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Author Topic: 2.5 years of healing multiple patella fracture, still have very weak VMO  (Read 1461 times)

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Offline thegirlracer

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I posted my story on here awhile ago, but nobody ever responded. Maybe this time, I'll have better luck!

2.5 years ago, I fell and had 3 patella fractures. Healing was delayed, non-union. Had to have bone stimulator after 6 months. Took 1.5 years to completely heal the fractures, no screws or rods though!

I do also have cartilege damage from the same fall. I get Euflexxa shots every 6 months, which seem to help with pain, swelling, movement, etc.

Went to PT for almost a year because my quad VMO muscle completely died from misuse. My body just turned it "off" because it was directly over the largest fracture. Could not lift my leg on my own first day of PT. 2.5 years later VMO muscle is still very weak. I have to work very hard to keep it engaged and strong enough to support weight going downhill or stairs.

Anyone else experience this issue?

Offline JamieDeanne

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Re: 2.5 years of healing multiple patella fracture, still have very weak VMO
« Reply #1 on: December 10, 2015, 08:36:38 AM »
I am sorry you're dealing with this. It sounds frustrating. Have you had a nerve stimulation test or seen a neurologist? If not, why not?
Don't Forget What Makes You Strong

Offline dal_knee

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Re: 2.5 years of healing multiple patella fracture, still have very weak VMO
« Reply #2 on: December 10, 2015, 09:58:13 PM »
thegirlracer,

Sorry I don't have much constructive help, but since you are still having pain & swelling due to the injury, that would be the most likely culprit for the inability of the VMO to recover.   
2007 - partial medial meniscectomy
2010 - full thickness chondral defect & adjacent subchondral edema MFC.   Direct result of stupid partial mensicectomy from 2007.
2014 - Subchondroplasty, chondroplasty, unauthorized 2nd partial medial meniscectomy.
2015 - partial failure of subchondroplasty.

Offline ArmstrongK

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Re: 2.5 years of healing multiple patella fracture, still have very weak VMO
« Reply #3 on: January 16, 2016, 09:10:25 PM »
I too have VMO weakness and PF pain.  I have had it for many years and it is terribly frustrating.

Check out this article, which explains why people with PF pain/pathology get VMO weakness:

http://www.jospt.org/doi/pdfplus/10.2519/jospt.1996.24.3.160

Offline msiniscal

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Re: 2.5 years of healing multiple patella fracture, still have very weak VMO
« Reply #4 on: January 19, 2016, 03:25:50 PM »
Hi Katee,

I can't respond to personal messages due to the brilliance of kneegeeks.

My name is Katee and I live in the DC metro area. I read a post from awhile ago that said you received biocartilage. How is going now? Do you have pain? What is your activity level like?

And, if you don't mind me asking, Who was your surgeon?
I have suffered from Patellofemoral pain since around 2005. I have a grade 2 or 3 patella chondral lesion. The only surgery I have had for this chondral lesion is a chondroplasty in 2007 by Dr. John Fulkerson. This helped the pain temporarily. Dr. Fulkerson would not perform an Anteriormedialization TTT on me because he said that my patella tracked normally. And, just so you know my ACL, MCL, PCL, LCL, and both meniscus are intact. I have tried conservative treatment for many years. I have tried physical therapy for months, ice, estim, activity modification, stationary bike, NSAIDS, cortisone injections, hyaloronic acid injections, brace.....etc but I still have pain! I do still have vastus medialis weakness even though I try and strengthen on a regular basis. However, I can only strengthen so much because I often have to stop due to pain!

I'm looking into stem cell injections, PRP, Biocartilage, Dr Broyle's treatment....etc. I would love to get your feedback and experience with biocartilage.


My surgeon was Dr. Klimkiewicz at Georgetown.  I had a Grade 4 lesion 10 mm x 10 mm on the medial femoral condyle. The Osteotomy was to change alignment and the microfracture with biocartilage was to regrow cartilage. After 8 months I went skiing (ice and bumps) and the pain returned. Any fibrous cartilage growth that existed was probably damaged due to the heavy eccentric loads. I had to stop lunges, squats and any explosive leg movements.

After 6 weeks of rest, the pain has subsided a bit. I went skiing yesterday using the OA brace (Breg which needs to be refitted after HTO surgery, tibia alignment changes). No soreness so it may be healing. I'm in NY now and going to HSS. I will be getting an MRI soon for assessment. In hindsight, an allograft would have had better success and is probably what I will do after ski season.

Your VMO problem is probably not originally due to cartilage wear, but has resulted from bad patella alignment/tracking. If you didn't sustain a high impact injury on the patella, then the lesion has to be wear. You can possibly repair the cartilage but the underlying PF needs to be addressed as well. I would see several surgeons, each specializing in different procedures you are looking into. If the chondroplasty worked temporarily then grafting donor cartilage (allograft) may last longer. Still that is just repair. You need to find a doctor who can determine the root cause of this wear.

Offline Clarkey

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Re: 2.5 years of healing multiple patella fracture, still have very weak VMO
« Reply #5 on: January 19, 2016, 05:12:53 PM »
Hi msiniscal,

To be able to respond to personal messages you need to have 20+ posts. Go to The Games Room Section to speed up your postings.

[email protected] 
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Beeps

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Hello there!

I hope you're doing well nowadays. I'm starting my own journey with delayed union and have been searching far and wide for people's experiences down this road. Wishing you the best, in case you come back and see this!
11/4/15 - car wreck, fx left patella
11/9 - saw OS, dx nondisplaced comminuted fx, no surgery
12/18 - WBAT, still on crutches
12/28 - started PT, ROM of 40
2/8/16 - can finally do SLL! ROM 75
3/17 - recent CT scan revealed no healing, dx delayed healing. ROM 96

Offline iwillwalkagain

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My VMO was completely wasted after 1 year of PFPS issues.  Gradual single leg work on an inverted leg press brought it back to life.  I started at a low weight, bending to 90 degrees and tried to tense up and fire the quads (VMO should begin to activate).  I would hold the isometric contraction for 30 seconds and then do 15-30 mini pumps until fatigue.