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Author Topic: Torn quad muscle/tendon complications  (Read 8926 times)

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Offline ek604

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Torn quad muscle/tendon complications
« on: January 28, 2011, 11:27:37 PM »
Hi everyone i am now 3 years post op from a torn quad muscle surgery on my right leg.

i am going to post my post-op report for the kneegeeks here to read and help me, i am quite desperate at this time

"A linear incision was made over the superior pole of the right patella. Dissection was carried through skin and subcutaneous tissue. The quadriceps mechanism was then identified. On the medial side, the vastus medialis inserted directly into the patella. On the lateral side, there was an obvious tear present of the vastus lateralis. It had torn approximately 1 inch above the patella and retracted. The defect between the vastus medialis and the lateralis was evident with a complete tear of the vastus intermedius. With the use of cutting cautery, a vertical incision was made in the area of the graunulation tissue. Inspection of the undersurface of the quadriceps tendon itself showed no obvious degeneration present. Following this, the medial border of the vastus medialis was then advanced distally and medially to plicate the original tear following which the repair was then reinforced with No. 1 Ethibond."

The problem i have been having after physio is that i have a ton of pain all around the quadricep area just above the kneecap. It is painful to the touch at some points and with some pressure it is excruciating. I also cannot put weight and bend my right leg to about 100 degrees such as squatting or else a sharp pain seems to strike the area where the quad tendon is and is extremely painful and would give out. I also cannot step up on the leg if it is around 90-100 degrees from a sitting position.

I am starting to believe that after 3 years of rehab i am still having these problems and the leg is actually worse off now than before the surgery. I am going to get another opinion from another surgeon as the on who operated on me wouldnt address my concerns and just said thats the price you pay for playing sports.

I have seen physios and other specialists and most seem to say its just scar tissue pain. but there is no way it can be this bad can it? i have been massaging it vigorously for a long time now and still no improvement. My balance is a bit bad as well and walking down stairs is a little painful/unstable, going down slopes causes alot of pain just above the kneecap and the pain comes from the tendon just before it attaches to the patella. My right leg constantly has this dull achey feeling as if it is not alive, the only thing that makes it feel "alive" is after leg extensions where i get the pump feeling and it would feel active, but this quickly wears off withing 15-30mins and the next day its painful/sore again.

Because of these complications that has been ongoing now for a long time i have been depressed. I am starting to feel like the surgeon messed up on my operation.
What do you all think i should go? do you think a possible next surgery can even fix this? I also have to mention my right quad has atrophied and is 2 cm smaller in diameter than my left. My biggest concern is the pain. All comments will be helpful thanks!
« Last Edit: January 28, 2011, 11:32:53 PM by ek604 »

Offline nwc07

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Re: Torn quad muscle/tendon complications
« Reply #1 on: February 04, 2011, 03:54:01 AM »
I havent had this type of surgery but I can relate to the dull achey feeling like your leg is not "alive."  I looked at your previous posts and see you were immobilized for a long time.  I had prolonged immobilization and now at almost 5 months post injury I struggle with regaining that lost muscle.  Do you do alot of strength training?

Your OS sounds insensitive.  Unfortunately thats not all that uncommon as I have dealt with that myself.  I would get 2 and 3rd opinions if at all possible...

09/10- left knee subluxation..

Offline frederico

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Re: Torn quad muscle/tendon complications
« Reply #2 on: February 08, 2011, 02:35:13 PM »
Ek604- sorry you are still having problems.  I would certainly get another opinion if you do not feel the OS is of a help. 

I am 3 years post- QTR and my knee is doing fine. However, those feelings you describe:
 "My right leg constantly has this dull achey feeling as if it is not alive, the only thing that makes it feel "alive" is after leg extensions where i get the pump feeling and it would feel active, but this quickly wears off withing 15-30mins and the next day its painful/sore again."
were very common for me during my first year after the QTR.  I would accept them, allow a few days to recover and then push again.  Slowly but surely they abated.  Even now, if I really push hard, (long bike ride, lots of deep knee bending)  I can get some tenderness in the QT area. 

I think the massage would be helpful.  You don't speak much about your PT program, but IMHO, an aggressive PT regimen would be the way to go rather than another surgery.  I would also assume there are no other underlying medical issues. 

Hope that helps.  :) 

 


Offline ek604

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Re: Torn quad muscle/tendon complications
« Reply #3 on: February 10, 2011, 04:02:47 AM »
my major problem right now is when i stand for say 15-30minutes it feels like my tendon/muscle starts to swell and would be tender n painful with slight pressure applied on it at the area just before it attaches to the patella. Once i get this warm/swelling sensation if i proceed to do any kind of activity which involves the leg being at a 90 degree angle or lower to be painful suhc as controlled squat on the way down, stepping up steep stairs, lunges, etc This swelling/pain does somewhat seem to get released when i bend my leg, so when i stand for a long time and it feels like it starts to swell i would jus bend my leg towards my butt a few times or do a slight quad stretch and that feeling would go away and would feel a lot better but not completely pain free. Another concern i have is after workouts where i do get a pump on the leg, once standing my leg feels like its hyperextending or wants to really bad and this starts to give me a pain similar to when you flex a muscle and its like a strain feeling and my leg would start to shake n i would limp a bit. again this feeling gets slightly relieved by bending the leg

Offline TCKRDR

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Re: Torn quad muscle/tendon complications
« Reply #4 on: February 22, 2011, 06:24:56 PM »
The operative note mentions that the vastus lateralis and vastus intermedius were torn, but does not describe any repair or reattachemnt of these heads to the patella.   It doesn't sound like a tyipcal repair/reattachement, but perhaps there were techical reasons for this.
(The vastus lateralis was described as retracted - did you wait for a while between injury and your surgery?).
I would get another opinion and a MRI of the repair might help to establish whether the vastus lateralis and vastus intermedius were reapproximated with the patella.

Offline ek604

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Re: Torn quad muscle/tendon complications
« Reply #5 on: February 23, 2011, 02:07:34 AM »
The operative note mentions that the vastus lateralis and vastus intermedius were torn, but does not describe any repair or reattachemnt of these heads to the patella.   It doesn't sound like a tyipcal repair/reattachement, but perhaps there were techical reasons for this.
(The vastus lateralis was described as retracted - did you wait for a while between injury and your surgery?).
I would get another opinion and a MRI of the repair might help to establish whether the vastus lateralis and vastus intermedius were reapproximated with the patella.

I just saw a new OS today and i am scheduled for another MRI to check for the outcome of the surgery, and yes i did wait about 4 years since my injury until the surgery. I would have to say i injured it in soccer when i kicked really hard against the ball while another player did as well and after that i just collapsed and sat out for the game ( couldnt walk, was limping). Right after this i went to see my doctor and got x-rays and ultrasounds with no help. I also forgot to mention that the end of my report states this: "At the time of his repair today, the vastus lateralis and the intermedius were advanced and plicated over the remaining vastus medialis"

The new OS cannot say what may be wrong and where the defect is at the moment and is why i am getting another MRI, he think it may be swelling of the tendon or there is still a defect. Either way i dont know what option to do at the moment, the thought of another surgery just seems daunting and maybe i just have to live with this which really sucks too. o well i will update in a few months when i get my MRI and next appointment with the new OS. This has been a long struggling battle.

Offline TCKRDR

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Re: Torn quad muscle/tendon complications
« Reply #6 on: March 04, 2011, 01:23:12 AM »
What did the MRI show?

Offline ek604

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Re: Torn quad muscle/tendon complications
« Reply #7 on: March 05, 2011, 10:36:50 AM »
I have not got the MRI done yet it will take anywhere from 4 months+ as i live in canada and there are long lineups for MRI's unless i pay privately to get one done which will cost upwards of 2000$