post ORIF long term pain

[MrsKoz]

I had an emergency ORIF a year ago after i fell onto concrete and broke my left patella in two.  Everyone at the hospital described it as a 'very nasty trauma'.    I was told that approx 50% of patients would need the K wiring removed at some point. I had a fixed leg brace for 6 weeks and then a hinged ROM brace for several weeks.  I have worked very hard at physio and am now back to walking up to several miles a week and do yoga most days.  HOWEVER... I am not able to 'sit back on my heels', cross my legs for any length of time, get 'crunching' on flexion and extension particularly going up and down stairs.  If i walk on unstable ground (muddy paths/pebbles) the following day/days are uncomfortable.  My surgeon has me on a list for wire removal when C19 restrictions are lifted. My wiring is very visible (i don't have fat knees!) and if i knock it..... ouch. 

 He also told me yesterday that even once the wiring is removed my knee will never return to pre ORIF movement or be pain free as it's an articulating joint and the cartiledge is damaged and can't rejuvenate apparently. Obviously i have to wait to see how things go after the wiring is removed.

 This was quite a shock and although i am in my 50's i am very active and not overweight at all I was upset to think that continuous knee pain and restriction will be with me forever.     Although i do not take regular painkillers as any pain i get is transient (my family is used to be shouting 'aaghh' when i go upstairs etc!!) I just wanted to know if anyone 'out there' has similar issues or can provide any guidance.  I am in the UK by the way so don't have my surgeon 'on call' as it were!

[lissygirl]

Hi there
I was so pleased to find someone else on the forum who is/has been in a similar situation to me.  I am a 65 year old woman who shattered her left knee in to six pieces in October 2020 slipping on detergent on a wet floor, tore four ligaments and ruptured the medial retinaculum.  ORIF surgery, immobilizer and all other bits that go along with it.  Although I am older than you I have been super fit my whole life and have done yoga for 35 years.  I am back doing limited yoga and am so sad that it feels like I will never be able to sit back on my heels again.  Crossing legs is also not a great experience.  I also work really really hard on physio and the exercises I have been given.

I should add I broke the tibia and foot on the same leg 12 months prior to this accident (dog leash wrapped around wrist as my large dog chased another and hurled me down a bank)  I do not have osteoporosis, just lots of bad luck!!  After my tibia fracture I was determined to get back to yoga and worked so hard at physio and my goal was to sit back on my heels.  It took a year and I had finally managed to achieve this goal and then this accident happened.

My hardware is also very visible, three screws seem to stick out to the left side.  I get quite a bit of pain in the front of my knee, especially when trying to do straight leg raises.  This particular exercise seems to be getting more difficult instead of easier.  Walking up stairs is now achievable with a hand rail but walking downstairs I have to kind of go sideways.  I am working hard to correct a small limp.  Some days I find wearing an open elasticised knee brace helps keep my knee more stable (the closed elasticised ones press on the hardware and are painful)  I am a full time working artist and work on large canvases and am on my feet all day (only recently started back in the studio).

I am seeing my surgeon tomorrow actually to discuss hardware removal.  He suggested at my last appointment I could benefit from early removal - mostly he likes to take hardware out around the 10month/1 year mark but he said my bone is healing well and he thinks surgery for me is a good option (who wants to do surgery again, not me!!)  I need to talk to him about the ongoing - I was so sad to hear that your surgeon told you pre ORIF movement would never happen. No-one has suggested that to me so I think we can prove them wrong ha ha - you sound fairly determined like me and I am in it for the long haul and will do my absolute best to get back to being the best I can be.  I want to sit back on my heels again!

As you are further ahead than me I would love to hear any more tips you have - this is certainly the most frustrating thing in the world.  I do give thanks that my body can hopefully slowly heal from this trauma- some people have a one second accident and never get out of a wheelchair.

Good luck, hope to hear from you.
cheers
Lisa

[ginanoelle10]

HI,

I am soo sorry DR telling anyone....never be the same!! I had  ORIF Patella  (Right side) surgery and fractured left shoulder.  I am not at year mark but saw your posts and thought Id ask a few questions

 My ORIF Patella surgery 5 months ago and Dr really didnt give me much information--but his patients did. I think my ortho kinda different and let me fend for myself as I had surgery Nov 1 2020

6 weeks laid up in hospital--no movement,no elevation, no direction-no weight bearing
4 weeks couldnt get into any  formal PT---did little leg exercises on own --had huge metal brace and never got a walker or crutches and just took tiny baby steps----------literally insurance wouldnt pay for anything and I was broke
2 full months after surgery got 6 weeks PT and worked like crazy but feel very behind on walking. Cant walk for more than 15 minutes and big pain.

I dont have a Dr now, so figured I would try a cheap gym and bike 15 minutes a day or swim. If anyone has advice, I really appreciate it.   I usually walk 6 miles a day at work and Im really worried about my future, cant do my normal job now---- I am in my 50's but active. I also had first cortisone shot and, it had adverse side effects and was on shoulder not knee--I dont think I want another one.
Thanks for listening

[lissygirl]

Hi there
So sorry to hear of your accident.
It really sucks this patella fracture business.  Compared to my broken leg 18 months ago this is a long haul recovery I am finding out.
Without knowing anything about what happened to your knee I am surprised you had 6 weeks laid up - gosh your leg must have really lost so much of its strength.  I was allowed to do partial (20%) weight bearing on affected leg two weeks after accident.  I was given crutches and a walker but was in a lot of pain doing very much at all during that period.  I did get some good PT advice and followed it doing very limited movements to try and keep the leg moving.  The big thing is to let the bone mend, not to try and push anything and certainly not even to the discomfort level at 6 weeks.
I have spent a huge amount of time on You Tube and various other places endeavouring to narrow down some good exercises.  At this point in your healing (my surgery was 26 Oct 2020) you should be able to push beyond pain with many things in order to make headway but it is important you get guidance on this.  I am happy to give you some of my exercises if you like.  I am booked to have hardware removal at the end of May as it is inhibiting and causing me a lot of pain.  This injury is not for the faint hearted - it affects every part of your life.  I am up to 30 minutes walking now but it is slow and I am still working on getting my limp sorted.
I think you must live in the US?  Here in Australia our medical system means you can access very good help if you need it but largely I have found the good exercises I do align with what the physio told me.

Hope I can help, it sounds like you are struggling and I SO understand that. 
cheers
Lisa