research, you'll want to start in the section below called "Soft tissue healing problems."  Then go to www.google.com and look up some key words:  arthrofibrosis, infrapatellar contracture syndrome, patella baja, patella infera, internal adhesions & knee, quad tendon rupture.  That should get you started for your second opinion appointment.

One other thing to consider--you said you previously had a lateral release, plica removal, and VMO advancement, so it sounds like you were having some knee tracking problems.  That would put your issues in the 'patello-femoral syndrome' category--there's a whole section of posts on this web page for that, too.  Sounds like the quad tendon rupture was a bit of really bad luck.

Anyway, research is the best thing for you to do right now.  Hopefully others will respond with some advice or their stories.  I can't stress enough how important it is to have a really good surgeon who specializes in complex knee issues deal with this.  Most of us on here have had to travel out of state to get this type of treatment--I had to go to Colorado and stay there for a month after surgery.

There are a variety of options--surgical and non-- that are open to you.  I've tried them all, and some are working to improve my life.  I'm still very much affected by the knee, though.  Wish I had better news.  Unfortunately, it takes a long time to recover from something like this.

Hope this helps, be sure to look around for more reading material and talk to your new doctor.

Heather
« Last Edit: May 22, 2003, 08:19:15 AM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: Quad Tendon Rupture
« Reply #2 on: May 22, 2003, 08:22:38 AM »
Here's a good link to start with...it refers a lot to ACL repair patients getting scar tissue, but the principle is the same.

http://www.physsportsmed.com/issues/2001/03_01/eakin.htm

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Janet

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Re: Quad Tendon Rupture
« Reply #3 on: May 22, 2003, 05:38:14 PM »
Dear Heather (sorry this is very long):

Oh, I feel so bad that you are in this situation. I can really empathize with you. My story is this: I fell on a wet floor at work and ruptured my quad tendon. It was misdiagnosed in the ER, but it only took the OS about 10 seconds to diagnose it in his office four days later! I had surgery the next day where he repaired the tear and did a VMO advancement. I was immobilized for almost three months. My quad had completely shut down (as was to be expected), but it didn't want to "wake up."

By five months post-op, it was becoming obvious that I had a scar tissue problem. My ROM was stuck at 60-70. At six months, I had manipulation under anesthesia, chondroplasty and partial synovectomy. I continued in PT for another three months and eventually got ROM to 120. This was after a total of nine months of PT.

At this point, I felt I wasn't getting any better. My doctor disagreed, but didn't do any other tests (not even an x-ray). He kept telling me to be patient. Well, I finally decided to get another opinion (I wish I had done it sooner). So 18 months post-op, I went to a knee specialist. She immediately diagnosed patella baja and confirmed that I more scar tissue, the quad was not working well, the VMO was completely shut down, and my ROM was back to 90. I went for 3 more months of PT where I was able to get back to 120. But I could never regain quad strength and had great difficulty walking, along with pain all the time. So we scheduled more surgery, although she didn't want to if it could be avoided. She removed a ton of scar tissue, cleaned up the back of the patella, and did a lateral and medial release. My patella was so tight, it wasn't moving at all. It was back to PT for another 3 months.

At that point, I had rehabbed from the surgery, and my pain was improved. But my functional ability was still very low, and my quad was still extremely weak. I was sent to PT with a biomechanical expert for another 6 months, where I had some improvement, but eventually had to quit becuase it was causing so much pain I couldn't progress any further. I was then sent to a pain management/functional recovery program run through a Physical Medicine specialist, which (again) helped some, but didn't fix the problem. Everybody threw up their hands and said there was nothing else that coud be done.

I finally decided to get another opinion, and settled on a doctor in our region who has expertise in the area of scar tissue and patella baja problems. I am having more scar tissue surgery in June. We won't be able to tell how successful this surgery is for about 6-8 months post-op.

Anyway, sorry for the LONG answer. HeatherM has given you the best advice. In reading articles and doing your research, you should be able to find the top doctors. Get an appointment and see what they say. I hate to give you bad news, but there really isn't much (if anything) that can be done for patella baja. Even when they remove the scar tissue, the patella position doesn't change because the patella tendon has shortened and thickened. I have been told there is no surgical way to move the patella that has proven good results. Unfortunately, the damage in your knee causes pain, and the pain prevents you from strengthening your quads, and since the quads are the shock absorbers for the knee, your knee takes the shock, which causes more pain....it's a vicious cycle. HeatherM is by far the most knowledgeable person on this forum about these issues. I have learned a lot from her. Keep us posted. Send me a private message if you'd like (click on my name by this message, scroll down to "send a private message"). I'd love to keep the conversation going. Good luck!

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline ~*Heather*~

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Re: Quad Tendon Rupture
« Reply #4 on: May 22, 2003, 06:38:55 PM »
Janet,

I looked on line last night and found patella baja.  Well, it was an x-ray of it and it was my x-ray exactly!  How come this happens?  They really can't fix it?  OMG! That's so crazy!  I will never walk or run again?   I refuse to accept that!  I want my life back so badly. I am in tears as I write this!  I can't go through life with my knee locking in mid stride!  I will do so much other damage to everything else in there! Obviously, you have been down this road so don't be offended that I said I refuse to accept it. I am sure when it's been as long as it's been for you, I will then! :-[  What other exercise can you do to stay in shape?  Why wasn't I warned about this potential problem?  You mentioned you had several surgeries to remove scar tissue....but doesn't that just create more?  I don't want anymore surgeries, can't I just tape it like I used to?  Can't they lengthen the patella tendon?  I know these are questions for my doc, but I'm just venting now! Thank you for your response and I WILL try to message you!
Thanks Heather for your knowledge!  Much appreciated!!!!!!

Heather :'(
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline ~*Heather*~

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Re: Quad Tendon Rupture
« Reply #5 on: May 22, 2003, 06:43:25 PM »
Just wanted to add that I have full ROM, so do you still think it's scar tissue?    
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline Heather M.

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Re: Quad Tendon Rupture
« Reply #6 on: May 22, 2003, 08:51:43 PM »
Heather,

I'm right in the middle of this whole thing, so I can't really answer your questions.  But I've talked to my doctors and PT, and they are not as pessimistic as Janet's--their opinion was that Dr. Wojtys (Janet's very highly regarded OS) was giving a worst case scenario.

As for improvement, I really do think it's possible.  I'm not at the point of accepting that I will never run again...but I'm darned close.  You get to a stage where you would be happy to do regular things without pain and be happy with that...anyway, I still have plans.

As for your situation:  I'm guessing your knee is catching when you walk because you have such bad quad strength.  The problem is, as long as the patellar tendon is scarred down, you can't get your quad strength back--read my posting from December in the soft-tissue section.  I was EXACTLY where you are--knee locking with every step, stuck with taping and pain meds but making no real progress.  I also had about 130 degrees of flexion, so don't think that scar tissue is only about limited ROM.  I had a my fifth arthroscopy in 15 months to take care of the scar tissue at Christmas, then began a very specialized and aggressive PT program.  I was able to strengthen the quad enough that the catching went away.

I am MUCH better than I was before the last surgery.  However, because the patella is still too low, and it has sunk into the knee joint (infrapatellar contracture syndrome) I am developing severe patellar arthritis.  So it's not necessarily the patella baja that hurts and causes disability--it's the side effects from that.  Patella baja in itself occurs naturally in some people, and they don't have any problems until much later in life.  But because this isn't the natural position for our knees...it causes all kinds of problems.

Cont'd

« Last Edit: May 22, 2003, 09:00:37 PM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Heather M.

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Re: Quad Tendon Rupture
« Reply #7 on: May 22, 2003, 08:59:21 PM »
There is no real explanation of why it happens to some people--the trauma of the first surgery and the build-up of scar tissue under the kneecap and patellar tendon cause everything to contract.  It is a VERY rare complication, I'm sure you'll be happy to know.

You asked what your treatment options are.  I saw 6 different orthopedic surgeons around the West--all known for their skill in dealing with tough knee problems.  The first three didn't want to do anything, saying that surgery causes scar tissue and it's clear my body doesn't respond well to this.  They gave me no options.  The fourth surgeon said to do a repeat clean-up and do the lateral release again.  The fifth surgeon wanted to do an open TTT, specifically a Maquet procedure, to manually elevate my kneecap out of the joint.  Unfortunately, after a Maquet procedure you are pretty much permanently disabled so I didn't want to go that route.  Other types of TTT leave good function, but not the Maquet for some reason.

The sixth doctor I saw is a specialist in arthrofibrosis.  He said it was a tough condition, but he was willing to try.  He said it would take two or more surgeries with very prolonged recoveries.  I chose this option because he had the most experience and it was the least invasive--the surgeries were scopes.  I had to promise to stay in Colorado for a month post-op and do PT twice a day at a clinic there, then an addition two times a day at home.  I was on crutches for four weeks, which I think really helped.  Read my "Lysis of Adhesions" post.

At this point, I'm about 50% better in terms of function, but the same in terms of pain.  I'll take it.  My surgeon is talking about another surgery to remove further scar tissue, even though I'm able to touch my heel to my butt and hyper-extend my knee.  At this point, it is unclear whether my pain is from scar tissue or arthritis.  I know the worst of my pain is below the knee, where the patella baja hits the shinbone.  I'm in kind of a manic state about my recovery--one day I'm very optimistic, the next I'm not.  It's a real rollercoaster...for a while I was working out like a real person on the elliptical, treadmill, bike, weights...but then the pain started getting worse and worse.

Anyway, from what I've been told here are your options:

1.  Surgery to clean out as much scar tissue as possible.  This is the starting point.  The best results are found when the scar tissue cleanup surgery occurs within six months of the surgery that caused scar tissue in the first place.  Must also address tracking and arthritis problems that resulted from patella baja.  My surgeons all told me there was no way to achieve good results without a clean-up surgery to start the program, and I believe Janet found the same thing.

2.  Immediate post-op PT to restore ROM and quad strength without irritating knee joint to make it produce more scar tissue.  No weight-bearing or exercises that irritate knee.  I also had to have another small procedure called an insufflation to address the scar tissue that was forming as early as 2 weeks post op.

3.  Very specialized long-term PT incl. taping, E-stim to build quad with elliptical and weights, ultrasound, patellar mobilizations, scar tissue massage.

4.  Aggressive pain management:  I see a specialist for this.  She uses acupuncture, lidocaine patches, TENS units, myo-fascial release, narcotics, anti-inflammatories, and SSRI's to help with pain.

5.  Failing the above approach, there are more aggressive surgeries:  Maquet procedure and tenodesis are the most common.  They are both considered salvage procedures for scar tissue and patella baja.  Tenodesis is intended to stimulate the patellar tendon and make it heal itself, the Maquet procedure actually lifts up the point where the patellar tendon inserts into the shin and raises it up to 2 inches, so it's like lengthening the tendon in it's results.  But it's major open surgery and requires bone from your hip as well.  The final option I was given is removal of the patella, which I flat out refused.  It will apparently resolve some pain issues, but causes real disability and makes a total knee replacement in the future very difficult.

I know you want to avoid more surgery, but it often is not an option with patella baja.  Yes, more surgery can create more scar tissue--that's why you have to have a very specialized post-op protocol.  Most surgeons don't know anything about this issue.  They see a couple of cases in their whole careers.  My surgeon in Colorado saw five cases over Christmas when I had my surgery, so I felt very comfortable with him treating it.

You've got lots to think about.  Don't be surprised if you now know more than your doctor about patella baja!  Like I said, it's a rare problem, one that only PFS specialists tend to deal with.

Let us know what your new OS says.

Heather
« Last Edit: May 22, 2003, 09:06:22 PM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline ~*Heather*~

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Re: Quad Tendon Rupture
« Reply #8 on: May 22, 2003, 09:02:28 PM »
HeatherM,

I have been looking at your suggested searches and found out a lot so thanks!  I got depressed about it so I took off for the gym and worked on the Quad...lol! I found some sites that state there is a surgery to correct this, it is involved, but has anyone here tried it? I know you mentioned it in your post.  Is removing scar tissue the way to go?  Would an MRI show scar tissue because I have one coming up and am scared there might be other problems.  I have had 3 surgeries on this knee already, the two I mentioned previously and an IT Band release in 12/99.  I have also had two surgeries on the Right knee for IT band issues.  This all started with the IT Bands, can you believe that?  They seem so minor compared to the probs I am now facing! Thanks so much for your advice, you have been a great help and so has Janet! Thanks for all the time and effort you put into the last post! It's comforting to know that other people like me exist!  Are you the one from the other board that sent me here?  Someone reccommended this site with the name Heather.  Thanks again!  ;)
« Last Edit: May 22, 2003, 09:12:24 PM by Heather »
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline Heather M.

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Re: Quad Tendon Rupture
« Reply #9 on: May 22, 2003, 09:17:00 PM »
Hi, Heather.  It looks like we're posting on top of each other.  Which surgery were you looking at for correction of patella baja?  What was the name of the procedure?

As for the MRI, no--it usually won't show scar tissue.  However, it will show the placement of your kneecap and how much damage has been done to the back of your patella, so it's a good way to go.  The only way to confirm scar tissue and contracted patellar tendon is to look with a scope.

I know your concerns about multiple surgeries.  I've now had five on my left knee, plus severe IT band syndrome as a result of all the scarring.  I can't believe your doctor did an IT band release!!!  That's something my surgeon absolutely recommended against because it changes the tracking and placement of the patella--be sure to ask this new doctor about it, because the IT band could play a different role in your condition.  I have a severely inflamed one in my surgical knee because it got scarred down to the bone below the kneecap--the pain goes all the way up to my hip and back.  But I was able to FINALLY calm that down with acupuncture and myo-fascial release, so I'm a much happier person now.

As for surgery--it really seems like a scope to remove the scar tissue is the starting point for improvement/recovery.  Once that crap is in there, there is no getting rid of it except through surgery.  But you've got to do the procedure with someone who has a real plan for preventing the adhesions from coming back as much as possible.  Yes, there will be some scar tissue, but you don't want it rampantly out of control like before.  For me, I think the 2X/day PT and swelling control measures were the key.  I was non-weight-bearing on crutches--basically in a wheel chair--for about 10 days post op.  Then only limited weight-bearing.  As soon as I did more than that, the knee ballooned up and the doctor put me right back on crutches.  Swelling control is key.

Anyway, I know it's a lot to take in.  You're still young, and you haven't had this condition for very long, so maybe you will be able to make a full recovery.  I would definitely ask your doctor if he thinks your pain is from the cartilage issues that led to the lateral release last year, or if it's due to scar tissue.  My surgeon in Colorado told me that until the scar tissue was gone, we couldn't really address whether my knee needed further intervention for the cartilage damage.  Other doctors wanted to go straight for the big arthritis surgery (TTT) and then deal with the adhesions later...it's all in the personal approach of your surgeon.

Good luck, definitely keep us posted.  There are at least 8 people who have posted with the same problem, but only Janet and I post regularly.

Heather

PS yes, I'm the one who sent you to this board.  There are a lot more active posters here than on the other one.....
« Last Edit: May 22, 2003, 09:17:57 PM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Janet

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Re: Quad Tendon Rupture
« Reply #10 on: May 23, 2003, 05:13:44 PM »
Heather:

HeatherM gave you such a good answer, but I'll try to add a little more.

1.  I was told that patella baja usually occurs after trauma or surgery when the quad is weak and scar tissue forms. Because the quad doesn't have enough strength to move the patella, the patella tendon (which attaches the patella to the tibia) gets scarred down. This causes changes in the tendon itself, where it shortens and thickens. Once those changes occur and are not addressed, there is no way to change the tendon back. No, they cannot replace or lengthen the tendon. And I was told the TTT procedures do not have good results for patella baja, and would not be recommended in my case. Because the patella has "settled down" into the joint, if they move the patella up with a TTT, it will still be hitting the femur. At least that's true in my case.

2. I have accepted that I will never run or kneel again. My dream is to be able to walk normally. Fortunately, while I always have pain, I don't have excrutiating pain. But then again, because it has been four years for me, my whole lifestyle has changed. I know my limits and don't exceed them. I can't even imagine functioning as I used to post-injury. And now my "good knee" is also painful, which is very common with chronic knee problems, (as Dr. W says) "secondary to compensatory weightbearing."

3. Yes, one of the big problems with patella baja is that is causes damage to the articular cartilege behind the patella. I have hope that technology will soon catch up with this problem. They are starting to do some resurfacing behind the patella, but progress has lagged behind other cartilege replacement in other areas of the knee joint.

4.  As for the MRI, Dr. Wojtys told me that MRI's don't really show scar tissue or the condition of the articular cartilege behind the patella. The only way to really know is to look inside the knee. I have had two MRI's and both have been fairly normal. Both times I have ended up in surgery anyway with major scar tissue issues. Before the last surgery, I was  diagnosed with infrapatellar contracture syndrome....basically my patella was completely scarred down and not moving at all. It is still tight, but at least now it moves. I appreciate that my OS didn't overcorrect in releasing it since at least I no longer have tracking problems. She was afraid that further release would cause the patella to become unstable.

5.  Yes, surgery causes more trauma and more scar tissue can form. That is why you need a really top surgeon with special emphasis in arthrofibrosis. It sounds like my rehab protocol this time will be quite different from last time. I will be non-weightbearing for 2-3 weeks. I was told the "trick" to not having the scar tissue reform is to balance getting ROM and quad strength back with not irritating the knee and causing more scar tissue to form.

6. I can't give you any advice about taping. It has never worked for me.

Please keep us posted. And ask any questions you can think of. I sure wish I had found this site earlier. I know so much now that I would never have known. I may have done things differently. Good luck.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline ~*Heather*~

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Re: Quad Tendon Rupture
« Reply #11 on: May 26, 2003, 11:27:09 PM »
Janet and HeatherM,

I was just wondering what your current limitations are as far as everyday life.  What have you had to give up doing (besides running and exercises).  Also what kind of work do you do now?  I used to work as a dental assistant, but now I find that type of work difficult because I can't be on my knee for hours on end.  Thanks!

Heather
0 : ^ )
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline Janet

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Re: Quad Tendon Rupture
« Reply #12 on: May 27, 2003, 03:48:26 AM »
I have a desk job, so I can still work full time. But by about noon, my knees are killing me. Luckily, I don't have to walk around very much at work. But even back and forth a few times has me hurting.

I have trouble sitting with my knee bent to 90, it's usually about 70 comfortably (even though my ROM measures at 120). So whenever we go to a theater or anywhere with limited leg room, I have to sit on an aisle and stick my leg out. I have had to give up going to a lot of sporting events (which I love) because there just isn't enough leg room. I definitely cannot sit in the back seat of a car. All my friends and co-workers know I always get to sit in the front seat!

As for walking, I can walk about 30-45 minutes before I really feel like I can't do it anymore. I start to feel it after about 20 minutes. I swing my leg from my hip because I don't want to bend my knee. I guess everything comes down to that.....I don't want to bend my knee. I even wake up at night sometimes when my knee has been bent too long. It's odd....yes, my knee hurts, but it also has to do with how easily my leg fatigues, probably because my quads are so weak. Sometimes when I go to the mall with my daughter, I can walk a little while then go to a wheelchair. Today was not a good day and I didn't feel like I could walk at all, so we got a wheelchair right from the beginning. We just don't do anything anymore that requires walking.

I also have trouble standing for any length of time. Sometimes even standing in a check-out line is too hard. It does something to my knee/hip/back that is quite painful and makes it very hard to walk once I start moving again.

I can go up stairs with the aid of the handrail. But I can't go down stairs foot over foot at all. We live in a two-story house, and are thinking of moving to a house all on one floor so I don't have to deal with stairs.

This has affected everything in my life. If you can't sit or walk comfortably, about all you can do is lie around. I refuse to give in that much, but I know my limits and stick to them. And it hasn't just affected me. My husband gets extremely frustrated with the whole situation. Thank goodness I was young when I had my kids and now they are grown (24 and 18). And while I look forward to being a grandparent someday, I know I won't be able to babysit on my own because I can't kneel or chase kids around.

I know that sounds bleak. But I don't feel life is bleak. I have gotten past the depression and now find ways to do the things I really want to do and let the other things go. Life is still good....just slower, more painful, and different.

Janet
« Last Edit: May 27, 2003, 03:50:28 AM by Janet »
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline ~*Heather*~

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Re: Quad Tendon Rupture
« Reply #13 on: May 27, 2003, 07:39:21 AM »
Janet,

Thanks for your reply. Your life sounds like mine almost exactly!  My knee catches and locks when I do try to walk normally.  I still try to do a lot with it and I hate to have to give up, but when I get to the gym I just want to cry.  I focus on keeping my other quad strong because I have alignment probs there too and also IT Band syndrome.  Sometimes it acts up due to overcompensation and then I'm about as good as bed-ridden.  I have a hard time believing that there is no help for us, but then again, I'm new to these problems and still am in denial. I am NOWHERE near out of the depression state and I don't want to give up.  I'm only 26 and I'm going to miss so much in life now. I only wish I knew when this kneecap fell.  It has always looked distorted to me but I was told my the first OS that it was atrophy, that was his answer for everything...atrophy.  He was supposed to be the best in town, but obviously not.  I don't have any kids and I was talking to my husband about that too.  I don't think having them would ever be wise because like you said, you can't chase after them.  It's kinda dangerous to be like this and be with a toddler.  Just one more thing I will miss out on I guess.  I would also worry about trying to carry one for 9 months being this unstabile!  YIKES! How long have you been at this stage?  How did you get through the depression?  Sometimes I just feel like living sucks and I am so jealous of all the things everyone else can do!  What do you do to stay in shape now? I have taken up upper body stuff to maintain lean muscle and to limit the weight gain.  I haven't gained but about 4 pounds, but it's starting! I figure add 5 pounds to that for what my quad used to be and gee, I better diet! LOL!  Thanks again for your responses, they truly help!  It's nice to know I'm not alone.

Heather ;D      
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline ~*Heather*~

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Re: Quad Tendon Rupture
« Reply #14 on: May 27, 2003, 07:45:42 AM »
HeatherM,

You mentioned different types of TTT surgeries, the  manquet not having good results.  Would any of the other types be successful in our condition?  I know it's best to avoid surgery, but the way I feel is that I am already disabled, why not try something?  It seems like the MRI and the next visit to the OS is forever away and I can't help wanting a quick fix (don't worry I will do my homework before I do anything!), I'm tired of being this way! I didn't know about any of these potential complications before any of my other surgeries!  I appreciate you sharing your knowledge!  Any info?  Thanks!

Heather  
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04