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Author Topic: Patella fracture/ACL reconstruct  (Read 2172 times)

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Offline jsulli

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Patella fracture/ACL reconstruct
« on: February 03, 2011, 03:11:16 AM »
First of all, I feel so relieved to have found this site. After crying (again) in frustration tonight, I feel like I have found hope! I am six weeks out from a right ACL reconstruct, and one week ago I slipped on the ice and had an "eccentric contraction" unstable patella break on the same knee. I had surgery for that, luckily with only metal sutures, no other hardware. I thought the pain from the ACL was bad, but this has been much more painful. I did not think I was a wimp but this surgery is proving me wrong.  ;) I guess my main concern is what is next in the process. I was so completely depressed when the second injury occurred, I did not ask any questions as far as post op progress. I have not seen the surgeon for my follow up yet, (weather has had the office closed) but I am supposed to see him tomorrow. I have the immobilizer on now, and have not even seen my new incision. How long do you keep the brace on? How long are you on crutches? Will I be able to gain my extension and flexion that I had worked so hard to get back after the ACL reconstruct? Obviously I know each case is independent of the next, but I am just looking for some points of reference. I have really struggled remaining optimistic. I had just gotten back to walking and driving, and to lose that again so quickly has been rough on me mentally. I am sure my husband will be just as thankful I found a site to talk to!! Thank you in advance for any information anyone is willing to give!!  :)
11/25/10-ACL tear (playing the Wii "just dance"!
12/20/10-ACLr w/ patella graft
1/24/11-eccentric contraction patella break (unstable)
1/25/11-surgical repair

Offline randoknee

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Re: Patella fracture/ACL reconstruct
« Reply #1 on: February 03, 2011, 05:28:54 AM »
jsulli,
I know how you feel.  You are not a wimp.  You... I mean we, are just having a world class streak of bad luck. 

18 months after a ruptured patellar tendon repair (slipped on ice the 12/26/08, two days after my dog died)   my patella snapped on me while walking across my back yard on a sunny day.  :P  Now today, 6 months after my surgery to repair my patella, my OS told me I still have a fracture line and "delayed healing".  It's frustrating and depressing.  If my wife leaves  me and I wreck my pick up truck, I'll write a hit country song.

With this busted patella,  I pretty quickly got off the crutches and walked FWB with my brace on and locked.  I have a left knee injury, so it was pretty easy to get back driving an automatic once I was off of the narcotic pain killers.  I still had to sleep with the immobilizer brace on for about 12 weeks.  It makes for crummy sleeping.  When I was released from the TROM brace, I pushed for and got a functional (athletic style) knee brace to allow for better mobility yet provide some protection against possible re-injury.

Priority one for me is to get my patella healed up.  So I'll keep taking calcium and vitamin D supplements and work on the PT as much as I'm able.  I'm now going to cut out the caffeine and hopefully improve bone growth.  Tomorrow I get to start my electronic bone growth stimulator "phase". 

Hang in there.    this too shall ... that which doesn't kill us, makes us...  blah, blah   One final thing... just to be safe, I suggest you not go swimming with great white sharks for now. ;)

Dan





12/08 L patellar tendon rupture (mush) -ORIF  -  8/10  fx of L patella  - 8/10 ORIF L Patella 9/10  dx patella alta  - 2/11 dx "delayed union" - 6/11  L knee scope / HW remvd.- 6/13  R Knee Scope - 11/13 R knee PFA - 6/14 Left knee PFA - 10/14 L Knee TTO- 11/16 L patellar tendon repair & augment

Offline jsulli

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Re: Patella fracture/ACL reconstruct
« Reply #2 on: February 03, 2011, 09:29:18 AM »
Thank you so much Dan!! Night time seems to be a bit brutal, as evident by my being on this site at 3:15 a.m., so it was very helpful to read this-and laugh really hard when I got to the part about great whites! (cancelling that trip now) :D Hopefully I will get good news today at the doc. Good to know on the calcium and vitamin D too-I had read that a couple of times, but not been told. Thank you so much again!

Julie-voted most likely to be injured in high school-guess those things really are accurate!!
11/25/10-ACL tear (playing the Wii "just dance"!
12/20/10-ACLr w/ patella graft
1/24/11-eccentric contraction patella break (unstable)
1/25/11-surgical repair

Offline Snowy

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Re: Patella fracture/ACL reconstruct
« Reply #3 on: February 03, 2011, 03:55:19 PM »
Julie - you poor thing! It's been hard enough managing an ACL reconstruction on its own; I can't imagine going through a patellar break in the middle of rehab. I'm afraid I can't offer advice about the break, but I just wanted to offer you my sympathy and support. Hopefully once the kneecap is healed you'll be able to get back on track with the ACLr recovery; thank goodness you didn't hurt the graft during your slip on the ice.

Do I see by your signature line that you tore your ACL while playing on the Wii? I think I shall have to mention that to my friends and family members who like to make horrified noises at me for wanting to ski again, and telling me how dangerous it is... ;) (We also have an ACL on here that fell victim to a pair of high heels, so nothing's safe.)

I know just what you mean about a reputation for injury. A friend of mine just started working with a former coworker and when she asked if he remembered me, his response was "Kay? Wasn't she the one who did a lot of extreme sports and was injured all the time?" Some things don't change. ;)

Take care, and heal up well...
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline jsulli

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Re: Patella fracture/ACL reconstruct
« Reply #4 on: February 05, 2011, 03:57:20 PM »
Thanks Snowy-glad to know I am not alone! I have made it two days with no tears, so I am considering this huge progress!! I saw the surgeon, and he wants me to work on the straight leg raise. I had to work pretty hard with the ACLr, and had only added a 2 pound weight two days before the patella break. I seem to be unable to get to the leg raise this time. Any advice? I know how weak my quad was, and I am getting nothing from it now :-[
I am also supposed to bend to 30 degrees. I can get there off of the side of the bed or a chair, but not without the help of gravity. Any words of wisdom welcome!!  :)
11/25/10-ACL tear (playing the Wii "just dance"!
12/20/10-ACLr w/ patella graft
1/24/11-eccentric contraction patella break (unstable)
1/25/11-surgical repair

Offline randoknee

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Re: Patella fracture/ACL reconstruct
« Reply #5 on: February 05, 2011, 06:44:34 PM »
Julie,
I've been using my good leg and a "tender" for my bad leg for getting it up and down onto the bed and pillows and stuff like that. Gravity helps getting it down, but I have to control it more than 9.8 meters / sec^2.

On straight leg raises.  My new physical therapist has me first engage and contract my hamstrings before engaging my quads.  With my leg flat on the surface, I push down with my heel to engage the hamstring muscles and with the hams contracted, I then contract my quad before doing the straight leg raise.  It's really helped reduce the amount of pain across my knee and has made the straight leg raises doable for me.    Maybe that will help a bit.    With me, my patella is riding high (patella alta) and my quads are knotted and bunched up all the time so it may not work for you. 

Dan
12/08 L patellar tendon rupture (mush) -ORIF  -  8/10  fx of L patella  - 8/10 ORIF L Patella 9/10  dx patella alta  - 2/11 dx "delayed union" - 6/11  L knee scope / HW remvd.- 6/13  R Knee Scope - 11/13 R knee PFA - 6/14 Left knee PFA - 10/14 L Knee TTO- 11/16 L patellar tendon repair & augment

Offline Snowy

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Re: Patella fracture/ACL reconstruct
« Reply #6 on: February 06, 2011, 12:00:54 AM »
I struggled a lot with regaining flex after my surgery, so I sympathize. This is what worked better than anything else for me, though I would stress that you should check with your PT before attempting it as a healing kneecap might alter your capabilities considerably.

What I did was sit on my stationary bike and use the pedals as a lever to push the knee into bending a tiny bit further each time. I couldn't turn them all the way around when I first got on the bike, but I would rock them gently at the maximum point that I could get to to try and encourage the knee to bend a degree or two more. This worked really well, and made a big difference to my overall efforts to work on flex. Cannonballs (lying on your back with your legs bent and letting gravity pull your knee down toward your chest) were also helpful.

Good luck...it's a battle, that's for sure...
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA