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Author Topic: Quad Tendon Revision Repair Failure  (Read 14125 times)

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Offline quadder

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Quad Tendon Revision Repair Failure
« on: January 26, 2014, 10:01:39 PM »
Hi guys,

On the 14/06/2012, I shared with you my experience of a failed repair to a ruptured quad tendon of my right leg. As a consequence a revision repair was carried out in May 2013 using a LARS ligament. Unfortunately the repair has also failed.
I have a consultation with my OS and one of his colleagues at a complex case clinic in 2 weeks time at which time they will have the results of the latest MRI scan and will  discuss this second repair failure and advise me what, if anything, can be done to carry out an effective repair. At my last consultation prior to the scan, my OS did say that depending on the scan results the present condition of my leg could be the best that it will get.
I have since found an article on the net reporting on a relatively new technique which appears to fit the bill for my situation however I am unsure if it is approved in the UK, the link is :- http://orthojournal.org/2011/08/21/revision-quadriceps-tendon/

To conclude, as I am the eternal pessimist, if anyone has had a similar experience to myself or are aware of any other repair techniques out there or any other help or info which I could benefit from, it would be great to know about and also add some fodder to discuss at the planned consultation with the OS.

     Cheers,
          Quadder.

Offline Frank550

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Re: Quad Tendon Revision Repair Failure
« Reply #1 on: January 27, 2014, 08:52:33 PM »
Thats a very interesting article and one that I may well be showing to my prof in case he isnt aware of it.

Whether thats approved over here in the UK, who knows, but it reads like there may be light at the end of the tunnel. I can see similarities in my own situation although quite different, I like the case study, have atrophy of the quad muscle and adhesions also, now whether the repair would be suitable for my situation Im unsure, but it sounds like you would be the perfect candidate.

Let us know what your OS thinks.

Good luck
Ruptured (complete) quadriceps tendon 14 April 2013
Surgical repair 19 April 2013
Scar tissue surgically released 17 December 2013

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #2 on: January 28, 2014, 11:17:34 AM »
Thanks Frank, I have my consultation on the 10/02/2014. I will keep you posted.

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #3 on: February 11, 2014, 11:14:06 PM »
Update for those interested :-

Well, I had the consultation at the complex case clinic yesterday with my OS together with two of his colleagues and three junior doctors. After thorough examinations and numerous questions from them all, the MRI scans where perused over and the decision made to carry out a second revision  operation using more of the LARS ligament technique to reinforce the repair. The knee will then be braced in the extended position with any movement only being introduced after six weeks, as opposed to two weeks as the previous ops, to allow the surgery to heal and strengthen. The OS did explain that I could loose some bend in the joint however he thought that it be unlikely. Out of curiosity, I asked about the repair which I posted the link to in my initial post. My OS explained that he had performed the procedure a number of times albeit on younger patients than myself. He explained that as I am 65 years of age it is considered that I need the hamstrings/ligaments to remain where they are to maintain the strength etc in my legs but was still young enough for the planned procedure to be effective.
 I was advised that he would hope to carry out the surgery within six weeks and was asked to return to the hospital later to attend a pre-op assessment.
 For those interested, I will keep you posted.

     Quadder.       

Offline fishy

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Re: Quad Tendon Revision Repair Failure
« Reply #4 on: February 12, 2014, 04:42:27 AM »
Hey Quadder, I am a 67 yo with double RPT, 39 weeks post operation.  There are members of our "club" 77 years old.  I will follow your posting and look forward to your continued progress thru this.  Our  rule one is "patience", our second rule is "see first rule".  I really understand your situation and I want you to heal.  Stay positive, get grumpy, be testy, then remember rule one...... Bob

Offline Frank550

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Re: Quad Tendon Revision Repair Failure
« Reply #5 on: February 12, 2014, 01:07:03 PM »
Hi Quadder, thanks for the update.

6 weeks braced, wow, personally that wouldn't work for me as I now have found out I am prone to scar tissue build up and inactivity makes this worse, my new OS likes his patients to have movement very early but no load bearing initially until the repair can hold, then introduce the load work then.

In any case I wish you all the good fortune I can send and please do keep us updated as to progress etc

Frank
Ruptured (complete) quadriceps tendon 14 April 2013
Surgical repair 19 April 2013
Scar tissue surgically released 17 December 2013

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #6 on: February 12, 2014, 11:45:48 PM »
Thanks for the interest guys, I will keep you posted.

Quadder,

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #7 on: April 27, 2014, 10:09:18 PM »
Hello again to those interested.

Well needless to say and thanks to our wonderful NHS system, I didn't make surgery within the said six weeks as the surgeons planned. Little wonder there is wastage of resources, with pre-op assessments being carried out and admissions not arranging a slot. Anyway the surgery is now confirmed for the 9th May 2014. 
Here's hoping that it's third time lucky, I will let you know.

Offline carkeltom

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Re: Quad Tendon Revision Repair Failure
« Reply #8 on: May 09, 2014, 02:15:40 AM »
quadder, good luck on the surgery tomorrow.  Sorry about the wait for surgery.  Keep us updated or post on the RQT thread during your rehab.  Keep strong.
Bilateral patellar tendon rupture 7/19/13

Offline Stuart Rulka

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Re: Quad Tendon Revision Repair Failure
« Reply #9 on: May 09, 2014, 03:18:49 AM »
Quadder, I echo Tom's sentiments re Surgery and updates. All of us on this site are cheering for you!
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #10 on: May 12, 2014, 02:51:05 PM »
Hi guys,

Well the op went ahead as planned and the consultant gave me the thumbs up and said that it's "sorted".
I'm now in a fixed cricket brace for 4 weeks as opposed to 6 as originally suggested. The staples are to be removed in 2 weeks and I see the consultant again in 4 weeks. Meanwhile I have been instructed via the physio that touch weight bearing only is allowed on the affected leg for the 4 week period. This is easier said than done. As a big guy, 6ft 2inch and over 17 stone (weight gained through relative inactivity) I'm finding it extremely difficult and tedious getting about with this restriction using the forearm crutches supplied. So, I was wondering if underarm crutches would be more suitable. I would welcome comments from past and present crutch users.

    Thanks, Quadder.

Offline bballkingofnba

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Re: Quad Tendon Revision Repair Failure
« Reply #11 on: May 19, 2014, 01:51:00 AM »
I definitely prefer underarm crutches. I am 6'2 as well and I find them a lot easier to balance and you could cushion the tops of the crutches so you don't get too much pressure in the under arm area. My 2 cents since I can relate to being tall and went through this injury.

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #12 on: June 18, 2014, 02:04:53 PM »
Hi guys,
Well I'm 2 days short of 6 weeks post op, 4 weeks of which were touch weight bearing managing with the forearm crutches. I developed a small Infection in the wound following the removal of the clips which with a course of antibiotics cleared after just over 2 weeks. The leg is still in extension which I hope will be released a little tomorrow when I see the consultant. I'm getting around better now full weight bearing and only use one crutch when I venture out otherwise I get around without in the house. I can't comment on the strength of the repair just yet because I haven't been allowed to bend it, I may judge better after tomorrow.

Offline quadder

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Re: Quad Tendon Revision Repair Failure
« Reply #13 on: November 06, 2014, 07:34:01 PM »
Hi guys,

Sorry it's been so long since my last update.
I saw the OS on the 19th June 2014 as planned where he explained that he repaired the tendon this time using the method shown in the link which I mentioned on the 26th January 2014.
He asked could I walk without the brace and could I bend my knee. I replied that I hadn't tried because I was told not to remove the brace. He then removed the brace and asked me to raise my leg from the examination table. This I tried but as the leg was showing an amount of lag I couldn't fully staighten it. He then told me to walk across the room and back. He seemed happy with the result and  told me to ease myself off the crutches in my own time and that he would see me again in a further six weeks.
This has been the reason for not updating sooner as after twenty weeks of waiting and two emails to the OS I finally had a follow up appointment today. He apologised for the delay saying it was due to administration procedures and asked how the leg was. I explained that I reported in my first email five weeks ago that the lag was still evident in my leg. He examined me and asked me to walk across the room a couple off times while he observed.
He then explained that this is probably the best it is going to get and that because I am type 2 diabetic, my tendon tissue is not supporting the repair.
He asked if I would prefer a second opinion, I agreed and he confirmed that he would arrange it with one of his senior colleagues.
I am at the moment pretty devastated at the prospect of living with this and I am more than a little sceptical about a second opinion from the same camp, so to speak. I will however take the second opinion and if, as I expect, my OS's opinion is supported by his senior colleague, I will consider paying for a private consultation.
I would welcome any comments/opinions that anyone may offer.

   Thanks,
      Quadder.     

Offline Stuart Rulka

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Re: Quad Tendon Revision Repair Failure
« Reply #14 on: November 07, 2014, 08:11:57 PM »
Quadder. First of all, condolences on your predicament. That being said ,I have seen no references to your having received Physiotherapy ( PT  if you prefer).  OSs  deal in physical repair of tissue, (I have heard them referred to as a hammer looking for a nail to hit) but the rehabilitation following the repair should be guided by the PT. My Surgeon was excellent in his performance of the physical repair but completely at odds with the PT. Fortunately for me the PT is someone I have known for 20 years, and was also Chief Therapist for the Vancouver Olympics. Under his guidance I was back to my normal, relatively strenuous, activities in 6 weeks. Find a good PT before you give up hope.
  Good Luck!
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013















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