Advertisement - Hide this advert





Author Topic: Quad Tendon Rupture  (Read 13555 times)

0 Members and 1 Guest are viewing this topic.

Offline ~*Heather*~

  • SuperKNEEgeek
  • *****
  • Posts: 620
  • Liked: 4
  • Why me? Why is it always me?
Re: Quad Tendon Rupture
« Reply #30 on: June 10, 2003, 09:39:56 PM »
WENT TO THE OS TODAY!!!!!!!!!!!!!


Well he went through each MRI film one by one with me.  Explained to me the difference in the right and left  quad tendons. He thinks the other OS may have reattached the quad tendon without realizing it was almost all scar tissue (went 4 months with it ruptured before repair was made). He stated that sometimes healthy tissue and scar tissue on a tendon can look similar.  

Anyway, he thinks this is why the patella fell because the tendon/scar tissue streched out, he also feels it is not healthy.  The patella tendon still looks good but it's slowly changing shape and appears to be just a little thicker and a slight bit curved compared to the Right one.

My knee is locking because it is hitting on the thigh bone when my knee goes from bent to straight.  This means that the top of the patella is hitting the groove and over time it will wear that groove down..OUCH! Also when the MRI scanned my good knee, when its at the bottom of the patella there it is just picking up the top of the patella on the left knee.  So that's a pretty big difference he said.  All ligaments and cartilige look good as of right now.  

Here are my options:

1.  Leave it alone and continue life as it is.  With the possibilty of getting worse over the years.   He says my quad will never come back because of the scar tissue quad repair. The locking will most likely get worse and become more painful. Other than that, my life would be what it is now......nothing! (But at least there are no risks involved)  

2.  Surgery.  He isn't sure what kind though.  He is referring me to a specialist at Duke University because I am in North Carolina already. He spoke with several of his colleagues and nobody felt they had the experience to deal with it. He mentioned the specialist in Cincinattii that someone here mentioned, but for location we agreed to try Duke.  

He explained the type of procedure that needed to be done.  He says I will need a lateral release (not a usual release that we all have had, one towards the bottom part of the knee) on both sides to free up the kneecap and then to have the quad tendon repair redone with removal of the scar tissue which is what the attachment was done with.  >:(  

This could lead to a permanant loss in flexion because they will be advancing the tendon once again and removing all unhealthy tendon.    Also the two releases will cut off blood supply to the patella tendon and this could be cause for weaking of that tendon and lead to possible problems later on as well. He did mention that the patella could be trapped by adhesions and scar tissue only and then in that case that would be the plan of attack, however, the quad repair still has to be redone because that tendon is too stretched out now.  

I told him I didn't want RSD or any of the other complications that could come along with this and he said that they definitely were risk factors but if he were me he would try to get it fixed.  He was a very nice doctor and took so long with me, it was nice! I did not feel rushed at all. He even asked me if I knew of any surgeons that I would WANT to do it!  I was thrilled that he was willing to send me whereever I needed to get this dealt with.  I would love to thank all of you once again for giving me so much information and making this visit so much easier.  It was so nice for him to use terminology and for me to understand it because of all you guys lending me a hand!

Oh yeah! He also thinks the reason the suture ties are sore enough to make me scream is because one of the nerve endings may have tried to grow back and i may have a nueroma under it and that is why it is sticking so far out and excrutiating.

He will be contacting me with the name and number of a Sports Medicine Specialist at Duke soon.  What would you guys do in my situation? Would you leave it alone or chance it with another surgery? Thank you for reading this!


Heather  ???      
« Last Edit: June 10, 2003, 09:46:57 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*~

  • SuperKNEEgeek
  • *****
  • Posts: 620
  • Liked: 4
  • Why me? Why is it always me?
Re: Quad Tendon Rupture
« Reply #31 on: June 17, 2003, 04:49:46 AM »
Hi all,

Just wanted to add one more thing.  This Wednesday     ( June 18 ) I will be seeing another specialist at Walter Reed Medical Hospital in Washington DC just to get another opinion.  I can't schedule the other appointment (the one at Duke/Chapel Hill NC) until that OS gets back from vacation and that is July 6th.  I just thought I would get one more opinion to go to the one back home with.  The OS at Duke/Chapel Hill is suppossed to be one of the best, so we will see.  Thanks again for all your posts and information!  You guys all know so much and are so smart about this!  

Take care,
Heather
« Last Edit: June 17, 2003, 04:52:24 AM 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 Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: Quad Tendon Rupture
« Reply #32 on: June 17, 2003, 05:07:09 PM »
Heather:

Wow! As if having patella baja isn't enough, now they tell you that the quad tendon needs worked on! At least it sounds like there is something that can be done. I think you are really smart to get other opinions. You can never have too many! This is definitely not "routine" surgery, as they are basically reconstructing your extensor mechanism. My last surgery was also removing the scar tissue that had built up everywhere in my knee, plus the lateral and medial release. I didn't even know I was tracking laterally, but when my OS got in there, she found that I had a lateral strike near full extension.

It sounds like you are getting your opinions from top notch doctors, and that should help you make a decision. Let's hope that since the changes are just beginning to show in your patella tendon, once the quad tendon is repaired, it the patella tendon will be able to return to it's normal length and size. As for loss of flexion, I would ask how much to expect. Many people go nicely through life with less than full extension. As long as the pain would be gone, I think I could live with that. But it seems you don't really have much choice, since living with it the way it is doesn't seem like much of an option! I will be anxiously waiting to hear what opinions you get.

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 Sonia_B.

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
  • User's Text
Re: Quad Tendon Rupture
« Reply #33 on: June 18, 2003, 04:21:50 PM »
Hi all!
Not sure if this is the right place or not, heather (lilangel) told me about this place.  I used to post here years ago and no one knew what patella baja was then.  I see now that there are several who not only know what it is, but unfortunately also have it.  Nothing like first hand experience  :'(  .  Any way, I just found out that my patella baja started when my old OS did a retinaculer release, he cut too far, cutting into my quad tendon.  This made my knee unstable and I fell, a lot!  Each fall I would tear the tendon a little more.  When the bursa (capsule surounding the knee joint) started tearing, the baja finally showed up on a MRI.  On Dec. 10th 2002, I had surgery to repair the baja.  My new OS took a small piece of my tibia (with my patella tendon attached) and moved it up to place my patella in the correct place.  It is held in place with 2 screws.  He also used a donor hamstring tendon to replace mine.  Mine was unusable because it had been torn for 3 years and (according to OS) "looked like cooked spaghetti instead of a big hunk of steak!"  Makes you wonder what doctors are thinking of during surgery ;D.  I was doing pretty well in PT.  Not very aggressive as in March I had a stress fracture and just re-started PT after that healed, but last week I twisted my bad knee in the mud and have had a lot of swelling and pain since.  In my first PT visit, I had 73 degrees flex (my biggest problem) and yesterday it jumped to 97 degrees.  PT and I are afraid that I re-injured my quad repair or something, as before I was LUCKY to get 2 more degrees per PT visit while being VERY aggressive (while in the wall slide position I would have 30 pounds hanging on my ankle) and now I all of the sudden get 24 degrees without much effort!  I see OS July 16th, and will hopefully know more then.  If anyone else had this happen, or has any questions for me I would be glad to answer!  I have had Patella baja for over 3 years and in that time I have learned way more about knees and insurance than I ever wanted to know :D
Thanks Heather for showing me this site again.  There is a lot more info now than before!
Lots of luck everyone!
Sonia
1st scope 00, 2nd april 01, 3rd nov. 01, patella baja repair 02.  Still not fixed and no help in sight!

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: Quad Tendon Rupture
« Reply #34 on: June 18, 2003, 05:12:22 PM »
Sonia:

Welcome back. Well, sorry you had to come back, but you know what I mean! It's encouraging to know that there was something they were willing to do to address the baja. I'm lucky in that my baja isn't too bad (my patella only dropped about 1/2 inch). But it has been so long now that I am told the changes in the patella tendon are permanent and there is nothing they can do about the baja that has a good chance of working. So we deal with the other issues and try to keep my knee as functional and pain-free as possible. Please keep us informed as to how you're doing.

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 Sonia_B.

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
  • User's Text
Re: Quad Tendon Rupture
« Reply #35 on: June 19, 2003, 04:53:07 PM »
I finally found out the name of the procedure I had in December.  I can't believe the OS thought I was so stupid!  He kept calling it a "total knee reconstruction" but when I talked to him yesterday about what happened in PT (gaining so much flex), I asked if this was normal for someone recovering from a Fulkerson Procedure.  He was shocked  :o, then asked how I heard that name.  I told him that knee people stick togeather on the internet! ;D Anyway, he admitted that I did have the Fulkerson procedure and gaining so much flex without much effort is not "normal", but I wonder just when did I become normal? 8)  So, now maybe he will talk to me like an adult and not a child!  They will try to get me in sooner (my appt. is 7/16) if they get a cancelation, but I have to have 4 hours notice because thats how long it takes to get to his office!  Wish me luck!
Sonia  :D
1st scope 00, 2nd april 01, 3rd nov. 01, patella baja repair 02.  Still not fixed and no help in sight!

Offline ~*Heather*~

  • SuperKNEEgeek
  • *****
  • Posts: 620
  • Liked: 4
  • Why me? Why is it always me?
Re: Quad Tendon Rupture
« Reply #36 on: June 20, 2003, 06:36:13 AM »
Sonia,

I'm glad you are on a new level with your OS! lol!  I went for my second opinion at Walter Reed and that doc there said that he thinks the first surgery I had was too harsh for my original condition. That really upset me! The lateral release was necessary but the medial plication, VMO advancement was NOT necessary.  I couldn't believe it!  It was because of that part that I fell and all this has happened to me!!!!!!!!!! Anyway, he said that it looked as if the other OS did not measure for the quad tendon repair or something because it's all stretched out and that's why the kneecap has fallen.  He physically pushed my patella up a bit, of course it fell again, however, that showed mobility.

My patella tendon is also very loose so as of right now he feels a simple quad tendon repair (repeat of the last surgery) will be the fix.  He advised me that I have about a 60-70% chance of getting it normal again.  He was hestitant to give me more than that because he feels with those surgeries that the tendon can be stretched out and it could repeat and end up as baja again.  

He also said the other OS attached the tendon to my patella at the wrong angle, it should have more toward the back rather than directly on top.  I feel some hope here, I just hope I can get someone to do this before the patella tendon tightens down. Even if it did he still said you can get it lengthened, but then that leaves more room for error and also possible further problems in the future. This particular surgeon is booked until November and I still have the one in Chapel Hill to see soon, so like everyone advised me here, I am getting a zillion opinions!!!!!  I know I need the quad tendon repaired again, but there are differences on whether each OS feels the baja will return or if all pain will be gone.  I hope everyone is doing good!  

Take Care,
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.

  • SuperKNEEgeek
  • *****
  • Posts: 4007
  • Liked: 10
    • Check out my photography!
Re: Quad Tendon Rupture
« Reply #37 on: June 20, 2003, 07:31:47 AM »
Heather,

This guy from Walter Reed sounds much more optimistic than the other one.  I'm really glad you have the patellar mobility, that means you probably don't have tons of scar tissue causing the patella baja!  That's good news.

It sounds like you have a complex case, and I highly recommend the approach you are doing.  Another thing you might want to try is going to online medical journals and looking up your procedures.  You should be able to get abstracts, statistics from studies, and doctors' names.  That's how I got the word doc I sent you a while ago.

Anyway, I hope things are going well for you.  One new thing that I've discovered is lidocaine patches.  They really help with the pain when I have to do stuff and can't take pain meds.  They are almost dangerous...I wore them daily when I was traveling last week, but you can't use them for more than 12 hours a day.  When I took the patches off...YOWZA.  I guess I might have overdone it.  However, I still highly recommend the patches for those times you simply have to be on your feet.  Also, patellar taping from below in a V shape should help keep your kneecap in the right position, that might help you get by until you can have this addressed.

Were you able to get the records from your other OS?  I have to say, when you told me you'd had an IT band release--YIKES.  That's a really rare surgery.  And LR is usually tried without VMO advancement, though not always.

Anyway, I'm glad you're getting some answers.  How is the rest of your life going?  Yes, we do have lives outside of our knees.....

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 Sonia_B.

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
  • User's Text
Re: Quad Tendon Rupture
« Reply #38 on: June 20, 2003, 04:39:01 PM »
Heather,
I'm glad your getting so much info from lots of docs!  The info you have, the better prepared you will be and a better selection of OS's from which to choose!  I wish you luck and please keep us posted!
Sonia :)
1st scope 00, 2nd april 01, 3rd nov. 01, patella baja repair 02.  Still not fixed and no help in sight!

Offline Janet

  • SuperKNEEgeek
  • *****
  • Posts: 3679
  • Liked: 2
Re: Quad Tendon Rupture
« Reply #39 on: June 20, 2003, 04:55:54 PM »
Heather:

Just as I had hoped, it sounds like your patella tendon hasn't changed too much and they can redo the quad repair. Ugh, I'm sure you're not looking forward to going through that again....but at least you have an option that sounds encouraging! As for that OS being booked through November, what did he say about waiting that long? If he thinks that it should be done sooner, I'm sure he will make room in his schedule. But good for you that you are still seeking other opinions. With complicated cases, there usually isn't only one answer and it will be best for you to get all the options on the table before deciding which one will work best for you. It sounds like you're on the right track. Congratulations!

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 parky_13

  • MINIgeek (20-50 posts)
  • **
  • Posts: 26
  • Liked: 1
  • User's Text
Re: Quad Tendon Rupture
« Reply #40 on: July 06, 2003, 11:36:04 PM »
 :'(  I had bi-lateral knee replacement in Dec of 2001. The day after surgery about 10 hours after pt came in to  get a measurement on how far I could bend the knees on my own. As she grabbed the right one she kept on forcing it back until I could feel the quad tendon tear.  I start yelling and screaming at her telling her she had hurt my leg. She didn't say anything just moved to the other leg. My pain at the time was not under control from the surgery. Nothing was working so I was cold turkey at the time. It took about three weeks to confince my dr's and therpist something was wrong. Went in an repaired a 90% tear in the right quad tendon. While that was healing the left quad "blew out" 5 inches going up my thigh. Had to have that repaired. The right one froze up and had to have it relased and scar tissure removed. The wire holding the quad together broke it had to be removed. More scar tissue removed and a release again. Then I fell in my kitchen, went to take step nothing there. I tore both knees the right one 20 % the left one 10%. Dr waited 6 weeks to see if ti would repair itself it didn't went in to repair ti 30 days ago it was torn at 50%. Put in graft everything ok for about 3 weeks indentation the size of a ping pong ball at the top of the knee can not lift leg straight up to painful. Left leg not holding up at all.  I jhave had a total of 7 surgeries since knee replacements. Help//

Offline ~*Heather*~

  • SuperKNEEgeek
  • *****
  • Posts: 620
  • Liked: 4
  • Why me? Why is it always me?
Re: Quad Tendon Rupture
« Reply #41 on: July 07, 2003, 02:18:50 AM »
Hello all,

Just wanted to let you all know that I have that appointment with the specialist from Chapel Hill University on August 4.  My b-day is August 18, so I'm hoping he will have news so I can really celebrate! lol.  I'm hoping that he will have the same outlook as this other OS that I saw at Walter Reed.

Heather,
Thanks for the advice, I am continuing to research all that I can.  You have been a tremendous help along with everyone else here.

Janet,
Hope all is well is with you!  I am worrying about you and your surgery!  I see you are back posting so that must be good, huh?

Sonia,
Where are you?  I've been emailing you hun!  Hope you are okay and PT hasn't got the best of you!

Anyone know how long it takes for the patella tendon to tighten down?  I know it must differ for everyone, but if there are stretches I could do or exercises to stay away from......?????


Thanks to all for all the continuing support and best wishes!

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















support