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Author Topic: Acute Patellar Tendonitis 3.5 Weeks Post-ACL  (Read 1037 times)

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Offline Esoteric Wench

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Acute Patellar Tendonitis 3.5 Weeks Post-ACL
« on: December 22, 2014, 03:54:48 AM »
Hi everyone! This is my first post on Knee Guru. I'm so happy to have found this site!!!

I was hoping you guys could offer me counsel.

Background: I am 3.5 weeks post op (ACL allograft reconstruction and partial meniscectomy). Up until two days ago everything was going swimmingly. For example, I was out of walking around sans crutches by day eight. My surgeon cleared me to go sans brace on day 14. My PT told me just five days ago that I was progressing better than expected by about two to three weeks. I had absolutely no pain.

Problem: Two days ago - seemingly out of nowhere - I began having pain/tenderness just below my patella and just above my tibial uberosity. On a pain scale of 1-10, I'd say it was only a 2 or 3. My PT thought my patella was not aligning properly because of an imbalance in the strength of my muscles. She immediately started me on VMO and hamstring exercises. She also taped my knee to give me extra patellar stability. But within 6-8 hours, my knee pain went from a 2-3 all the way up to 8-9. Now it hurts every time I put weight on it, every time I extend or flex it, and even when I just sit on my sofa with my leg hanging over the side.

Ice and Aleve seem to do nothing to lessen my pain. In fact, the pain is so bad that it keeps me up at night and it has caused me to go back onto the remainder of my post-surgery Oxycodone. Without the assistance of my opioid pain meds I can barely walk from my living room to my bathroom. Plus, for the first time in three weeks, I have a swollen ankle, foot tingling, and a noticeable coldness in my foot. Needless to say, I'm really very concerned.

My Questions: After several hours on the Internet, I've self-diagnosed my problem as Acute Patellar Tendonitis, Stage Three. But this doesn't completely fit. I've never had any problems with my patella before. Nor am I an athlete so I'm not regularly overloading my knee with long jumps. From what I've read, patellar tendonitis comes on gradually due to overuse or suddenly do to injury. Neither circumstance applies to me.

  • Do you agree with my self-diagnosis? Given my symptoms, does Acute Patellar Tendonitis, Stage Three, seem like a reasonable diagnosis? (It's not Osgood-Schlatter - I'm too old and not an athlete. I suppose it could be infrapatellar or pes anserine bursitis, but I don't kneel hardly ever.) I'm stumped.
  • Can anyone share their similar experiences?
  • Does anyone have any advice on lessening my pain? I'm in real agony right now.
  • Thanks in advance for you help!

- Esoteric Wench  :)

« Last Edit: December 22, 2014, 03:58:33 AM by Esoteric Wench »
ACL Reconstruction and Partial Meniscectomy 11/26/14

Offline Scubagrl4

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Re: Acute Patellar Tendonitis 3.5 Weeks Post-ACL
« Reply #1 on: December 22, 2014, 04:18:43 AM »
Those symptoms don't seem to completely match up with tendinitis...but I am not a doctor, just answering from what medical experience I do have.  I can't tell you what is going on, but can tell you that the swelling, tingling, and cold foot are a pretty significant concern. Although unlikely, you should get checked out sooner than later to rule out a blood clot and compartment syndrome. With out the nerve symptoms, I wouldn't be as concerned, but with them, I would say you really need to get looked at. I'm not trying to alarm you, just trying to make sure that you rule out the big stuff. I would also recommend that you get back on the crutches until your symptoms improve. Irritating your knee further won't do you any good.
How does your knee look? Is that swollen too? Red or hot? Decrease in range of motion? Fever? Those would all be symptoms to mention to your doc.
I hope it is something minor....good luck and feel better soon.
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Vickster

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Re: Acute Patellar Tendonitis 3.5 Weeks Post-ACL
« Reply #2 on: December 22, 2014, 07:25:02 AM »
If you're in agony and very concerned as you say, contact your surgeon asap (i.e. today, especially with Christmas coming up).  The worst thing you can do is self diagnose after any sort of major surgical intervention

Good luck :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
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LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline Esoteric Wench

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Re: Acute Patellar Tendonitis 3.5 Weeks Post-ACL
« Reply #3 on: December 22, 2014, 02:21:54 PM »
I am going to PT in about an hour. I'll let you all know what she says. Thanks for all the input so far.
ACL Reconstruction and Partial Meniscectomy 11/26/14

Offline Stuart56

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Re: Acute Patellar Tendonitis 3.5 Weeks Post-ACL
« Reply #4 on: January 04, 2015, 08:23:54 PM »
Hi EW,

How did your appt go?  This is my first post on kneeguru. I found the site as I am trying to start my rehab for bilateral patellar tendinopathy.

Scubagrl4 said it. It may be a case of PT but unlikely given the very fast onset. It does sound that it may be a case of patellar maltracking syndrome though, as this can manifest itself in several ways, with symptoms including very sharp pain on the outside edge, and underside of the patella as it rubs on the tendon or hoffa pad (fat pad behind the tendon). Usually this occurs after a period of
a) Muscular imbalance in the glutes, hams, TFL and/or VMO.  Eg through running or cycling or other sport.  This may have been caused by an increase in training or gradually over time. Or...
b) Muscle atrophy in the lead up to and after an operation.

Lets us know what it is and good luck.

Bilateral Patellar Tendinopathy (Tendonitis) since April 2014. Started rehab in October 2014. Stopped due to wrong exercise protocol.
Restarting now with the right protocol in Jan 2015. Going to beat this thing.....