new- qus on open # patella, poss. muscle damage, rehab knee supp's. warning PICS

[mike216]

Hi, new here so not sure where this goes so put it here.
3 weeks ago I suffered an open and comminuted patella fracture while fell running - basically I smashed my knee on a rock in falling over like a felled tree!
I had a deep, 3cm-wide cut just below the knee (pictured) and according to a friend who was with me, some yellow fluid was squirting out of the joint. More on this later perhaps? My patella (see x-ray) was broken into '3 main' pieces and 'some fragments', the fragments were retained during the surgery as they were 'floating round' and apparently were 'useful' in reforming the kneecap. I had a tensioned wire inserted around the outside of the kneecap.

Ffwd 3 weeks and while I'm able to get about reasonably easily on crutches and my knee can bear some weight briefly, but not bend as it's still in a splint and will be for at least another week. I still have next to no ability to lift my injured leg - I'm sitting upright or lying down, with both legs straight in front of me, I cannot tension my injured leg and can exert next to no upwards pressure on the leg. Maybe about 1-2% of the usual power even if just to hold it up while someone lifts and slowly lowers it.

At this stage is this anything to be worried about? I move my foot fuller, have full sensation all over the leg, just wondered if perhaps the cut to the front of my knee had damaged a muscle badly that was used in 'locking'/tensing the leg which is needed to lift it.

I've tried asking docs about this and they say it's fine as they can feel some 'resistance' when I try to hold my leg up as they lower it, as described above.

Is this something anyone else has experienced following a similar injury, does it sound unusual? Should I just be patient? Lol.

Next up what is the significance of the yellow fluid, is this cartilage or similar and what does this mean, I had read about higher risk or severe arthritis if the knee fluid was lost.

Finally any advice on knee supports? Should I buy my own or will the NHS provide anything decent? I want to be back playing tennis, cycing and climbing hills by Sept/Oct, does this sound feasible?
I have looked at the Neo G range on amazon:

'Neo G MEDICAL GRADE OPEN PATELLA KNEE SUPPORT 'breathable design' for £18.49
'Neo G MEDICAL GRADE STABILISED OPEN KNEE with PATELLA SUPPORT- THE ULTIMATE SKIERS SUPPORT' for £27.99
'Neo G MEDICAL GRADE ADVANCED HINGED OPEN PATELLA KNEE BRACE/SUPPORT 'breathable design'' for £34.99

Does anyone have any views on these? Sorry not sure if allowed to post ext links here.

Thanks in advance for any help or advice anyone can offer.
Mike

[cahiker]

The advice I'll give you is to be mindful of overdoing things and trying too many times to raise your leg, if in fact your quads are firing.  I say that because your other legs muscles will try to do the movements you are asking of your body and they will do everything they can to compensate for your lack of quad muscle strength.  That can easily lead to tendon problems of the compensating muscles, and that can be extremely painful and difficult to get rid of once you have it. 

Your quads may have mechanical damage and/or be on shut down from quad inhibition from the injury you suffered and/or from the surgery.  Are you currently in physical therapy?  Have you been told it's ok to flex your quads - which will  move the patella up and down, since the patella is embedded in the tendon that all your quad muscles converge into.  Are you cleared to do "quad sets"?  If so, can you feel any tone in the muscle when you try to flex it with a straight leg flat on a couch - trying to press the back of your knee into the couch?