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Author Topic: Ruptured Patellar Tendon Surgery  (Read 1181807 times)

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Offline EngKnee

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Ruptured Patellar Tendon Surgery
« on: April 08, 2004, 04:33:06 AM »
Last week I ruptured the patella tendon in my left knee and as you all know my life has changed since that happened.  My surgery is scheduled for Monday AM and I feel confident in my OS as he has had 27 years experience in his field.  He told me that I would not be able to put weight on it for three weeks after the operation and that I wouldn't be able to start bending for six weeks and that's with the aid of a motion brace.  This is NOT arthoscopic surgery, he will have to cut and drill four holes in my patella to fasten the tendon.  How much pain should I expect to be in?  How long will it last?  Will I ever be able to go back to normal?  Is this a routine type procedure?  I would like to converse with folks out there in cyberspace who have experienced this particular surgery and how they made out and any advice they might have for me going in.  John
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline Janet

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Re: Ruptured Patellar Tendon Surgery
« Reply #1 on: April 09, 2004, 05:37:52 AM »
John:

Good luck as you start on your knee journey. A ruptured patella tendon is not a fun injury (as I'm sure you've already figured out). I had a similar injury, a ruptured quad tendon (which is on the thigh side of the patella). In my case, I had open knee surgery to repair the tendon. I was in an immobilizer for about two and a half months, then went to a hinged brace. But during that time, I was weight bearing after the first week or so. I started PT at about three weeks post-op. I didn't return to work for about 3 months (I have a desk job), but then only for a couple of hours per day. I didn't get back to work full time for about nine months.

If you go to the top of the page and do a "Search" for patella tendon (or similar search words), you will find others here who have had your injury. I know I was told that it would take 12-18 months before I "forgot I had an injury." But I had complications and it has now been five years, I have had four surgeries, and my knee will never be normal. I would not expect that to happen to you. Just remember that the people you talk to on this forum are usually ones who have NOT had a smooth recovery. Good luck!

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #2 on: April 10, 2004, 12:13:32 AM »
Thanks Janet, I sure hope I don't have similar results to yours as it sounds like a living hell that you've experienced.  My OS hasn't given me the least impression of this outcome which has me worried a bit.  But it may be that it is a completely different set of circumstances in that my tendon is the lower one and it evulsed from the knee cap itself, not sure if that has any bearing on it or not.  I sure hope my recovery is more timely than what you experienced for I will have to go back to work at some point in the next year I'm sure.  Thanks for letting me know how to find stuff on this board, I appreciate it very much.  I will let you know how it turns out if you want, I am looking forward to recovery as this injury is very painful while in limbo. John C.
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline Nigel

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Re: Ruptured Patellar Tendon Surgery
« Reply #3 on: April 11, 2004, 07:24:22 PM »
Hi EngKnee, just read your posts about your patellar tendon repair in last few days. Hope it's going well post-op. I ruptured mine completely one month ago, below the patella. I'm 45, about 165lb. Was repaired in France (I'd been skiing there), with neutralisation wire loop put in. I'm now back home in UK. French rehab protocols seem more conservative than here...French surgeon wanted NO motion for 4 wks then very gradual passive movement. But Brit ortho consultant prescribed physio from 3 wks and I've quickly managed to get to 90 degrees passive flexion. Subjectively, I'm really glad I've been able to get moving early rather than waited 4-6 weeks when I'm sure everything would have locked solid. Very little pain now and starting to put a little weight on the leg (not supposed to, though!). I'm feeling optimistic about outcome although I know it will be frustrating when I get into the real PT phase. Hope that encourages you at the stage you're at, let us all know how you're getting on. What kind of work do you do (or is the user name a giveaway)?
Cheers! Nigel.
Left patellar tendon break and repair with wire loop mid-Mar '04.
Full recovery, signed off by OS in September.

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #4 on: April 11, 2004, 09:49:28 PM »
Nigel, thanks for the reply to my post, yours was encouraging and I will try to experience it too with the help of the OS and god.  I go under the knife tommorrow morning and don't expect much to happen for at least a week or so since I won't be able to move the knee or put weight on it for at least three weeks per my Docs orders.  I consulted another OS staff and they indicated two weeks would be enough so I guess it's open to interpretation as to the length of incapacity or maybe its the method by which each OS performs the surgery, not sure which.  I will keep this thread alive with my progress and anyone else who can share similar experiences please by all means contribute.  My OS has not recommended any PT post op but did say he would give me exercises to perform in order to regain strength in my knee, time will tell on that.  Best wishes, John C. aka engknee
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #5 on: April 11, 2004, 09:55:52 PM »
Nigel, sorry I didn't answer your queries, I do work as an engineer aboard ships and don't expect to be able to work anytime soon also I was wondering what exactly a nuetralisation loop wire is, it's purpose etc., I'm not aware of that terminology.  My OS has told me that he would drill four holes in my Patellar, (kneecap) and attach the tendon with screws, not sure if it's four tendons or just one  screwed four times for extra strength. Any ideas? John C.
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline Nigel

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Re: Ruptured Patellar Tendon Surgery
« Reply #6 on: April 12, 2004, 02:00:10 PM »
John: in my case the neutralisation device is a wire loop. One end goes through the patella and other goes through the top of the tibia (shin bone). It's to keep pressure off the tendon while healing. Looks like a bit of old fence wire on the xrays, but seems to work. Will probably need to be removed at some stage.

Sounds like your repair might be to a rupture at the patella end of the tendon rather than a mid-section break? Presumably several screws necessary as the tendon is quite wide where it meets the patella. But maybe the gurus can enlighten!?

I'm finding the swelling and stiffness decreasing daily. Ice and elevation in the evenings (when swelling is worst) helps a lot. Also massaging the knee to loosen the skin tightness. Got 100 degrees of flexion this morning! (op+4.5wks).

I have a desk job so I've been back at work since op+1wk - commuting into London has given me a lot of practice on crutches, there are an amazing assortment of stairs and obstacles on our ancient Tube (underground railway) system.

Anyway keep in touch and good luck!

Nigel in UK
Left patellar tendon break and repair with wire loop mid-Mar '04.
Full recovery, signed off by OS in September.

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #7 on: April 13, 2004, 03:57:22 AM »
Thanks Nigel, I am back at the school where I'm staying to finish a course started before all this happened.  My surgery went well, no complications were revealed to me so I assume none happened.  The rupture ocurred exactly where you assumed and four holes were drilled for that reason.  My leg is elevated with ice being applied, not sure how much good it's doing since there is quite allot of dressing over the incision for the cold to penetrate.  I had a great dinner tonite as the food in the school's cafeteria is fantastic and I feel absolutely great, what a relief!!!  My OS set me at ease before the surgery downplaying the procedure as pretty routine and also shared with me that I should have 100% movement and confidence in a four month period, that doesn't sound so terrible.  I'm very lucky to be at the school at this time since at home I live alone and it would be extremely difficult for me since I can't drive, here no worries as everything is being attended to.  I hope the worst is over and I can get on with my healing.  Keep in touch and keep the faith!  John C.
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline Nigel

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Re: Ruptured Patellar Tendon Surgery
« Reply #8 on: April 14, 2004, 09:31:45 PM »
John, fantastic to hear your op went well, and you sound in good spirits. Don't worry if you have some down days (or weeks!) too, I've had a couple. Just take it easy as you can meanwhile.

I can well believe you'll get 100% recovery. Our kind of injury/repair, although a major op, seems pretty straightforward compared with some of the things I read about on this board. My PT was very pleased today as I'm up to 125 degrees ROM after 5 wks - 135 is considered full range I think? - although still not allowed to start any active exercises or weight bearing until 6wks when the brace comes off. Maybe that's when the fun and games will really start.

Good luck with yours!

Nigel
Left patellar tendon break and repair with wire loop mid-Mar '04.
Full recovery, signed off by OS in September.

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #9 on: April 15, 2004, 12:44:40 AM »
Nigel, you were right about good days and bad days last night was a tough one for me as I think I overdid it on my knee and boy did it let me know.  Swelling and pain increased as I was going in the rack for the night so I remembered to elevate the leg with a pillow and put more ice on it so I could at least get some sleep. Today much better but I won't be taking anything for granted any more.  the wire loop you have in yur knee, do you have to have that removed? I think yur ROM is fantastic and I only hope to have that kind of motion in the weeks to come.  I have to go back in about 8 days to get the staples removed, nothing until then just rest and elevation I guess.  What kind of pain medicene were you on?  I'm on percocet 5 mg and it's not very strong, at least not last night it wasn't, I've been eating them religiously every four hours and it helps quite allot.   The weather here is bloody awful, almost as awful as the speech by our president bush last night, that's enough to make you sick.  Hope all is well with you. John C.
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline Rosbif

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Re: Ruptured Patellar Tendon Surgery
« Reply #10 on: April 15, 2004, 05:31:43 PM »
I completely ruptured my Patella tendon (mid) at the end of January. Was able to put some weight on it a few days after the op and bagan passive flexing on a CPM machine at the same time. Think that was the key to getting good ROM.

went back to work after 5 weeks. before that it was just too painful.  Still having problems at work with my kee swelling and muscular problems due to my leg being straight out all day. Think this is because I was given the cheap option of a lightweight removable cast. Think a hinged post-op brace would have been better, but I didn't have the choice.

Now 11 weeks post-op with good ROM (don't know how much) and just 3 more weeks to go before i can finally get rid of my immobilisor.  

Things do improve. I'm now walking at home without my cast. The key to recovery is doing you PT exercises to get your quads going again. Don't give up, at first nothing will happen, but they will come back.
Patella Tendon rupture when a drunk fell on my leg.
Open surgery repair with disolvable wire loop 29.01.04

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #11 on: April 15, 2004, 06:48:08 PM »
Rosbif, misery loves company I guess, I think it's great that we all can share our experiences here on this bullletin board, it's so helpful.  I see you are from Germany and I find it very interesting that methods of recovery do vary somewhat dramatically between docs.  I am not even a week post-op so I don't have any experience to share on recovery just yet but I do know that you have to keep it elevated and rest it as much as possible during this critical time because the more I try to do the more pain I have to endure, so it's all about rest and elevation at this point for me.  I have been told I have a four month recovery for full range of motion and confidence which in my line of work is very important.  Sounds like you are doing well despite the cast and are on the road to full ROM, good luck. John C.
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline Rosbif

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Re: Ruptured Patellar Tendon Surgery
« Reply #12 on: April 15, 2004, 07:29:30 PM »
I certainly wouldn't recommend the German system (I'm English working out here). I had to wait 4 days post-op before I spoke to the OS to find out how it had gone. This only hapenned coz I pestered the nurses.

I would certainly recommend getting a CPM machine at home (if your OS allows this). This really made a big difference to me.

i'm just hoping to get back playing hockey by Autumn.

hope your recovery goes well

Tony

Patella Tendon rupture when a drunk fell on my leg.
Open surgery repair with disolvable wire loop 29.01.04

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #13 on: April 15, 2004, 07:41:59 PM »
Tony, not sure what a CPM machine is?  My doc hasn't talked with me either post surgery so I have to assume that all went well but it could be that he was on vacation when he performed the surgery and hasn't gotten back to the office yet, I'll have to inquire soon to find out.  Is this machine something they have in the US?  How much does it cost to rent or do you have to purchase one? John C.
Ruptured Patellar Tendon lower left leg 3-30-04 while playing basketball
Open surgery to repair 4-12-04 , sans wire loop
Brace removed/heavy PT since 8-11-04
Able to dance w/o complications 1 yr. post-op

Offline kdhfrank

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Re: Ruptured Patellar Tendon Surgery
« Reply #14 on: April 16, 2004, 03:26:26 AM »
John

I too ruptured my patellar tendon (or should I say my ex OS did it for me), yep...he snapped the sucker in half and told me 4 days later! my recovery has been long and somewhat grueling due to massive amounts of scar tissue in the joint...the new OS that took over my care was able to somehow repair the tendon damage...I dont think I have a wire loop, but he did drill holes and ran sutures through. I spent two weeks in the hospital due to this mess. I then spent 10 weeks on a CPM set at 45 degrees (that is the level of bend my knee would tolerate post repair in the OR before everything fell apart) I was not to contract my quad at all for 10 weeks and had to be non weight bearing on that leg...I also had to wear a knee immobilizer at all times when out of bed...even in shower. I am now 5 months post op, I go to PT weekly and swim 1 to 2 miles every day to increase my quad (it turned into a rubbery blubbery mess) because my knee will not bend past 45 degrees (this will be operated on by a arthrofibrosis specialist in June). My leg no longer hurts like it did but still feels weak and achey after standing for long periods of time. I returned to my job part time at 12 weeks post op and will stay at that level till scar tissue is removed in June. Post operatively I had no complications from the surgery although I do think I have some sensory nerve damage on the area below the scar. The scar has healed nicely (8 inches) and I dont experience much swelling now. Pain during the 10 weeks post op was a challenge though. Worked my way through demerol, loratab, and ultracet. I was also on bextra which I continue to take daily. Otherwise no pain meds. While I dont know the specific protocol for care post op as patellar ruptures are very infrequent, I do know that passive ROM on CPM was important as was protecting the repair by not actively contracting the quads. Dont overdue it as this type of injury truely needs time to heal...will give you plenty of time to use your laptop in bed and watch CNN (my choice for news as my feelings politically echo yours). I did experiece frustration at trying to make it to the bathroom when I really had to pee bad though, and straight legging it on the toilet is an obstacle you are probably wondering how to get around (there is no way). Anyways, take it easy!!!!

Kim
L pat. dislocation, 1977;  run over by a car, L pat. dislocat., multiple burns & fxs, 1981; L knee scope, 8/03; L knee MUA, 10/03; L knee MUA & patellar tendon rupt; 6/22/04 lysis, debride, pat. baja!















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