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Offline aussiegirl1

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100 degrees - will that be it?
« on: October 06, 2010, 02:53:11 AM »
Hello all,  I have just joined the group and wish I had found this site 18 motnhs ago.

I broke my patella March 09 - 5 pieces.  I had a wire circle around the bone, figure 8 over the top with 2 clips.  I started physio in May 09 an stopped in October as the wire was really impacting my level of bend.  I had the hardware removed in Feb 2010......instant relief.  I started back at physio once the stitches were out and then began a program at the gym to improve strength and muscle tone.  I am now back doing Body Pump classes at the gym and have also given Zumba a try.  I was feeling pretty good within myself and felt like I was getting back to some kind of normality.  I stopped in to get my degree of bend measured at physio yesterday as I thought for sure I would have increased.  To my disappointment it looks like I am stuck at 100 degrees.  :o

Has anyone been in a similar situation?  Does anyone know if some kind of surgery could assist?

I have not suffered with any pain since having the wires removed.   I am trying however, to deal with the "clicking" sound and feeling when bending.  Should I be happy with 100 degrees and just leave it as it is?

Hope to hear from you soon.

Offline Kimberly 77

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Re: 100 degrees - will that be it?
« Reply #1 on: October 06, 2010, 07:57:05 PM »
If there is no pain and you are able to be active, then I would leave it as it is. If it is causing disability or problems getting around then I would probably check more into it. Surgery can sometimes make a problem worse so if you aren't in pain now you maybe after you have it "fixed". Thats just my opinion though, it probably wouldn't hurt to seek a orthopedic Dr for their opinion.
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline Greta

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Re: 100 degrees - will that be it?
« Reply #2 on: October 06, 2010, 10:21:35 PM »
Hi Aussiegirl

Your case sounds very like mine. I don’t know how whether you have read any of my posts, but I will tell my ‘story’ below in case you haven’t.

My ROM is probably only about 90 – and I am now 14 months post break. I had the MW removed at 9 months, and an MUA. I am now waiting to have an arthroscopy to see what is going on and to clear out scar tissue, and to have another MUA. A CT scan I had 2 months after my break showed 2 loose fragments of bone; it is thought that one of these is catching on my thigh bone when I bend beyond 90 – hence my limited progress.

Like you, I am in no pain (except when I try to bend further) can live more or less a normal life apart from going up and down stairs. I get a clicking feeling with extension which is at maximum. I am working on my leg strength as much as I can.

I wonder if it could be that you have a physical reason, like I do, for the lack of ROM increase. I assume that had X-rays or scans since your MW removal. However, you don’t say you experience pain on trying to bend further, so this may not be the problem. I do think it would be worth your while going to see your OS for advice.

This is a wonderful site, I didn’t discover it until October – over 2 months after my accident. I have picked up lots of good advice but more than that the moral support from all the other knee sufferers has been wonderful and I am so grateful to them all.

All best wishes to you – I hope you get the answers you need.

Here’s the saga of my last 14 months:
•   1 Aug 2009 Patella shattered
•   2 Aug ORIF: 2 pins, figure of 8 and cerclage wiring.
•   Ankle to thigh plaster
•   Mid Sept plaster removed – hinged brace
•   Physio begun. Inexperienced PT (won’t go into this now) More experienced PT took over on next visit
•   Beginning Oct ROM stuck at about 40 – PT thought metalwork could be the problem
•   1 Oct – hosp appt CT scan ordered (possibility that either MW had shifted or loose fragments. Told to cease physio until results known
•   16 Oct CT scan
•   12 Nov hosp appt – not told result of scan (different doctor) – reprimanded for not doing physio (!)
•   Restarted physio – still getting no improvement. Suggested GP may have CT result
•   12 Dec GP appt – CT scan showed 2 loose large fragments of bone
•   7 Jan hosp appt postponed because we were snowed in
•   28 Jan saw OS for first time ever. He agreed  there was problem with MW which was now protruding sharply from patella. Said he would operate to remove it
•   10 Feb operation for removal of MW scheduled but cancelled because I had an e-coli infection. This took 5 months to clear up.
•   12 May MW removed and MUA (110). Instant freedom from pain and ROM 90 on release from hospital
•   Resumed physio, but unable to increase ROM. Worked on leg strengthening. Pain at outer side of knee when trying to bend further. Large lump sticking out.
•   10 Sept appt with OS. He plans arthroscopy to clear out scar tissue and have a look inside and also will operate at the side to remove at least one of the fragments which is not mobile but firmly attached to something – he thinks probably scar tissue.
•   Unlikely to have this 3rd procedure before Christmas as I am mobile and not in pain. This will be done as day surgery, although I will have a general anaesthetic.
1Aug:comminuted L patella#+RPT
2Aug:ORIF+cylinder cast
Sept:hinged brace
ROM poor
Oct CT scan:2 large bone fragments
May:all metal out+MUA[110]ROM:90
Sept:ROM still 90
7Feb:MUA[130]+excision to remove fragment;no arthroscopy;all cleaned thru incision
25Feb:followup;more PT

Offline aussiegirl1

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Re: 100 degrees - will that be it?
« Reply #3 on: October 07, 2010, 01:46:59 AM »
Thank you for the feedback Kimberly and Greta.

Knowing that the entire process is a very long and slow one I will continue doing my gym classes and see if it decides to give a little over the next few months or so.

You are right, if I am not in pain and can live a reasonably normal life it would be best just to leave it.  There are just times when it would be nice to sit with you leg tucked up on the is the simple things in life you miss. 

Greta, I wish you all the best for the next stage of having you scar tissue removed.  I will be sure to follow your updates.

Stay in touch.