Banner - Hide this banner





Author Topic: Early Hardware Removal  (Read 16798 times)

0 Members and 1 Guest are viewing this topic.

Offline mjeffrey

  • Forum Faithful
  • ****
  • Posts: 188
  • Liked: 52
Re: Early Hardware Removal
« Reply #15 on: August 15, 2014, 11:50:26 AM »
Yep, good luck Jacob keep us posted on how it goes. What do you have in the way of hardware?

edit: I was doing too much too soon. Don't follow my example

For me it's now day 7 post removal. I decided my early cycling was a bit aggressive and decided to stop for a while. I thought it might be contributing to the inflammation. Although I stopped the inflammation continued so maybe it did, maybe not. In the last few days I just did some gentle stretches.
I've also been working 3 days this week (from home at the computer) but could only comfortably manage around 4 hours per day: after sitting for a while, I get a throbbing in the knee and so prefer to lie down which seems to help.
 
Although it is swollen, the kneecap area now looks more like the other one, I think the cerclage was making it look bigger.

No real improvement in pain or flexion so I'm a bit disappointed at that but still early days.

Anyway not much to report. Just thought I'd record it so others would know what the experience could be like.

cheers
Mark
« Last Edit: August 22, 2014, 04:53:46 PM by mjeffrey, Reason: attach warning »
2014:
20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion

Offline mtb1

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 26
Re: Early Hardware Removal
« Reply #16 on: August 15, 2014, 03:01:10 PM »
Day 9 update.

My recovery is significantly slower than I expected, but still pretty good compared to round #1. I removed my staples yesterday. After the first couple, I developed a technique which popped them out virtually pain free. I didn't even feel over half of them come out. It was much better than having someone else do it. I think my incision will be a little tidier than the original which is nice to see.

I may have gone off the prescribed pain meds a little early. The pain was nasty there for a few days, but I think I have it under control now. The areas around the k-wire entry points were particularly painful, and still are tender. I rubbed on some Arnica gel yesterday ( being careful not to get it on the incision) and it felt awesome.

Swelling really hasn't gone down much since day 1, but it's not like I have taken it super easy either. The incision itself has been tight and has restricted ROM, but is getting better daily. It looks like I'm over 100 today, so It's definitely time to get on the trainer. If it feels ok to pedal, I won't be there long....outside I'll go!

So Mark, it looks like we are on a similar trajectory. You seem to be having much the same experience that I am having, which is reassuring.

Good luck with your removal there Jacob, hope all goes smoothly.
fractured r patella into 3 pieces 2014/01/23
surgery - k-wires, tension band, screw 2014/01/24
sent home, no cast/brace/immobilizer same day
follow-up with OS 2014/02/04
2nd follow-up 2014/03/11, ROM 90
3rd follow-up 2014/04/08, ROM 130
HW removed-2014/08/06

Offline mjeffrey

  • Forum Faithful
  • ****
  • Posts: 188
  • Liked: 52
Re: Early Hardware Removal
« Reply #17 on: August 15, 2014, 04:05:25 PM »
Thanks Aaron, Yep reassuring to know we are similar. Lol with the staples , crazy :).
If you have knee pads like the DH guys use, i'd wear them outside for a few months just to be sure. Last thing you want is another break and the bone will still be more fragile than the original.

Cheers
Mark
2014:
20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion

Offline mtb1

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 26
Re: Early Hardware Removal
« Reply #18 on: August 15, 2014, 06:24:17 PM »
Check...got these back in May - http://www.raceface.com/guards/legs/ambush-knee/
They're soft & supple, and go on & off easy. I was worried that they would irritate the hardware at the time, but they are actually fairly comfortable, non-restrictive, and somewhat supportive.
 
Suggest to me 8 months ago that I should ride xc with knee pads and I likely would have scoffed. I wear them now, no question.

I'm just livin' the new reality  ::)

Jacob - just re-read your post about pain while pedaling....my pain was opposite to you. I had none on the downstroke (extension), but plenty on the upstroke (flexion). I had no power, but no pain.
« Last Edit: August 15, 2014, 06:38:57 PM by mtb1 »
fractured r patella into 3 pieces 2014/01/23
surgery - k-wires, tension band, screw 2014/01/24
sent home, no cast/brace/immobilizer same day
follow-up with OS 2014/02/04
2nd follow-up 2014/03/11, ROM 90
3rd follow-up 2014/04/08, ROM 130
HW removed-2014/08/06

Offline jacobj

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 9
Re: Early Hardware Removal
« Reply #19 on: August 18, 2014, 03:41:42 AM »
Yep, good luck Jacob keep us posted on how it goes. What do you have in the way of hardware?



Hi Mark

I have two pins and a figure-8 tension band wiring. Only two more sleeps to go now. I just hope they don't ring me today to postpone the surgery (like they did last month) due to something more urgent coming up.

I must admit I'm a bit apprehensive, not so much the surgery itself, but the result. I'm going to be pretty disappointed if the pain is still there. It's really stopping me from doing a lot of things like running around with my kids etc.

Cheers

Jacob


Offline fsugirl

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 19
Re: Early Hardware Removal
« Reply #20 on: August 18, 2014, 05:18:26 PM »
Thanks for sharing, guys!
Everyone's experience (pre/during/post) is different, so it's always good to hear from different people in our 'tribe'. :)

Two things that stood out to me that I wanted to comment on...

No restrictions regarding flexion post-surgery - I, too, was very surprised by this - I don't know how many times.... and in different ways... I asked them (docs, nurses, anyone in earshot) to confirm that before I left.

Stitches, staples, etc. - related to my first comment - I was a little surprised I didn't have any real stitches or staples.  My OS put my incision back together this time with mostly glue and a few dissolving 'stitches'.  I thought for sure flexion would not be good for this!!  But it really was fine...
3/17/12 patella fracture
3/22 ORIF - 3 screws, wire, immobilizer
4/2 - sutures removed, crutches, nwb
4/30 new brace-locked, referral for pt ~20/25ROM, pwb
5/9 started pt 30ROM
5/18 45ROM
5/25 50ROM-brace to 30
6/1 60ROM-brace to 50
7-MUA
More PT
Dynasplint fullROM
10/30-PT release
4/30/14-HW remova

Offline mjeffrey

  • Forum Faithful
  • ****
  • Posts: 188
  • Liked: 52
Re: Early Hardware Removal
« Reply #21 on: August 18, 2014, 08:52:12 PM »
Hi Anne, hope things are still going well with you. I agree, it's amazing to hear the different approaches, they can't all be optimal which is a bit worrying. My stitches (last time staples) will only come out after 18 days, which seems really long given what I have read and Aaron's at 9 days.

I wan't really expecting to have to work so hard to get back the ROM though so that's disappointing. Stupid knee. I'm now only at 115 degrees assisted, still 25 (non-assisted) to go.
As Jacob says, it is the worry of it not getting better that is the main thing.

On the plus side, the pain I had in the quadriceps tendon (where the tension band(s) go through the tendon) is a lot less on extension and reducing and the pain I felt from one of the angled k-wires on the lateral side is on the way out as well. And before I hit the current flexion limits, the knee seems to move a lot more freely as well, before it used to "catch" a little at about 80 degrees and now that's gone.

edit: I was doing too much too soon. Don't follow my example
As for exercise I did 40 mins on the bike today in 10 minute chunks, the saddle is at the lowest now so I'm going to have to trim the stem or put on thicker shoes next :). I'm also using electric stimulation (NMES) but the VMO is still requiring a lot more stimulation than the other parts of the quads. Going up stairs is OK, going down I need the handrail.

Tomorrow is the 6 month anniversary of my accident - now that's a day I want to forget...
« Last Edit: August 22, 2014, 04:56:06 PM by mjeffrey »
2014:
20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion

Offline jacobj

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 9
Re: Early Hardware Removal
« Reply #22 on: August 19, 2014, 05:12:35 AM »
Looks like surgery is going ahead tomorrow. Just got the call from the admissions office. Even though it's day surgery they want to keep me in overnight after surgery for some reason. I was hoping to jog straight out of there  :P

Jacob

Offline Madyakker

  • Regular Poster
  • ***
  • Posts: 124
  • Liked: 21
Re: Early Hardware Removal
« Reply #23 on: August 19, 2014, 09:03:57 PM »
Good Luck Jacobj
Hope it helps with the pain. Let us know.
Madyakker
15/12/13 Kayak accident trap under by leg diag. depr. lateral TPF
20/12/13 ORIF 8 screws
21/12/13 Vasovagal episode
22/12/13 Walk + frame
24/12/13 Home
02/1/14 stiches out vasovagalattack sono physio
16/1/14 1st phys  crutches
27/2/14 PWB
20/3/14 FWB
29/4/14 no crutch occ stick
08/5/14 1st step up

Offline mtb1

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 26
Re: Early Hardware Removal
« Reply #24 on: August 19, 2014, 09:48:52 PM »
Day 13 post-removal update.

I feel good.  :) There are still a few painful (to the touch) areas around the surgical site, mainly top & bottom - where the k wires used to protrude. Flexion gives me very little discomfort until I hit the limit of my ROM. Extension is quite painful still, but is improving. My ROM is approximately 120.

I got outside on the bike for a few laps of the neighborhood today, for about 1/2 hour. The legs felt surprisingly strong, but the last 2 weeks of inactivity has definitely had an effect. I'm gonna jump for joy when I can stand up and pedal again, but it looks like that is still going to be a while. If the week goes well, I think I might just be ready for a trail ride on the weekend with my wife though, so all is good.

I'll be returning to my welding job in 8 days....I should be ready for that too.

Aaron.
fractured r patella into 3 pieces 2014/01/23
surgery - k-wires, tension band, screw 2014/01/24
sent home, no cast/brace/immobilizer same day
follow-up with OS 2014/02/04
2nd follow-up 2014/03/11, ROM 90
3rd follow-up 2014/04/08, ROM 130
HW removed-2014/08/06

Offline daihard

  • Regular Poster
  • ***
  • Posts: 76
  • Liked: 10
Re: Early Hardware Removal
« Reply #25 on: August 20, 2014, 02:45:31 AM »
I feel good.  :) There are still a few painful (to the touch) areas around the surgical site, mainly top & bottom - where the k wires used to protrude. Flexion gives me very little discomfort until I hit the limit of my ROM. Extension is quite painful still, but is improving. My ROM is approximately 120.

I got outside on the bike for a few laps of the neighborhood today, for about 1/2 hour. The legs felt surprisingly strong, but the last 2 weeks of inactivity has definitely had an effect. I'm gonna jump for joy when I can stand up and pedal again, but it looks like that is still going to be a while. If the week goes well, I think I might just be ready for a trail ride on the weekend with my wife though, so all is good.

Aaron,

Can you pedal comfortably with a 120-degree ROM? If so, that's encouraging news to me as I'm currently 120 unassisted (though I'm 7 weeks post-op and still have my hardware). I'm supposed to get the green light to do some more vigorous PT the day after tomorrow, and one of the things my therapist wants to have me do is pedal a bike trainer. I know it's going to be a while before I can hop on a real bike, but being able to pedal anything would make me feel great.

Thanks,
Dai
2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline charlottekatt

  • MINIgeek (20-50 posts)
  • **
  • Posts: 29
  • Liked: 13
Re: Early Hardware Removal
« Reply #26 on: August 20, 2014, 03:27:48 AM »
Daihard -

Ask your PT if you can do your warm-up on a recumbent stationary bike....the seats can be adjusted closer/further so flexion isn't an issue.  Plus you can scootch the seat an inch or two forward every visit n get a little extra flexing in.

Offline jacobj

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 9
Re: Early Hardware Removal
« Reply #27 on: August 20, 2014, 06:02:04 AM »
Hi all
It's about 3 hours post hardware removal op. I must admit that it's more painful than I had expected. I managed to walk unassisted to the bathroom which was good. It's weight bearing as tolerated are the instructions. Staying in hospital overnight. Not much more to report at this stage.

Cheers
Jacob

Offline jacobj

  • MICROgeek (<20 posts)
  • *
  • Posts: 16
  • Liked: 9
Re: Early Hardware Removal
« Reply #28 on: August 20, 2014, 11:17:42 AM »
8 hour update. Haven't had any pain meds since being in the recovery ward. It's sore but bearable. Standing up for more than a minute or so causes it to throb and sting.

Offline fsugirl

  • Regular Poster
  • ***
  • Posts: 64
  • Liked: 19
Re: Early Hardware Removal
« Reply #29 on: August 20, 2014, 01:52:41 PM »
Great to hear, Jacob.  Sounds like things are going as expected!
3/17/12 patella fracture
3/22 ORIF - 3 screws, wire, immobilizer
4/2 - sutures removed, crutches, nwb
4/30 new brace-locked, referral for pt ~20/25ROM, pwb
5/9 started pt 30ROM
5/18 45ROM
5/25 50ROM-brace to 30
6/1 60ROM-brace to 50
7-MUA
More PT
Dynasplint fullROM
10/30-PT release
4/30/14-HW remova