Partial patellar tendon tear: my story

[sfknee]

37 y/o male. Had been running about 6 miles/day 6 days/week on a treadmill for about nine months (previously, had done less running and more elliptical and bike).

Woke up one morning and after about ten minutes got an intense pain in my right knee (prior to that, absolutely no knee pain ever in my life). Had to sit down for about a half hour before I could walk.

Went to urgent care center, they said no big deal, just don't run while it hurts. After a couple of days it wasn't hurting much so I resumed running for several months, with increasing pain.

Went to a sports medicine doctor, got an X-Ray, diagnosed as PFPS, suggested eccentric PT, again the doctor did not make a big deal out of it.

A few months later went to another sports medicine doctor, same deal.

A few months later it was not getting better, so I went to a knee surgeon, insisted in on MRI, finally got diagnosed with partial patella tendon tear. Got one dry needling treatment + PT reigmen (he did not pressure me to do surgery, but presented it as an option, which I declined).

Three months later--today--knee is about 10-15% better than it was before the treatment (in other words, not very much). I haven't run in about nine months; have been biking on a spin bicycle about 45 minutes/day but can only do low-to-moderate intensity to avoid pain. I really miss running.

At this point I'm pretty frustrated, not sure what to do. Walking around, the pain is barely noticeable (1-2 on a scale of 1-10) unless I walk a long distance or stand in place for more than a few minutes. Pain is only truly bad when I try to do anything more vigorous than light to moderate cycling. I've been doing decline squats for a couple of months, which might have helped a little but not much, at least not yet. I have zero interest in surgery (debridement), having read the reports here and elsewhere on the Internet. I've read about prolotherapy, PRP, etc., but doesn't seem much more effective than PT (which is to say, not very effective).

Just wanted to share my story. I've read enough on this forum to know there's no much I can really do (except avoid irreversible treatments that are likely to make things worse, and continue the PT).

[carkeltom]

SFknee, that sounds somewhat painful.  Sorry you are not able to return to running.  Was the patellar tendon torn from the knee cap or is it in the middle of the tendon?  I am not a doctor, but I have read most of the information on the threads, as I have had the time after rupturing both of my patellar tendons, and most surgeons insist on surgery for fully ruptured tendons, because they do not heal themselves back together.  Not sure what the dry needling treatment is and I will look up the prolotherapy.  I am counting on at least a 9 month recovery before I get back to coaching softball.  Do your own research and be informed.  The doctors might think you are being a smart-ass, but being informed is your job and so is being active in your treatment.

tom

[sfknee]

Thanks for your reply. Yeah, it is pretty painful. :-(

The MRI analysis said "partial thickness tear" which I believe means it is torn in the middle, not from the bone. As a result, the surgery that is done for full a tear (reattach the tendon to the bone) isn't appropriate. The surgery they would do for me is basically to remove the damaged part of the tendon and hope the rest heals.

If this had been diagnosed properly right when it happened, I could have kept weight off of it for a few months and would be much better off now. Let that be a lesson for everyone...

[fishy]

Thanks for your reply. Yeah, it is pretty painful. :-(

The MRI analysis said "partial thickness tear" which I believe means it is torn in the middle, not from the bone. As a result, the surgery that is done for full a tear (reattach the tendon to the bone) isn't appropriate. The surgery they would do for me is basically to remove the damaged part of the tendon and hope the rest heals.

If this had been diagnosed properly right when it happened, I could have kept weight off of it for a few months and would be much better off now. Let that be a lesson for everyone...
[/quote


SFKnee, I am very familiar with both you and carkeltom's condition.  I am a double RPT (like carkeltom) except my right leg was a partial torn ligament.  BOTH legs were treated the same....I had surgery to repair the left leg (resecting the ligament) and fluid was drained by needle from the right (10cc).  Both legs were placed in leg braces, right 90 degree ROM/left 30 degree ROM). at week 9 braces were removed (ROM increased during this period for left leg only from 30 degrees gradually up to 90 degrees, right leg stayed at 90 degrees).  Atrophy was the big deal for both legs...I was a marathoner for 25 years plus running around 60 odd marathons....I lost a total of 4 inches off each leg around my quad.  The scaring on my right leg and resultant pain from PT was far worse than my left leg.  I am now at week 19 and both legs are getting stronger, I can stand from being seated without using my arms for assistance, the night pains have reduced to bearable (1-2 on scale of 10) so I don't take meds to sleep.  We are all different, our recovery will be unique, PATIENCE, ice, PT, rest, hydration, PATIENCE.  This is a process that will take 12 months to heal, and my OS (VA surgeon with gazillions of similar operations to his credit) says I will have a complete recovery, my PT doc says realistically 80% recovery plus or minus is more realistic.  Honestly, I want a full recovery BUT will take whatever god has in my plan.  Take care, and if the "SF" in your name is San Francisco....well, lets just say Bay to Breakers, Valley of the Giants, been there, done that (and lived in San Francisco until 1981 moving to Alaska where I really learned to live...).  Take care, you and all my RPT brothers and sisters are in my prayers.

[RCMiller]

i will give you some insight based on my experience with a partial patellar tendon tear. I am a 26 year old female and I was experiencing pain for approx. 8 months that gradually got worse. In the beginning I was able to run and work out normally and would have pain for a few hours after long runs (4 or more miles). It progressed to where I was struggling in everyday life and in constant pain.

I was first diagnosed with patellar tendonipathy and did 4 weeks of PT. I did not have any success with that and got an ultrasound which showed calcification in my patellar tendon and a very unhealthy looking tendon. The next step was trying a PRP injection to help with blood flow in the tendon to repair it and another 4 weeks of PT. This was also not successful. I got an MRI which showed a partially torn patellar tendon and possibly a piece of my patella that was broken off and lodged inside the tendon. My choice at this point was to live with this constant pain and possibly cause more damage or get surgery.

I decided to choose surgery and I am now 2 weeks post-op. The surgeon did a patellar tendon debridement to repair the partial tear which was done with a 3 inch incision. They also did some arthoscophy to clear out scar tissue and also smoothed out the rough edges of the chip in my patella that was catching on things in my knee.

The first week was very painful but at two weeks post op I have started PT. They predict that after all the rehab that I will be back to 100%. I honestly recommend the surgery and wish I wouldve done it sooner because all the other conservative options did not help at all.

[sfknee]

Thanks for the reply, RCMiller! Please follow up in a few months and let us know how you did. I have been avoiding the surgery because it seems somewhat risky and has the potential to make things worse. (Of course, it also has the potential to make things better!) On the other hand, like you, I have not been getting better with PT and other conservative treatments.

[WMTS Guy]

How is your knee now? How long post surgery before you could get back to full activity?