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Author Topic: Ruptured Quadriceps Tendon  (Read 468075 times)

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Offline JoJoe

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Re: Ruptured Quadriceps Tendon
« Reply #1095 on: June 03, 2014, 09:49:53 PM »
Hello all. I haven't been here in almost 7 years, but sadly I'm back  :-\. I had a full quad tendon rupture back in 2007 (left knee), had the surgery, and after more than a year, basically fully recovered. I was very satisfied with my results (and that of the surgeon). Well, a couple of weeks ago, it would appear I have now partially torn the same tendon. I've yet to have it fully confirmed, but I'm pretty certain (seeing a ortho surgeon this Friday). I felt it tear playing my favorite sport (volleyball), and there is now a noticable bulge on the left side of my knee, right above the kneecap. It swells anytime I'm active. So, under the assumption I have a partial tear, can I hear from anyone who has had a similar injury? I could probably exist w/o getting surgery, if all I wanted to do for the rest of my life was to walk. I can still extend my knee, but something is totally missing in terms of strength and lift. I'm afraid if I don't get it repaired, I can no longer be active with my favorite sports (running, volleyball, etc.). My main question is are partial  tears easy to detect from a MRI? Why types of surgery are available for partial tears? If a physician tells me surgery is not an option, what are my options? I'm under the assumption tendon tears don't heal, and will never get better. Anyway, if there is anyone out there with a similar issue (or had a similar issue), please respond.

Thanks!

Offline tcraig1992

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Re: Ruptured Quadriceps Tendon
« Reply #1096 on: June 08, 2014, 05:10:27 AM »
So my journey with my knee has been a long one these past few months. On march 15th I broke my tibial plateau in my left leg. I had plates and screws put in. They never checked for ligament or tendon damage initially cause they said I would have to wait till the bone healed anyway. After the fact they found I had also fully ruptured my quadricep tendon. I am a little over 2 weeks post op from the quad tendon repair and have started pt. I am allowed 50 degrees of range in the brace, but I struggle to get 30 to 35 degrees of motion as it is now. I haven't been without crutches since March 15th and I am just exhausted. Has anyone had such a low starting range of mobility? About how long did it take to get to 90 degrees?

also, with the repair does the tendon end up reattaching to the patella or do the sutures hold it in place forever?
« Last Edit: June 08, 2014, 05:13:17 AM by tcraig1992 »
3/15/14 Lateral TPF fracture
3/19/14 Surgery plate and 7 screws

5/12/14 Torn quad tendon
5/21/14 Surgery for quad tendon

Offline John42

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Re: Ruptured Quadriceps Tendon
« Reply #1097 on: June 08, 2014, 07:35:26 AM »

Hi tcraig1992

Welcome to the RQT thread on KneeGuru

You have sustained a serious injury with a long rehab in front of you.   Suggest that you read ome of the previous posts on this thread - ASK questions - many buddies out here to help you on this long road. 

Average time to increase your ROM is about 30/40ROM aftr six weeks and the next milestone of 90 ROM is 10/12 weeks.

Suggest that you click onto the undermentioned thread - I have collated a number of documents together with KneeGuru, which will give you a comprehensive idea/information of your injury and the rehab timescale.

How did you sustain your injury?  Where do you live?

Keep posting and take care

JohnK/ Manchester UK 




https://www.facebook.com/QuadricepsPatellarTendonRupture
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline tcraig1992

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Re: Ruptured Quadriceps Tendon
« Reply #1098 on: June 08, 2014, 08:13:02 AM »
Thank you for the advice, I am gonna devote some time browsing through these previous posts. Its great to find such a large collection of people who are willing to share their experience of the same injury, its a massive help and a huge stress relief. As far as how I injured my leg, it was a skiing accident, I was skiing at Whistler in british columbia. I am from North Carolina though in the United states. My ski tip dug into a mogul and my leg torqued and rotated near 180 degrees.
3/15/14 Lateral TPF fracture
3/19/14 Surgery plate and 7 screws

5/12/14 Torn quad tendon
5/21/14 Surgery for quad tendon

Offline John42

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Re: Ruptured Quadriceps Tendon
« Reply #1099 on: June 08, 2014, 09:17:07 AM »
Should have mentioned that the sutres are disolvable, so you will not notice them.   It will take up to six months before your reach a reasonable ROM - anything over 120ROM is a bonus - have your good leg measured on your next PT visit.

Take care

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline SE27Eagle

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Re: Ruptured Quadriceps Tendon
« Reply #1100 on: June 08, 2014, 07:08:49 PM »
Hey tcraig1992 - sorry to hear about your injury which made me gasp out loud in quite a crowded departure lounge - that sounds excruciating.  You did well not to pass out on the piste.

As John says, the sutures disappear entirely.  They are traces upon which new fibroblasts form and connect up to each other, anchoring your tendon through surgically drilled holes into the patella and the ends of the quads just like they used to.  Although the injury was almost three months ago, a repair that is only two weeks old will still substantially be suture - the general rule of thumb seems to be about 12 weeks for the tendon fully to grow back (and absorption for sutures depends on materials, but will be something between 6 and 10 weeks). 

During that 12 week period your quadriceps atrophy significantly, which is why you then need another three months to build up sufficient strength to support the knee in the full range of active and eccentric extension (i.e. going down as well as up stairs).  But if you put undue force through the tendon too early, you'll just re-rupture it. 

To make things a bit more complicated still, the fibroblasts which form the first connections are good at connecting with each other but are not usually aligned and therefore do not have as much tensile strength.  On the other hand, you want to be switching those fibroblasts to the longer, weight/force-bearing ones during the period of regrowth, which is why you should engage in gentle and progressively greater movement to start the process of the tendon gliding over the knee again during those 12 weeks.  But most post-operative protocols would suggest you kept it pretty immobile for 4 weeks.  There is a range of opinions on this board (indeed, on this thread) and some of us are more adventurous still.  But I would go for not too much movement for the first month - what you have done is more than enough as far as I am concerned for two weeks - and get ready to build up a bit more each day (1-2 degrees a day is just fine) in a couple of weeks' time.  The good news is that you are not behind schedule (you may even be a tiny bit ahead).  The bad news is that it is a tediously long schedule.  I have been here twice now and the tedium never ceases to surprise me - though to be truthful, it all ended up going very well the first time and I am ahead of that schedule this second time. 

Because of the delay in your tendon repair there might be an increased risk of reduced ROM if you were to be slow off the mark in terms of rehab movement.  But again, you're actually ahead of schedule compared to most of us - and being allowed 50 degrees already is at the progressive end of the experiences we have all had with our OSs and PTs.  So bon courage and keep talking to us.  From the sound of it, you're a lot younger than we are so you'll recover all the quicker.

 
L RQT 2 April 2007
R RQT 22 October 2013
Surgical repair 5 November 2013
First two leg bath 28 November 2013
First standard cycle commute into London 6 March 2014

Offline tcraig1992

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Re: Ruptured Quadriceps Tendon
« Reply #1101 on: June 08, 2014, 11:00:31 PM »
Hey tcraig1992 - sorry to hear about your injury which made me gasp out loud in quite a crowded departure lounge - that sounds excruciating.  You did well not to pass out on the piste.

As John says, the sutures disappear entirely.  They are traces upon which new fibroblasts form and connect up to each other, anchoring your tendon through surgically drilled holes into the patella and the ends of the quads just like they used to.  Although the injury was almost three months ago, a repair that is only two weeks old will still substantially be suture - the general rule of thumb seems to be about 12 weeks for the tendon fully to grow back (and absorption for sutures depends on materials, but will be something between 6 and 10 weeks). 

During that 12 week period your quadriceps atrophy significantly, which is why you then need another three months to build up sufficient strength to support the knee in the full range of active and eccentric extension (i.e. going down as well as up stairs).  But if you put undue force through the tendon too early, you'll just re-rupture it. 

To make things a bit more complicated still, the fibroblasts which form the first connections are good at connecting with each other but are not usually aligned and therefore do not have as much tensile strength.  On the other hand, you want to be switching those fibroblasts to the longer, weight/force-bearing ones during the period of regrowth, which is why you should engage in gentle and progressively greater movement to start the process of the tendon gliding over the knee again during those 12 weeks.  But most post-operative protocols would suggest you kept it pretty immobile for 4 weeks.  There is a range of opinions on this board (indeed, on this thread) and some of us are more adventurous still.  But I would go for not too much movement for the first month - what you have done is more than enough as far as I am concerned for two weeks - and get ready to build up a bit more each day (1-2 degrees a day is just fine) in a couple of weeks' time.  The good news is that you are not behind schedule (you may even be a tiny bit ahead).  The bad news is that it is a tediously long schedule.  I have been here twice now and the tedium never ceases to surprise me - though to be truthful, it all ended up going very well the first time and I am ahead of that schedule this second time. 

Because of the delay in your tendon repair there might be an increased risk of reduced ROM if you were to be slow off the mark in terms of rehab movement.  But again, you're actually ahead of schedule compared to most of us - and being allowed 50 degrees already is at the progressive end of the experiences we have all had with our OSs and PTs.  So bon courage and keep talking to us.  From the sound of it, you're a lot younger than we are so you'll recover all the quicker.





Thank you so much for this post, I definitely feel a lot better about my situation now and I don't feel as if I am behind schedule. I am 21 so I do keep hearing that I will bounce back faster due to my age which is also a huge relief. I'll have to make more posts in the future and update my progress. Thank you again!
3/15/14 Lateral TPF fracture
3/19/14 Surgery plate and 7 screws

5/12/14 Torn quad tendon
5/21/14 Surgery for quad tendon

Offline Stuart Rulka

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Re: Ruptured Quadriceps Tendon
« Reply #1102 on: June 09, 2014, 01:32:14 AM »
Tcraig1992. As a resident of greater Vancouver I extend my apologies on behalf of our local mountains! My  PT was chief therapist for the Whistler Olympics and he  is one of the more aggressive practitioners. He put me on a bike on my first visit at 2 weeks to check my movement forward and back. By the third week I achieved a full rotation and never looked back. At no time did he actually measure my ROM so don't get hung up on numbers. Push yourself as much as you are comfortable with. I'm 66 for the record.
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline SellaVee

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Re: Ruptured Quadriceps Tendon
« Reply #1103 on: June 09, 2014, 11:07:55 AM »
Can I second what Stuart has said about not getting too hung up on the numbers.  I had 2 physiotherapists and neither of them was bothered about numbers, but they were both keen that I kept moving once I started physiotherapy.

SE27Eagle has once again given excellent advice having studied the subject twice on our behalf  :).

Make sure you work on extension as well as flexion, and strength.  I didn't push my leg to bend, but I did use a floor pedaller as recommended by John42 and then an exercise bike and I also walked.  My progress was frustratingly slow but I can now stand on one leg and touch my heel to my derrière on both sides so I'm pretty bendy but I have to work at keeping my thigh muscles strong.
Ruptured patellar tendon (avulsion fracture) 11 June 2013
Surgical repair with wire 5 July 2013
Wire removed 28 January 2015

Offline WWBC1955

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Re: Ruptured Quadriceps Tendon
« Reply #1104 on: July 09, 2014, 05:53:32 AM »
Hey everyone, I have been following everyone's progress but have not updated mine for a while. I am now 8 months PO and have slowly been getting back to normal.

During the day in our office I am constantly up and down stairs, I have been able to climb the stairs with confidence for quite a while but over the last 8 weeks or so I have been able to descend then with confidence also. No handrails or hanging on anymore and that is with a full backpack on, I can also now walk up and down inclines pretty close to normal, I can also slow jog across the road if needed (have never been a runner and have no wish to be one), I have started playing lawn bowls in the last month and this seems to help with my squatting and straightening up, I do some weigh lifting with my bad leg when time permits at work, now doing 100 repetitions with a 4kg ankle weigh on. Household and yard chores (cleaning, lawn mowing chopping wood) are no longer a problem anymore.

I still have occasions where my knee feels like it will buckle and still suffer a degree of atrophy in it but I am hoping that with time this will pass.

I can bend both knees the same amount so as far as I am concerned there I have the same ROM in both knees.

I have not used a the brace, crutches or a walking stick since I was 7 weeks PO, that to may have assisted in my recovery.

Anyway, I have an overseas trip in 3 weeks (Europe & Scotland) and am looking forward to getting away (this is the replacement trip for the one I was supposed to be on instead of being in a brace - Florida and the deep south - which I hope to go on next year).

To everyone keep up the good work, this is an injury I would not wish upon my worst enemy.

Wallace
Ruptured Quads 28/09/2013
Operated 4/11/2013

Offline SE27Eagle

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Re: Ruptured Quadriceps Tendon
« Reply #1105 on: July 12, 2014, 01:35:01 AM »
Well done Wallace!

As to the momentary buckling sensation (with no actual giving way), I can tell you my experience with the first one was something like a half life of shudder decay - quite literally the intervals between each event seemed to double over the years and now it is running at about a year.  So much so that I felt a strange sense of satisfaction when a couple of months ago, still relatively early in the recovery on the other side, I had that odd moment and then realised it was on the "wrong" side. 

Once you're walking down stairs without holding on you really are on the home straight. 
L RQT 2 April 2007
R RQT 22 October 2013
Surgical repair 5 November 2013
First two leg bath 28 November 2013
First standard cycle commute into London 6 March 2014

Offline Stuart Rulka

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Re: Ruptured Quadriceps Tendon
« Reply #1106 on: August 02, 2014, 03:11:57 AM »
This thread has been quiet for a while so might as well wade in!
52 weeks ago from this moment I was on a stretcher inside a Coast Guard Hovercraft being carried to a waiting ambulance with no idea what lay ahead!
 A year older and much much wiser I can be thankful for my  good fortune and the many lessons learned.
To those starting out on the journey read older posts, especially John's, listen to your body and your PT, your surgeon, not so much! You will pull through this , stronger than before, Mentally , if not Physically. Hopefully exercise habits learned will stay with you and excess pounds will be shed.
  Good luck to all, and perhaps some of our paths will cross,under better circumstances, in the future!
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline Frank550

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Re: Ruptured Quadriceps Tendon
« Reply #1107 on: August 02, 2014, 09:13:39 AM »
Good morning fellow sufferers of knee issues.

Its been a while since I posted, lots happening in my life which now includes a long trip around Europe in our RV.

I was discharged from medical care in June, some 14 months after my RQT in April 2013. I have had some issues and have settled at a 90 degree bend max. This allows me to drive now, which I started again in March this year.

Its a shame that this is the final outcome for me, but I am philosophical about it and I have no issues with my new found disability. The only thing I have now is sudden knee movement due to the nerve damage that accompanied the rupture, the signal to brain saying "steady yourself" has gone, I did have a fall recently and I cut my back on some glass when the door I fell through broke the fall!!

Its good to read that the "nutters" are still being nutty out there, and I see James (SE27Eagle) is still galavanting all over the world.

Happy rehab everyone,

Frank
Ruptured (complete) quadriceps tendon 14 April 2013
Surgical repair 19 April 2013
Scar tissue surgically released 17 December 2013

Offline SellaVee

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Re: Ruptured Quadriceps Tendon
« Reply #1108 on: August 04, 2014, 09:56:04 AM »
Great to hear from you, Frank, I've been wondering how you were getting on.  I'm pleased that you're so much further on than you were before and delighted to hear that you're driving.

I think we're all getting on with our lives, especially now that we're into the holiday season.  Enjoy your trip.

Sella
Ruptured patellar tendon (avulsion fracture) 11 June 2013
Surgical repair with wire 5 July 2013
Wire removed 28 January 2015

Offline fishy

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Re: Ruptured Quadriceps Tendon
« Reply #1109 on: August 04, 2014, 05:06:24 PM »
Hello everyone, Fishy here.  FRANK, we both are members of a very exclusive club, and we both earned our entry into this club.  It is a club that neither of us wanted to join, but now, as lifetime members, we owe a responsibility to its membership, especially the "newbies".  I believe there is a limit as to what the medical community can do for us (and in some cases, to us) beyond which just accepting and moving on is the only answer.  You seem to have accepted this path of acceptance, now go out and enjoy the wonders of this life (as I will).  Thank you for posting your journey, I appreciate your struggle and look forward to more posting.  And as for me, well, there are grand babies I can bounce on my knee, fish that need to be caught, roses that seem to attract weeds, and a wife that loves me for who I am....take care all, keep posting, patience, and remember to laugh often.  Bob















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