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Author Topic: patella tilted towards tibia after tendon repair causing clunking  (Read 204 times)

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Offline julianc

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I had a ruptured patella tendon repaired 14 weeks ago after a cycling accident. I thought I was recovering well, but have developed a significant 'clunk' at about 20 degrees when I move from extension to bent leg. So although I can use exercise bike OK, as I don't go to full extension, I am unable to walk or move foot up a stair without the clunk.

At fracture clinic today I had x-rays and the doc spoke to the knee specalist. I was informed that the cause is my patella tilting towards the tibia too much, and catching on a naturally occurring ridge in the groove. The plan is to see if I get used to the clunking over the next 6 months, and to try and walk naturally in spite of this, which is naturally hard to do and will mean not walking far at all. Beyond that, there is some surgery that can be considered, either smooth the ridge in the groove or using some metal within the groove.

When I though about the mechanics, I tried using a tight neoprene strap above the knee and about 1/3 onto the patella to tilt it away from the tibia. This resulted in some improvement, lessening or removng the clunk. There is also some improvement if patella is pushed inwards, this resulted in initial focus being on strenghthening VMO with the physio.

I am 2-3 weeks into strengthening physio (squats to close to 90 deg with feet slightly outward facing and straight leg raises with foot bent outwards to partly focus on VMO). There is still swelling (circumference is about 10% higher compared with good knee) and obvious quad reduction on injured side.  I had been hoping the doc would say all will be OK if you keep strengthening but they identified this downward tilting patella.

Has anyone come across this condition, does it have a name, and if there is any advice it will be highly appreciated. Thanks for reading, Julian