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Author Topic: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus  (Read 16188 times)

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Offline Perplexing

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Hey guys,

Fellow cripply here. I am a 34 year old male, was very active. Did Krav Maga, Muay thai, bjj, CrossFit, yoga...you get the idea.

Well on the 3rd of Jan 2014 (first freaking weekend of New Years) I took my daughters to a trampoline park. After jumping around with them for an hour, we were about to leave when I ran back and thought I would jump a little more - I may have jumped 2 feet high if that, and as soon as I came down heard a pop and fell like a sack of potatoes. And knew instantly something was seriously wrong. Didn't land wrong, wasn't off balance, didn't hit anything. Oh well

After a 6 hour ER visit and tests, the verdict was that I had a dislocated knee + complete ruptured patella, ACL, MCL + torn meniscus and IT Band + convulsion Tibia fracture. * Drum Roll please * Yeah I know there are couple of things left intact.

So exactly on the 7th day (10th of Jan 2014) I had my surgery to fix the Patella tendon and IT Band. The surgeon informed me that there needs to be a second surgery to address the rest of the issues. Its 4 weeks post op. I am full weight bearing, without crutches, in brace locked at -10. Can bend the knee till 90. The swelling is still not completely gone. And it still hurts mostly at night. Its still pretty stiff when I try to move it. Sometimes it feels like the knee cap is going to rip right off during PT.

I sometimes hope that its all a dream and I will wake up and everything will be gone.

---------------------------------------
34, M, 185 lbs, 5'9''

01.03.2014 - Injury
01.10.2014 - Surgery
02.01.2014 - PT
 

Offline John42

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #1 on: February 11, 2014, 09:30:56 AM »
Hi Perplexing

Welcome to this exclusive club for RPT injuries.

Not only an RPT, but a host of other knee related injuries.

By now, you will have realised that you have sustained a serious injury with a very long rehab. The key word is " PATIENCE" - don`t rush it.   Read as many previous posts on the RPT thread, and have a look at the undermentioned  webpage - it contains a collection of documents which I have collected together with KneeGuru and essential to get clued up before you commence PT/physio.

Where do you live?

Keep posting and take care.

JohnK/ Manchester UK

https://www.facebook.com/QuadricepsPatellarTendonRupture
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Perplexing

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #2 on: February 11, 2014, 04:33:53 PM »
Yes I figured that out pretty quick that this is not your run of the mill bruise. I have read alot and the hardest part has been coping with it mentally.

I went from basically leaving the house in the morning and returning in the evening to sitting in the recliner 23.5 hours a day. Takes a toll on you.

Offline John42

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #3 on: February 11, 2014, 06:46:43 PM »
I would suggest that you try and sleep with a cushion/pillow between your knees - they take the weight off your knees.

By the way, where do you live?   assume in the U S A ?

Best wishes

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Perplexing

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #4 on: February 11, 2014, 07:31:10 PM »
Just got back from a 4 week post op appintment. The surgeon said I need to slow down. My flexion is at 130. He seems to think I am moving too fast. He won't change the date of the second surgery citing the need for the tendon to heal (according to him it takes about 3 months for it to heal). So till then I am going to be limping around with a torn ACL, MCL, meniscus.

But I was glad to hear him say that I was healing very quickly and nicely.

And yes I am in USA.

Offline bballkingofnba

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #5 on: February 11, 2014, 09:50:00 PM »
I would find me a better PT. My surgeon only wanted me to bend to 45 degrees for the first 4 weeks but my idiotic PT made me bend to 90.,.. I have a longer tendon and I am not sure if the PT caused it....Take your time.

Offline carkeltom

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #6 on: February 11, 2014, 10:01:43 PM »
Perplexing, sorry about the severity of the injuries.  Wow, a second surgery to repair the other half of the issues.  I will tell you that I ruptured both patellar tendons in one fail swoop and spent at least 8 weeks in my braces locked at -10/0 degrees.  I did do some passive flexion, but at 4 weeks I know I was nowhere near 130 and had only been out of the rehab hospital for 2 weeks.   Now, this is all subjective and my injury was the only one my OS has or had seen.  I was advised when I first got on here and have advised all the newbies since I found this forum that patience is a key, but everyone is going to be different and as healthy as you sounded with all your activities, you might be able to handle the advanced progress.

So good luck with the recovery and I would be dreading another surgery and recuperation.  Quad sets if you can do them helped me along with muscle stim.  I am about six months out from the injury and am still finding some things very hard to do. 

Tom
Bilateral patellar tendon rupture 7/19/13

Offline John42

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #7 on: February 11, 2014, 10:26:16 PM »
130ROM, four weeks after surgery - watch out or you will rerupture your precious Patella Tendon, your knee should be in a brace or plaster cast for at least six weeks, and then your ROM will be about 30deg.  Then the physio will commence.   

Reminder --- PATIENCE, you have at least six months hard labour in front of you.

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Stuart Rulka

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #8 on: February 11, 2014, 11:49:27 PM »
Perplexing. You certainly bit off a tough one! It seems to be my role to play Devil's Advocate here. My rupture was QT rather than PT, so things are a little different but my PT, who was Chief Therapist at the Vancouver Olympics, had me on an exercise bike at 3 weeks, and my recovery has been little short of spectacular. I was back hiking up mountains at 6 weeks!
   The advantage of early movement seems to be less scar tissue and adhesions and obviously less muscle wasting, so don't be too quick to get down on your PT. he may know more about recovery than your OS.

Good luck
Stuart Rulka
Complete RQT Aug2 2013
Surgery Aug3 2013
Resumed work Aug6 2013

Offline Frank550

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #9 on: February 12, 2014, 01:14:22 PM »
My 2 pennies worth, is that this just shows how the views of the medical profession vary from OS to OS, some move early some brace longer etc etc...

What I have learned is that you need a TON of patience, listen to advice, don't always assume your surgeon has all the correct answers. Sometimes a second opinion is invaluable.

Stuart is a case in point, hiking after 6 weeks  QTR is amazing, I was just coming out of plaster! then into a brace. We are all individual and heal differently.

Remember PATIENCE PATIENCE PATIENCE. LISTEN to your knee, it will tell you if you're doing too much!

Good luck and keep us posted on developments etc

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

Offline fishy

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #10 on: February 12, 2014, 11:26:20 PM »
Hey Perplexing, Fishy here (double RPT 39 weeks in recovery).  Boy, did you get the "chefs mistake" of knee issues.  I think if you keep reading all these post there is a wide variety of opinions AND results.  The facts as I see them are 1)patience 2)12 weeks to heal the tendon surgery 3) about a year of recovery for the quad issue IF you 1)are patient 2) exercise for ROM and strength.
Remember to be proactive: ie, ask a million questions, don't be afraid to question your OS and PT doc's, and I'll add my own two cents....use every handicapped assist you can (parking, wheel chairs in store(I preferred the motorized)), etc., and lastly humor, laugh at yourself and your situation keep you in perspective....  keep posting....I know I will!
Bob

Offline John42

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #11 on: February 13, 2014, 09:10:38 PM »
Hi Perplexing

Well, you have seen posts by fellow RPT/RQT patients -   As I have stated before - 130ROM after six weeks is in my opinion dangerous regardless how fit you have been and in danger of rerupturing the tendon.

You should be in the region of 30/40 ROM with a slow increase to the twelve week stage.  The tendon is even weak after this stage, so calm down a little and remember PATIENCE.

On your next visit to the physio - ask him or her, have you seen this type of injury before, becuse a RPT is very rare.

Ten years on this board, and I have never come across anybody reaching 130ROM within six weeks - so be warned.

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Kaputt_Knee

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #12 on: February 14, 2014, 05:37:24 AM »
John,

remember this is an extremely complex injury not just a RPT repair! While I am also concerned with the rapid progress to such a good flex, Perplexing does have other injuries that actually require good movement during the preparation for their repair. It is a difficult situation - contraindications from both sets of injuries - the repaired ones need care and slower progress, the unrepaired ones need movement and flexibility.

Difficult one to call here so IF Perplexing's surgeons and PT are OK with it, I think we should maybe take it onboard and see how things go. You've been told to slow down by your surgeon Perplexing, so maybe focussing on other aspects should now be your priority - extension is fairly important as full extension permits you to walk without a limp.

Some people do heal quickly, others more slowly. When you have just one injury to concentrate on, you can be more gentle on the whole recovery programme. However, Perplexing has quite a collection there - after all my time on this board I don't think I can remember a torn ITB for example, let alone a repaired one!

What is your surgeon's time frame Perplexing for the remaining repairs? Are you looking at rehabbing this operation for 3, 4, 6 months or longer before the ACL and MCL are reconstructed? The meniscus will be taken care of during that operation if he has not already done it.

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Perplexing

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #13 on: February 14, 2014, 08:35:36 PM »
Sue,

I feel like I owe you a "thank you" for coming to my aid.

I had no intention of creating a storm about all of this. And I feel I may have mislead you guys to believe that my PT pushed me. The fact of the matter is that I just started going to the PT last week. I was already at 90 degrees on the 16th day post surgery. And I walked into the surgeons office without crutches, brace locked at -10, full weight bearing, 10 days post-op.

I do heal quickly, in the past my cuts and bruises have healed without leaving scars. Its just the way it is. Not something I did to attain that quality/skill. I am sure it transfers over to surgeries.

I didn't push/force myself to bend my knee either. Every day I would sit and try to bend me knee, assisted (my wife would bend my leg while holding the ankle and knee). She would stop where it got tight or I felt pain. Over time the angle kept getting larger and larger.

The other thing I would say is that mentally I was never defeated. I not for a second doubted that I would rebound back to my previous physical condition. After 10 days I started rowing on a concept 2 rower with one leg placed on a toy car (brace locked in extension). There are videos on youtube with people using skateboards and such. Just because one part of your body is injured doesn't mean you can't workout other parts. I learned this from watching an elite level athlete (my CrossFit Coach, former NFL Dolphin's linebacker). He worked out an hour before his knee replacement surgery and was back in the gym a week later (Did I mention he is 48 years old, insane).

I had a week between the injury and the actual surgery. All I did in that week is research. Also, purchased the 'Ruptured Tendon' book by Kyle Newell. Had multiple conversations with my brother in law. He is a Doctor of Physical Therapy (DPT). He had already sent me a post surgery rehab protocol. I made sure I asked him what NOT to do.

So the point of letting you guys know all this is that I took educated risks. And they paid off. Life is all about risks/rewards. The doctor examined me and was amazed that things were healing so fast. He actually checked to see if my tendon was still 'anchored' by asking me to do a leg raise and tried to see how much lag I had (he also pushed my tibia and femur in opposite directions to see how much they would move).

And there is always a possibility that I am enjoying this ROM merely due to still having torn MCL, ACL, and meniscus.

I feel everyone's journey is different. And I certainly wanted mine to be the shortest possible. I still have a long ways to go till the second surgery and then rehab. But I am confident that I will be back to doing everything earlier than anticipated.

Thanks.

Offline bballkingofnba

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Re: Complete Rupture of Patella Tendon, ACL, MCL and tear in ITB and meniscus
« Reply #14 on: February 14, 2014, 11:02:14 PM »
I learned the hard way that it isnt about bending, but controlling it. I probably could have bent even more than my PT wanted to but I didnt given that I was already going 40 degrees over the docs orders. Its about how collagen heals. If you stretch it out too early in the healing phases the tendon starts to elongate more than it should. Try feeling your surgically repaired knee and see how high the kneecap is compared to your other knee's kneecap. That is what I have noticed, but maybe your surgeon utilized a newer surgical technique as plenty of research is being currently done on tendons. Tendon length is related to functionality....















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