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Author Topic: Bad clunking at 20 degrees 16 weeks after patella tendon repair  (Read 648 times)

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Offline julianc

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Bad clunking at 20 degrees 16 weeks after patella tendon repair
« on: December 13, 2020, 08:58:18 PM »
Hi,

Tried in general section couple of weeks ago but no reply, maybe it's a unique problem, but any thoughts would be much appreciated as it's disheartening not to progress.

I had a ruptured patella tendon repaired 16 weeks ago after a cycling accident. I thought I was recovering well, but have developed a significant 'clunk' at about 20 degrees when I move from extension to bent leg. So although I can use exercise bike OK, as I don't go to full extension, I am unable to walk or go up a stair without the clunk.

At fracture clinic I had x-rays and the doc spoke to the knee specalist. I was informed that the cause is my patella tilting towards the tibia too much, and catching on a naturally occurring ridge in the groove. The plan is to see if I get used to the clunking over the next 6 months, and to try and walk naturally in spite of this, which is naturally hard to do and will mean not walking far at all. Beyond that, there is some surgery that can be considered, either smooth the ridge in the groove or what I now conclude is a partial knee replacement of the PF joint.

When I though about the mechanics, I tried using a tight neoprene strap above the knee to tilt patella away from the tibia. This resulted in some improvement, lessening or removng the clunk. There is also some improvement if patella is pushed inwards, this resulted in initial focus being on strenghthening VMO with the physio.

I am 4-5 weeks into strengthening physio (squats to close to 90 deg and standing up from sitting with good leg further away). Also cycling slowly to 10 miles. There is still swelling (circumference is about 10+% higher compared with good knee).

Has anyone come across this condition, does it have a name, and if there is any advice it will be highly appreciated. Thanks for reading, Julian

Offline vickster

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Re: Bad clunking at 20 degrees 16 weeks after patella tendon repair
« Reply #1 on: December 14, 2020, 07:42:50 AM »
Has your physiotherapist tried taping the patella into a better position to see if that helps? He or she can then show you how to do it for yourself if it does?
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Offline julianc

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Re: Bad clunking at 20 degrees 16 weeks after patella tendon repair
« Reply #2 on: December 14, 2020, 04:36:43 PM »
Has your physiotherapist tried taping the patella into a better position to see if that helps? He or she can then show you how to do it for yourself if it does?
Hi and thanks  for your thoughts . Yes she did, but as an attempt to overcome a weak VMO so it was all geared up to pulling the patella across with a wide 'half moon' of tape. I will ask if we can try some other locations as muscles should be stronger now. I'm thinking something above the patella may work to try and hold the lower part out a bit. She did say she would try and get an appointment with the OT to try out different kinds of straps, which may be useful.