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Author Topic: Quadriceps Tendon Tear. Surgery or Not?  (Read 394 times)

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Offline camilliscent

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Quadriceps Tendon Tear. Surgery or Not?
« on: August 27, 2017, 11:59:48 AM »
So I (now 21 Female) 18 months ago I fell down and slammed my knee on the corner of a brick step.
Initially, I thought it just bruised but it was agonising to walk on over the next day or so, so I went to the GP.

I had full range of motion and could still walk on it, so the doctor told me to rest it for a few weeks and I'd be fine.

Few weeks later, I went back to running but was still in pain so after getting MRIs and an x-ray I went to a specialist who told me he couldn't see anything wrong with me and passed me along to a physio.

The physio assumed it was a deep bruise and I worked with her for about 3 months. It helped alleviate the pain but doing any physical activity is still painful.

So I got a referral from to another surgeon/specialist (1 year since my original specialist and 18 months since injury). After looking at the MRI and Xrays he's determined that I have a tear in my quadriceps tendon and has suggested surgery to repair. He said it was a knee scope, debridement, tendon repair and then patella drilling, which is apparently where they let the bone marrow bleed out into the wound and aid in repairing)

I'm wondering if anyone has had anything similar or can offer any advice. I'm just concerned that this is a liveable injury and the surgery will make it worse.

Offline Brandon123

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Re: Quadriceps Tendon Tear. Surgery or Not?
« Reply #1 on: August 27, 2017, 01:38:38 PM »
Hi camilliscent,

From what I have understood, small partial quadriceps tendon tears do not usually require surgical treatment. And why did he want to perform knee scope, debridement, and patella drilling? Did they find cartilage defects in the MRI? Patella drilling (microfracture under the patella, I assume) is know to be quite a gamble. 
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline camilliscent

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Re: Quadriceps Tendon Tear. Surgery or Not?
« Reply #2 on: August 27, 2017, 02:01:56 PM »
Hi Brandon,

Thanks for your reply.

He did say they don't normally need surgical treatment, but as it's been 18 months with nearly no improvement, he said it was a viable option. Exercise Physiologist co-worker of mine also said that tendons are quite hard to heal on their own.

I'm not too sure about the cartilage defect, he pointed something out to me on the MRI but I honestly don't remember what he said about it.

Do you mind if I ask what you mean by gamble and what you know about the patella drilling/microfracture?

Offline jackson7

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Re: Quadriceps Tendon Tear. Surgery or Not?
« Reply #3 on: August 27, 2017, 08:01:22 PM »
fixing the tear is one thing, but I find it a little disturbing this doctor is plotting so many procedures before he's actually seen inside your knee (MRIs are notoriously sketchy).

With all these recommended procedures, you may be substituting one pain for several other new chronic pains...plus the added worries of a huge spectrum of other possible post-surgical problems (infection, blood clot, scar tissue, CRPS, mal-alignment, cortisone, etc, etc).

 
12/2015: slow speed bicycle crash
1/16: many x-rays & 2 MRIs only show tendinosis
3/16: bone scan shows uptake in all compartments
8/16: cortisone jab (no effect)
3/17: diag scope (part med meniscectomy, med fem chondroplasty, full synovectomy)
4/18: Pain finally diminishing. 65% function.

Offline Brandon123

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Re: Quadriceps Tendon Tear. Surgery or Not?
« Reply #4 on: August 27, 2017, 08:26:46 PM »
I'm not an expert, but in the search of a solution for my patella cartilage damage I have learned that microfracture under the patella is the most difficult place to achieve good results with this type of procedure. It also has to do with the fact that it is more difficult to fix patella cartilage than any other cartilage of the knee, independent of procedure. I'm not saying microfracture under the patella is never warranted, or that it cannot produce good outcomes, I'm just saying that you probably shouldn't rush into this surgery without being sure it is a) necessary, and b) the optimal procedure in your specific case.

You could also check out this old thread about patella microfracture: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=54086.0

If possible, maybe you should try to get a second opinion from another specialist regarding this surgery (especially the patella drilling part of it)? Just to be on the safe side.   

RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment















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