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Author Topic: patellar tendon repair, atrophy  (Read 1009 times)

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Offline mpowers

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patellar tendon repair, atrophy
« on: February 17, 2014, 01:39:38 PM »
I have been lurking here for a while and reading literally everything i can get my hands on about my condition. 

It starts in sept. of 2011.  I twisted my knee and felt to large pops and pain.  The next 48 hours the knee swelled, at which point i went to an orthopedic dr.  After some Xrays (no mri) he diagnosed me with having had a dislocated patella and possible tendon damage.  He proscribed anti-inflamatorys and after a few weeks of decreased swelling and somewhat decreased pain wrote a script for PT.  The PT continued, 3 days/week for the next 6 months.  During that time the swelling decreased but the pain persisted.  At my 6 month check up the DR did an MRI, the results of which suggested that I should have patella tendon repair.   

At this point I consulted with another DR at another facility.  He was insistent that the damage was not sever enough to warrant going in for repair.  He then prescribed more PT and pain management.  I did make some progress but was still having pain. 

In September of 2013, having exhausted all other options the second DR. suggested tendon repair...this was nearly 2 years after the original injury.  during the repair i was given a femoral block. 

After the after the tendon repair my knee was immobilized for 2 weeks.  After the 2 week healing period i began PT (Again).  For the next 3 months I sentimentally had no use of my quad mussel.  I gained passive range of motion.  During that time i was given an EMG which showed normal results. 

In early January i was able move get a few degrees of motion and have limited use of my quad.

obviously, i have severe atrophy in my quad.  I also have a twitching in my quad that won't seem to go is so intense it sometimes wakes me from a sound sleep.  My pain is much less than before but it is difficult to say that it was successful when i can only move (under gravity) my leg to 60 degrees, I am still getting swelling and some pain.  I am trying to balance the swelling with the fact that the anti inflammatory not make my stomach sick.   

I guess my questions are:
1) what is the long term prognosis for recovering from sever atrophy in the quad mussel? 
2) Is the twitching a good sign, bad sign or indifferent?
3) Is the swelling this far post op normal? 


Offline Jo L

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Re: patellar tendon repair, atrophy
« Reply #1 on: March 20, 2014, 10:43:10 PM »
I have very similar questions, my quad wasted after a dislocation two years ago, since then I have had two key hole ops and now a PKR ten weeks ago. I am working hard on my PT exercises but progress on my quad is very, very slow if at all. My knee still has quite a lot of swelling but bend is good, I really want to walk without sticks but can't see this happening until I build my quad up. Are you walking without support? Have you had any improvement since your post? Jo

Offline Sara10

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    • My patellar tendinosis
Re: patellar tendon repair, atrophy
« Reply #2 on: March 21, 2014, 03:56:13 AM »
Hello!  I have had severe quad atrophy.  It looked disgusting.  Like a shark bite right above my knee.  My MRI even showed how little my muscle was.  It is possible to get your quad back though.   So my atrophy was so severe I couldn't lift a knee cap.  It was almost like something was turned off in my brain that I couldn't engage it.   It goes into atrophy because of pain, swelling, and lack of using it.  ( i avoided using it because i had patellar tendon pain/swelling).  6mm of swelling will shut down a muscle.  I had swelling for a month.

I did have twitching in my quad.  Sometimes terrible quad pain.   I believe they are two different symptoms.  It twitches because it wants to "wake up."   I look at twitching as a good thing as it was usually a good symptom for me.  Especially when my quad would spasm.  This is when it was on the mend.   The quad pain i did have was occasionally. and almost felt like a growing pain.   It was a interesting symptom, but this went away.

The tricky thing is.  You quad will come back once the pain goes away and the swelling goes away.   For me this took months.  It was a hard balance.   My PT had me do quad strngthing over a towel but this didn't work.  It sounds silly but what worked best in the beginning to get my quad back was hanging in rag doll, staring at my quad and trying to lift my knee cap.  My quad would shake like crazy, felt good though when your quad comes back to life.

I am now a year and 4 months from initial injury.  My quad is normal size again and fairly strong.

Hang in there!
11/2012 R patellar tendon injury, immediate quad atrophy
12/2012 MRI- tendinosis
1/2013- OS- Patellar tendinitis and Chondromalacia
3/2013 L Patellar tendon pop, no quad atrophy
7/5/13   Normal MRI, right knee tendinosis cured!

Offline mpowers

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Re: patellar tendon repair, atrophy
« Reply #3 on: March 25, 2014, 01:31:57 PM »
This at least gives me some hope. 

I am walking on even surfaces without sticks. I still use a stick and a brace for unpaved surfaces also snow and ice are very difficult.  I have taken several pretty hard falls. I just don't have the leg strength to recover from even a slight misstep.

As I said before the pain at rest is minimal.  But I am still getting a great deal of pain from inside the knee when bending.   Also the growing pain like sensation from my quad is still there, as is the twitch.