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Author Topic: Lateral Release/Small Broken Patella Piece ROM Recovery  (Read 1252 times)

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Offline Shine

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Lateral Release/Small Broken Patella Piece ROM Recovery
« on: February 19, 2007, 04:33:12 AM »
Hi....
I am so glad I found this site. I got injured on January 1st and got placed in a straight leg brace.(HAPPY NEW YEAR to me!!!) Then had surgery on January 17th. Had a lateral release, a small broken patella bone reattached and was wondering what is the normal time frame to get rom and quad strength back. I have been going to pt twice a week and am at 68 degrees rom, but still cannot do a straight leg raise.

I appreciate any feedback anyone can give me? As my surgeon is disappointed with my ROM, but my PT said its fine as long as it is improving at each visit. Thank!!!

Offline misshilde

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Re: Lateral Release/Small Broken Patella Piece ROM Recovery
« Reply #1 on: February 19, 2007, 05:29:47 AM »
It depends..how was your rom before the injury..were you in good shape ..how old are you..how committed are you etc...but if your pt is happy  and you're happy with your pt, you';re usually ok...my first pt was way too careful and I changed after the first visit...I don;t remember exactly , but quad strength came back almost immediatly, vmo not so good...rom fast too(2-3 weeks I think), but I was in really good shape before surgery

hilde
born with bad knee
83 patella ligament pierced by iceicle
84 50%  hamstring rip
86 lateral meniscus tear
more dance 
99 menisectomy(finally)
more dance
patellar & quad tendontis
05 LR, bonespur removal, general clean out, stage 4 OA
oct 06 illiophoas release( hip ok) but knee still bad...

Offline Shine

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Re: Lateral Release/Small Broken Patella Piece ROM Recovery
« Reply #2 on: February 19, 2007, 08:00:33 AM »
Thanks for your response. I am 30........had good ROM before the surgery and am in pretty good shape. This is why I think it would be coming back quicker. What types of exercises did they have you do to get back your quad strength. She has me doing assisted straight leg raises, and I am doing side leg raises on my own. I don't know how good the pt is? But have been diligent at home about doing pt exercises and have been on the CPM machine for 4 hrs/day. Uh..........this is such a long process.

Offline Doc79316

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Re: Lateral Release/Small Broken Patella Piece ROM Recovery
« Reply #3 on: February 19, 2007, 09:40:41 AM »
Hi,

Really it's already been said!

If you are improving at every PT visit and you know you are pushing yourself a little adoing enough to sustain improvement then your progress is fine. An OS will always want you to have a better/improved ROM than you already have. It could be that your knee hasn't healed quite as quickly as others but it's nthing to worry about at this stage.
Keep pushing yourself and working at the PT. If you find you have some discomfort during your exerises that's OK. If you end up in pain then you're overdoing things. Physio was never meant to be easy but pain is an indicator of when you need to ease off.

Take care,

Laura x
Left knee surgery
08/06/02 - L/Release
13/08/03 - Fulkerson TTT
05/06/05 - Stabilisation & Medialisation/Tendon Transfer
13/01/06 - Proximal Hamstring Superior Stabilisation
06/03/06 - RSD/CRPS diagnosed
20/07/06 + 03/04/07- Excision of scar tissue
30/07/07 - PKR suggested by OS (no date yet)

Offline misshilde

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Re: Lateral Release/Small Broken Patella Piece ROM Recovery
« Reply #4 on: February 19, 2007, 05:20:47 PM »
Place a small ball or a blood pressure cuff under your knee, place a dobble rolled towel under you ankle then push the ball down with your knee and try to lift you foot off the towel....all without engaging your stomach or glutes...I did 3 sets of 10, I also did a lot of hamstring exersizes , pilates reformer and 10 minutes on the bike...also sit on a chair, knees hip whith apart, legs bent at 90 degrees, push your heel down on the ground as to stand up(but don't), both your quad and vmo will engage.....I had a hard time using pain as a gage because I'm so used to pushing myself and musclefatigue and pain got a bit mixed up in the beginning...either way, if you're happy with you pt and the pt is happy with you .....you're ok...most pt's know more about rehab than the docs anyway....good luck and keep up the good work

Hilde
born with bad knee
83 patella ligament pierced by iceicle
84 50%  hamstring rip
86 lateral meniscus tear
more dance 
99 menisectomy(finally)
more dance
patellar & quad tendontis
05 LR, bonespur removal, general clean out, stage 4 OA
oct 06 illiophoas release( hip ok) but knee still bad...

Offline Shine

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Re: Lateral Release/Small Broken Patella Piece ROM Recovery
« Reply #5 on: February 19, 2007, 07:56:50 PM »
You all are so nice! Thanks for all your responses. Its nice to hear from someone who has gone through this before. Good luck with your recoveries!

Offline kimmyxs

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Re: Lateral Release/Small Broken Patella Piece ROM Recovery
« Reply #6 on: February 19, 2007, 08:07:22 PM »
Hi, you might want to post in the Bone Breaks around the Knee section of this website.  Many of us have had broken patellas.  To be honest, this break is not all that pleasent as you have found.  Did the OS put screws and wires, or did what was the extent of the surgery.  A good deal depends on the type of surgery you have had.  I had an open ORIF - I was Non-weight bearing for two weeks after surgery (I was in a hinged brace with a nice incision down the knee).  It was 12 weeks before I was allowed to do PT, but at that time I had about 90 degress range of motion.  All that was mid-June.  I was able to spin almost 2 months out - from then on it was pretty great improvement until the knee started catching.  We thought it was a meniscus tear, but come to find out it was the patella trying to leap over the groove and dislocated.  It was a dislocation that caused the break in the first place.

I had screw removal, at LR, debridement, and VMO advancement on Jan 15.  I wish I were typical, but my break was unusal - vertical, it broke in a rare way, and who knew that I would end up with a VMO advancement - my OS thought it would just be a LR.  Anyway, each of us is different.  The LR has caused me the most issues with pain.  The VMO advancement is limiting my ROM (the OS won't open the brace more than 30 degrees every two weeks.  I just got to 90 degrees. 

Do what your PT asks.  Don't push it more that either your OS or PT say because you don't want to comporomise the healing of the patella.  Its function is cruicial.  ROM really will come, but in the intial stages it will be slow.  Work on your quad strength.  Quad sets watch the muscle move the patella.  Getting it going will aid in those SLR. 
6/03/89 - First Knee Cap Disclocation
7/05/89 - Returned to work
6/17/06 - Tramatic Knee Cap Dislocation and Vertical Fractured Patella
6/28/06 - ORIF - Screws - no wires
8/24/06 - Ditched the brace - start PT
9/20/06 - First spinning
1/15/07 - screw removal, LR , VMO Advanc  & patella cleanupl