Ruptured Quadriceps Tendon

[WestcoastMom]

Getting ready for PT here in the rainy Seattle WA area.  I will be driving there myself for the first time. 

Best of luck with everything Turbo.  It is hard enough mentally and physically deal with this injury, and then having to worry about jobs and insurance on top of it is too much.

And a happy holiday season to everyone. 

I am able to bend to about 80 degrees when I am sitting forward.  But it seems to be a lot harder when laying down or sitting back - much less range that way.  Still does not bend very far without pressure and thought.  And no strengthening yet and still walking fully extended.  (The leg has buckled once even fully extended with little movement or give in the brace.  A little scary for when I cam allowed to move on.)

It is nice to have a place like this for all the information and support.  I have found that friends and other mean well but just cannot understand the difficulties and seriousness of this injury. 

[TurboCoder3000]

Turbo,

It's great you're back doing PT.  Why do you think your ROM was only 89 degrees @ 1 year + surgery?  Were you doing anything on your own when you weren't going to PT?  I can't stress enough how important the home exercises are.  Heel slides and leg curls are your best friends..

Please keep us up to date!

It's mostly because between my lapses in insurance I 1. Had zero access to PT, 2. Zero access to exercises, and zero access to anything. And I have not been given those exercises yet.

All I could do were exercises PT had given me at that point.

Also, the other part of the story if you haven't seen my previous posts: my surgery was on 9/21/2016. Shortly thereafter around 10/5/2016, I started developing necrosis at the incision site (approximately the size of 2 dollar coins). Finally had the necrotic skin removed by wound care on 11/22/2016. The necrotic skin was so deep, I had to sit with an immobilizer brace on without much movement for 8 months while the wound healed from the inside out (going to wound care twice a week this whole time). I spent 9/21/2016 - 2/5/2017 in my recliner in an immobilizer brace, unable to bend my knee or anything until my surgery wound healed.

Because of all these complications, that's why I am still only at 89 degrees. It's a hell of a long road and I probably had the worst of the worst complications to hit my surgery.

The timeline version is:

8/28/2016 (crutches) - Tore my quad tendon completely while bowling (on lane 13, frame 3 of my first game in a while, no less).
9/16/2016 (crutches) - Diagnosed with completely torn quad tendon.
9/21/2016 (crutches) - Surgery to repair the tendon.
10/5/2016 (crutches) - Complications from the surgery begin with necrotic skin.
11/22/2016 (crutches) - Necrotic skin is finally removed, but it is so deep I need my wound to heal before bending.
11/22/2016 (crutches) - 2/3/2017 - twice a week wound care appointments with debridement until healing occurs.
2/3/2017 (crutches) - Bottom of wound finally heals. Can start bending my knee.
2/5/2017 (crutches) - My first PT appointment. Can only bend at 46 degrees.
3/26/2017 (throw away my crutches for a walker) - My wound finally finally FINALLY FULLY HEALS. OMG it's so good to finally be able to take a shower again - haven't been able to take a shower since 9/21.
4/11/2017 (walker) - Disability runs out, and I have to return to work in a brace with my walker, and have to do all of my recovery at work. Because of returning to work, don't want to start leaving work every week for PT.
5/1/2017 (walker) - Can finally remove my brace for good.
6/7/2017 (walker) - Finally strong enough to wear pants and shoes on a regular basis for the first time since 8/28/2016. Before this it was shorts and sandals always.
6/14/2017 (walker) - Can finally start doing PT again.
7/20/2017 (cane) - Can finally use a cane.
8/25/2017 (cane) - Lost my job.
8/31/2017 (cane) - Lost my insurance. Last appointment ever: can bend approximately 90 degrees.
9/2017 (cane) - Must do something like consulting work so I can catch up on COBRA.
10/2017 (cane) - Can finally pay enough to catch up on my COBRA so I can do PT again.
11/1/2017 (cane) - Insurance reinstated.
11/5/2017 (cane) - Authorization received.
11/14/2017 (cane) - First PT appt in ages. Can still bend 89 degrees.

Now the grueling work of returning to normal begins again.

Can't exactly get a new job until I can finally walk like a normal person without a cane. I can imagine all interviews think "LIABILITY, LIABILITY, LIABILITY" as soon as I walk in with a cane. Of course, they can't exactly say that.

I can't believe my consulting is going as well as it is. It could have easily been so much worse. A no or two and I would have been completely destroyed financially.

[John42]

Just a reminder

I found the most useful tool was the floor cycle - cost about $50 - £35 on Amazon, sat in my favourite chair and pedal away - a little bit each night whilst watching TV.

Was a very good investment.

JohnK/ Manchester UK

[WestcoastMom]

I will ask my Pt about the floor bike.  It would be good to do anything at this point!

While I am glad for other that there is not a lot of activity here.  I would love it for me if there were... 

I am a little shy of 10 weeks post op.  I can bend to about 90 degrees with a little difficulty.  There is tightness and a little uncomfortableness at such small bending.  But at least I am driving now.  Still walking fully extended.  I have not been lifting the leg on its own much but can.  (Although have not done any strengthening using the quad muscles)

The past day I have had more pain though.  A lot of the pain is below the knee cap.  I am never sure what is normal and what is cause for concern.  The PTs are great but don’t seem to be able to tell me what is a concern either.  They do feel around and have not been concerned with anything.  Also, the most swelling I still have is to the outside and slightly above the knee.  Seems like an odd place to be swollen.  Still pain over the knee cap and around the tendon when I massage or touch there.

Hope everyone is enjoying the holiday.

[TurboCoder3000]

At long last: I have begun PT again. And I can finally do this consistently. As of today I can finally do PT twice a week until I get over this thing.

I am bending at 92 degrees. Still improvement from last time early November when I was at 88 degrees.

Got new exercises to do to continue increasing my ROM and I see my PT next on Thursday.

I am so relieved to finally be able to have consistent PT. Life really isn't fair sometimes.

[PEB65A]

new member.
Ruptured my Rt Quad Tendon Jan 2017 51 yr old M
12 weeks Post op  6 weeks into PT still had Lag  MRI revealed complete tearing.

I had 2nd revision surgery and Lysis of adhesions surgery  mid April 2017. Took very conservative approach  to PT.  Full locked brace for 8 weeks. Very limited bending til week 12. 

At six month time frame of 2nd surgery I had another MRI.  This MRI revealed a 40% tear (1.5 CM) on the lateral edge.
The knee bothers me  no matter what activity I am doing.  I meet with the DR in a few weeks, the first meeting since the news of the latest tear.  We will be discussing options moving forward .

Do nothing
revision surgery
revision surgery with a graph

Has anyone been thru  this 3 times?
Any suggestions?

[WestcoastMom]

I am so sorry for your struggle, PEB65A.

Did you get any insight from your surgeon or PT on why they thought the re-tears might have happened?  Was there any re-injury or things somehow are just not staying put?  I have a lot of anxiety about any rerupture and the thought of going through this again or not healing is so difficult.  I feel terrible when others are going through that.

My doctor has cautious with recovery as well.  Although tough, I am glad as well.  I will probably start some strengthening and maybe walking with the brace opened to a small degree close to the 13 week mark.

I am sorry I don’t have any wisdom for you.  But just some empathy.

A 51 year old RQT rupture of the female variety...

[PEB65A]

We are unclear why it tore again.  We took a very conservative approach to PT. No forced bending, just strength training and light stretching.

i have my next appointment next week with the surgeon.  Am I wrong that a 40% tear is something to be worried about? 

I am back doing some of my daily activities, but much slower and with daily pain.  But I am far from doing all of the things I enjoy.

[Barrjoe]

In the same boat PEB. 3 timer here as well. My diary is pretty well chronicled here, but briefly, first rupture, 11/16.  Second rupture 12/30/16 . Third time, found at pt by therapist and confirmed by Ortho late March.  This was on my right leg. Also got my left knee replaced in mid July , 2017, and still recovering from that.

Not sure when and where I'm going to get my right one fixed again, but probably mid 2018 at the earliest.it needs a tendon transplant. It doesn't really bother me, but it feels a bit loose, for lack of a better description.

Anyway, would love to compare notes with you if you wish. Good luck!

[PEB65A]

Barrjoe,

 What fun we are having.  As stated I see my surgeon this week.  I have noted everything that bothers me, so I hopefully don't miss any of the details.  I would like to get this repaired ASAP, as it has been 11 months now. With a 40% tear, my fear is that it may give out and tear more or worse.
 But we are heading into winter here, with snow and ice coming.  I hate to not be able to clear the snow for my wife. But if I put if off till spring, then there are other things that need to be done.  So, there is never a good time, right.   I am a very active guy, and being slowed down has been a challenge. 
 My knee is so stiff, it bothers me all day.  If I sit to long, stand to long.  It is loaded with adhesions.  The surgeon has been telling us since day one of the 2nd surgery that he would need to go in and clean up the scaring.  I am wondering if he did that procedure, with a release, would it give me some relief and some more ROM. I will be asking that as well.
 
 Did your surgeon tell you how torn it is this time?

[Barrjoe]

Where to start....  My right knee/quad doesn't usually hurt. Does get stiff occasionally if I sit too long. Last nite being a prime example as we were at dinner for about 3 hours and when we went to leave it took me 5 minutes to get going.  Before I got hurt I was very active physically. Walked, hiked, biked or snowshoed almost every day. On top of that I have a fairly physical  job as a repairman in a power plant and, like you, live in a northern climate (upper michigan), with a high maintenance property.Without a doubt, being a spectator in life for about 12 months has f'ing sucked! I been back to work in a limited role since October and have also been walking 2 to 3 miles a day in an indoor football stadium. A far cry from what I did, but I'm grateful to be able to do that much.

As far as when I tore it the 3rd time I don't have a clue. It's not a total rupture is about all I know. My knee cap on the right looks like a healed over axe wound. Another problem I had was my left knee, which I knew was going need a replacement, got to the point where it was unbearable. So I had to get it replaced in July. If that didn't happen, I would have gotten the right one fixed. Guess that needs a transplant. Right now I'm not anxious to get carved again . 3 times in 12 months is enough for a while.

Keep in touch...

[PEB65A]

Being cut open is also not top on my list. But I  want my best chance to heal.
Went to a party Sat night, was so stiff standing.
Meeting is Wednesday. I hope we get answers on how to move forward so 2018 will be a better year.
I will let you know what happens.

[Vinny61]

PEB65a/Barrjoe,

Just curious on what procedure your  surgeon used for reattachment?  I've read in other blogs ( and spoke to my surgeon and she confirmed) that re tears are more likely if the initial procedure was done using anchors...and less likely if done with drilled holes through the kneecap.

   

[PEB65A]

Vinny , I had  the sutures thru the drilled holes in my knee cap both times.

[TurboCoder3000]

I'm so sorry for you guys and gals going through multiple / dual / etc. quad tendon ruptures.

I cannot imagine having to go through this twice. Or even both at the same time. I feel so badly for all of you suffering through this.

Anyway........

Finally more improvement in my ROM. I am up to 93 degrees. It's like a one degree improvement but I am excited to see some. There is some weakness that I discovered just today and still makes me realize I'm not a candidate for full 100% walking without my cane just yet. I can't exactly 100% straighten my knee by moving it up under its own power. I can do it using my left knee and pushing it up, but the strength to do it under its own power is nada.

Got a bunch more exercises from my PT to continue working on. Next PT appointment is Wednesday. I'm so excited to finally be able to do my physical therapy - and to have it be on a consistent basis!!