Ruptured Patellar Tendon Surgery

[quickrecovery]

Norene,

Can I ask what you did to get to 134?  Also, what was your progression like on a week by week basis?  Any areas you got stuck? What did you do to get over it?

Thanks.

[Norene]

Hi QuickRecovery

As soon as I was out of my hinged brace I would work at bending my knee.  When sitting in the recliner with my knee up I would often bend my left leg and pull it closer.   I still do this when sitting - bend my leg and pull it close to me.  Tomorrow will be my next evaluation and I am hoping it is better but thinking it may still be at around 134 as stairs are still so difficult.   

Ice, ice, ice - I find I move much better after icing my knee.

Being very diligent with your exercises and pushing yourself is important.  My leg lifts were becoming too easy for me so I asked if it was okay to add a 2 lb weight to my leg while doing them.  I was told that since my left kneecap is smaller now that my left quads need to be even stronger.

One of my biggest problems has been hip bursitis - which I had before my knee injury but has been aggravated by change in gait due to the knee injury.   I did get a cortisone shot after my cast came off but it did not last for long.  I think when I go back to my OS the end of the month I need another shot.

At the 5 month mark I am tired of my leg aching all the time.   My understanding is that it will be with me until I get my quad muscles stronger. 

[Bascat]

Trust all are going OK.  C. 10weeks plus since op so thought I'd post an update. Have done a whole week at work. Have found that the bus journey and walking has really helped loosen knees up as does sitting in a chair with legs bent as opposed to legs being straight out on the bed. I have found this evening though they have stiffened up a lot much more than normal and even more so after icing. Am wondering what is causing this stiffness. Is it a sign of overdoing it? Not much pain just lumpy heavy stiffness feeling and is the case in the mornings. Will perhaps give them a bit of rest tomorrow but it seems to be elevating the legs in extension that causes the stiffness. ROM of 90 to 100 and not too much persuasion is needed to get them there. All new sensations and no 2 weeks are the same. Just as you get used to one eay of doing things things shift and change and everything is slighty diffrent. Mainly in a good way. Its just a little dampning when things feel less better but know there are good and bad periods. All progressing in the right direction it seems. Clinic on Tuesday and indications were last time the braces can come off. Hope so as gait is difficult due to braces banging onto each other. Looking fwd to building quads up as really no strength in them. Cheers J

[carkeltom]

Hello all.  Tom here.  Well, I just happened to look at the calendar and it caught me off guard.  Monday 7/18 will be three years since my double rupture.  I thank this board and it's posters for keeping me afloat.  Not a lot of information out there on a double rupture.  Crappiest injury I have ever had the pleasure of having (and I have had a s**t load of them).  Seems like just yesterday I was out in my garden crying my ass off and wondering why I could not stand up.  Took like three tries before I realized I was screwed.  Think I did it all.  Surgery, PT, exercise and a build back up.  Not where I was before, but I can live with it.  I am back to coaching softball and soccer.  Giving pitching lessons to the girls and even though I only jog around the bases, that is good enough for me.  Still have some residual pain at times, with swelling after doing too much.  When I feel stiff, I stretch.  When I feel pain, I ice and elevate.  When I want to relax, I do.  Hope everyone is doing well with their recoveries.  Hope to meet someone sometime who has had this happen, but in three years, everyone still thinks I had knee replacement.  But, this is worse. 

[Johanna]

Hi RPTers...checking in a bit later than planned.  A pain in the gozaltz trying to type on a tablet or finger text on a cell.  Finally ready to post the latest, now that my shoulder aches aren't interfering from me handling my Mac laptop so much.

Met with my OS on 7/7...9 weeks post op.  He had me remove my brace and do some straight leg raises.  I gulped and hoped that my quad strength would support the move.  And, was I ever delighted to be able to do a few with ease.  (My sister and BIL were in the exam room with me...drove me to the appointment...my OS turned to them and said I couldn't do that prior to the surgery.)  Next, he had me bend my knee on to the floor.  It looked like I was at 90 degrees or so.  Yea!  [Visited my primary doc the same day...down 6 more lbs. :-) ]

Next order of business is removing the wire.  I'll be going in for that procedure on 8/4...a couple more weeks.  I am suppose to wear the brace in the same way until then...locked while I walk, unlocked at 90 degrees when sitting.  He also cleared me to drive.  Boy did I miss that !!!  I'm not driving very far...just a couple of miles near me, until I don't have to wear the brace at all.  I guess shortly after the wire comes out will be that step.

I did garner up the courage to ask him about my right knee.  At one time, he stated he might find a similar issue with it.  But since then, he'd clearly thought about it and what he is going to do differently to avoid another graft. Sure sounds good to me!  The worst couple of things about this recovery, is not the pain from the knee, rather it is the pain I've had in my shoulders.  I know some of that came about having to scoot on my bed several times a day, before I got my gadget for my recliner.  And, also scooting into the back seat of the car.  Hint...if you find yourself doing the same thing, use something like a plastic trash bag on the seat...you will slide much easier.  Wish I had thought of it much sooner.

I had three grab bars installed in my shower, plus a grab bar with a movable shower head put in.  I also had another grab bar that folds up against the wall installed in a stud outside of the shower.  With the transfer bench in place, I finally took an actual shower.  Holy Moly...I felt like being in there for an hour.  The one tricky aspect...when to take off the brace.  I took it off while seated in the shower chair which worked fine going in.  However, the transfer chair wobbled a bit while I tried to put brace back on after my shower.  I'm going to have my PT review that process again with me.  I'm not walking without the brace yet.  Any ideas from you fellow posters?

I mustered up my courage to try and sleep without the brace the last few nights.  I thought I'd have a sleepless night or two, but so far, so good.

The more I'm able to do, I find the more restless I've become.  I just want to get on with things now.  Enough already.  However, I realize that I am very fortunate that this procedure seems to have done the trick.

I'll see the OS a week after the wire removal, and that is when I'll learn about out-patient PT.  I'd like to have 2x a week sessions for at least 3 - 4 weeks, and then 1x a week for another month.  Will see if my OS is OK with that plan.  I'm also going to have him check out my shoulders.  The last thing I want is additional joint issues.  They are less sore of late; I ice them several times a day.  My home PT thought it would let up once I use the walker much less.  I still have my right knee to go, so I envision I'll continue using a cane and brace that knee until it is fixed.

I let myself fantasize something I've wanted to do for years.  Go to Kenya and visit the giraffe preserve.  That would be heavenly.  I do adore them so.  And, if after all of these years I become more normally mobile it might actually be possible.  Of course, I'd need to win the lottery too! lol  Medical expenses become so tedious.

Wishing you all painless mobility.  Perhaps you might toss a prayer or two our way here in the states...we've got quite the election circus going on...although this isn't a political or religious site, I do offer prayers for those globally dealing with violence.  I hope the mods are OK with that brief mention.

~ Johanna ~

[John42]

Hi Johanna

Read your interesting post - I repeat a little tip - sleep with a cushion/pillow between your knees, takes the pain away from the injured knee - remember to ask your PT - " have you seen this type of injury before?"

PATIENCE and keep posting.

JohnK/ Manchester UK

[Norene]

Johanna - will second John's comment about sleeping with a pillow between your knees.   I started doing this a few years back to take the stress off my left hip when my bursitis was acting up.   Has continued to help with my knee.

Major scar tissue break-up for me last week.  After feeling really good all weekend my knee has "seized" up a bit today.  Getting used to the recovery mode of a few steps forward then a step backwards.

Tomorrow will be 24 weeks since my surgery.   

[Bascat]

Clinic went okay. Permission for weaning myself off the braces and crutches grantec. It was vary traumatic walking around with them off. Felt very fragile and vulnerable and hit home what I'd done to myself. Quads are totally wasted and cant do any sort of leg raise . Have been doing quad setting etc but just not happening as yet. Patience i know plus think the proper muscles should now get  a work out with the braces off. Pt trying to pass us on to out patients pt as they now saying they will do a better job but they said there is a waiting list. Why they couldnt of been far sighted enough to sort the referral before hand is frustrating since recovery is following the plan set by the OS.  Anyway despite feeling very down this morning feeling optimistic this evening. Good luck everyone. Cheers J

[Johanna]

Bascat...sending you healing energy.  Sure hope you've not got a long out patient PT wait ahead of you.  Isn't it ridiculous - the hurdles involved for obtaining insurer promised services?  I'm on a first name basis with all kinds of folks at my insurance company, and the VNA (the organization that delivers home services).  I've taken the advice of my insurance agent.  I now document all my visits, my telephone calls (names and times) and every manner of communication, including what is shared with me re my progress.  It's like I build ammunition to make the case for what I perceive are essential benefits due me.

I surely relate to the emotional roller coaster of this whole thing.  I've had lots of surgeries over the years...most of them for my left knee...and even when I had to deal with a BC diagnosis/lumpectomy/radiation and a life threatening burst appendix sp?, none have brought on the emotional ups and downs like this one.  Perhaps it is because it is such a lengthy recovery and few people have dealt with an ordeal that robs a person of his/her independence to the degree this imposes.  Couple that with the uncertainty about the outcome, well I just want to say we're entitled to feel the despair when it comes.  The one good thing is that it does let up...at least for me...when I buckle down again and do some exercises, or bury myself in a book/internet/movie.  Over here...across the pond...we now have an insane election cycle to amuse (?) and or/or both alarm us...great distracting drama, at the minimum.

My latest report...yesterday I was evaluated by the PT for ROM...easily at 95 degrees when I took the brace off...and that was without seeing what the max probably is.  A relief for sure, my OS gave me very conservative estimates what I might finally have.  He had me sit on the bed, without the brace, and lift my lower leg up from the seated position straight out, which I was able to do...thank the good lord!  Then, he had me lift up my upper leg, while still in the seated position, to check out the intermedial quad I think he called it.  That worked as well.  I like how detailed/precise he is in his explanations of things.  He gave me a quick review of the quad anatomy:  4 muscle groups...quadlongitudinal...or something like that...underneath part of the quad, then there's the intermedial quad...the top part of it...down the middle from the top of the thigh to the knee, then the lateral and medial quad muscles.  Years of PT rehab taught me that the interior quad, the medial quad, is the hardest to strengthen.

It's hot out here...hot, hot, hot and I so wish I could take a dip in the pool...via the lift...not ready to tackle stairs just yet.  But, I've got to wear the brace yet, and I suppose I'll need to wait to give it a go after the wire removal/wound healing.  We've had wonderful summer heat...minus humidity and shower interference.  I want to go into that heavenly water before the season ends.  My PT said I'll need to be careful about the resistance the water imposes laterally about the knee.  (I've not been cleared to go into the pool yet anyway.)

The shower deal is something else.  What used to be so simple...just walk into the stall and turn the water on.  Still adjusting to a sliding bench and shower curtains in lieu of a shower door.  What a pain with the curtain...have to be sure I don't end up with a puddle of water outside the stall by neglecting to be sure the curtain is completely in place.  But, I at least can feel like I've joined the land of the living a bit, even if I do have to navigate getting the brace back on and then lying down on a towel draped bed to fully dry off.  (Not ready to try and take care of toweling off balancing act while not holding on to the walker...eek!) 

The sleeping without the brace is going just fine, thus far.  I ended up bending my knee a bit...like the old days...but I'm not waking up feeling weird/pain.

I do plan on weaning off the brace by walking around with it unlocked before just going totally without, unless I'm told that practice would really hinder my progress.  Bascat...it's got to be very unwieldy trying to go at it cold turkey to say the least.  I can't recall if you were non weight bearing before hand, too. 

Sending every one best wishes, mobility improvement and ultimate freedom!!

~ Johanna ~

[Bascat]

Can't grumble too much I guess Johanna as in UK we don't have to pay for treatment (although pay my taxex)unless you choose to go private. It should be sorted before too long and think the simple quad strength exercises will keep me going for the next week I think. Also have some inside routes to try and get pt from hospital nearer to where I work and istuff the hospital where I had the op. The PT I spoke to there was suprised I wasn't referred to them already due to the complex nature of the injury. Can't complain about individual care just the lack of joined up thinking is hampering things a bit. Havd to be a bit aggressive and assertive to get what you neec but not my 1st nature. Sound like you are progressing well Johanna and hopd you keep it up. Our shower is upstairs but we live nothere too far from  our local swimming pool so take a shower there. Hoping to go for a dip soon they will hoist me in and out😨 cheers j

[Bascat]

Forgot to add I found braces off very traumatic. Nothing untoward has happened but as both legs makes me feel vulnerable and don't trust my knees and also have had flashbacks of what happened. Bracex been a bit of a mask i think. As others have said injury in part is in the mind. Have been weight-bearing since dayou one and have gradually increasing flex whilst walking for the past 4 to 6 weeks. Still using crutches when outside and also braces for the journey to and from work. Harder to flex without braces since they must give some leverage and also work different muscles. Would be interestedto know more of the mechanics and where the stresses and strain goes with braces on and off. Cheers J

[tidileboss]

Hi, I ruptured my patellar tendon and I had surgery 6 days ago. I m having a hard time with the plaster cast they put on, it s really heavy and tight, to the point where I spend 99% of my days layed down, and I can t even move my feet when I m layed down. Getting up is hard, and when I walk to the bathroom, I can feel the weight of the cast dragging down my leg and also the bandage. I ve also had fever for the past 6 days.
I d like to know if this happened to any of you to feel the cast to be too heavy? The fevers and headache too?

I m scheduled to see the doctor in another 4 days, it s been really difficult so far.

Thanks for any return

[Norene]

Hi tidileboss

First let me say how sorry I am to hear that you ruptured your patellar tendon.   The road ahead will be long and much patience is needed.  Next Tuesday will be 6 months since my surgery.

I had a cylindrical cast on my leg for four weeks.  Cast went from my ankle to my upper thigh.  My foot was completely free and I was allowed to be weight bearing once it was comfortable for me.   I spent my days in a recliner chair and nights sleeping on our couch since I could not manage the stairs.   

My leg had only a slight bend in it with the cast on.   I do not recall it being overly heavy.  When I stood it would slid down and caused abrasions around my ankle.   I found that using moleskin and ace bandages around my ankle provided much needed cushioning. 

I did not run a fever but I did get night sweats when I was on my pain meds.    My knee was always ( and still is ) warm to the touch.

If it was me I would probably call the doctor about the fever since it can mean you have an infection.   It may be nothing but it doesn't hurt to check.    In reading on this site and doing lots of other research I have found that we all have differences with our experiences after surgery. 

[madvillain]

Forgot to add I found braces off very traumatic. Nothing untoward has happened but as both legs makes me feel vulnerable and don't trust my knees and also have had flashbacks of what happened. Bracex been a bit of a mask i think. As others have said injury in part is in the mind. Have been weight-bearing since dayou one and have gradually increasing flex whilst walking for the past 4 to 6 weeks. Still using crutches when outside and also braces for the journey to and from work. Harder to flex without braces since they must give some leverage and also work different muscles. Would be interestedto know more of the mechanics and where the stresses and strain goes with braces on and off. Cheers J

The flashbacks will fade with time but yea I know what you mean.  When I first had the injury I kept thinking about he exact moment. People said they heard some audible tears/pops from my knees.  I know I felt them.  I guess the best thing to do is just let time pass and not worry too much because now at 20 months I hardly think about it, certainly never when I'm running on the tennis court or otherwise in the moment.

Now almost exactly 20 months for me, will be 20 months tmr.  I can say that things are going well with my knees.  The odd pain I was having in the left one has gone away and the right one has never really given me any trouble thank goodness.  Things that have gotten a lot better in the past six months are my ability to squat (both in the gym and out) and ability to accelerate and stop.  I still can't stop as fast as I could prior and at moments I still feel a bit unsteady going down steep inclines on the hiking trail.

But overall things are good.  I've dialed back my gym routine some as work has been crazy this summer but I'm still getting in 3 days a week and still doing all my rehab stuff.  I'm pretty sure I'll do it for the rest of my life.  I still start off with a 2 or so mile stationary bike ride (try and maintain 20mph, which is pretty hard cardio wise) then do my ladder drill and butt kick and high knee stuff.  Then usually do a bit of easy jogging.  Recently I've been able to start doing some heavier weight squats but it's a long process getting the power back.  I can do 225x 5 times now which is good but prior to the injury I'd have thought nothing of it.

Biggest change of course for me is my weight loss since the injuries (down about 50lbs) and I'm still maintaining around 175-180.  Would love to lose the last 15 or so lbs around my gut but for now I'm happy.  The weight I have lost has made the recovery and my general quality of life much better.

Best of luck everyone.  The poster that had the bilaterals in the garden -- ugh, almost teared up a little when you said "realized I couldn't get up": man I had the same thought when i did mine.  I foolishly tried to get up with a hand and then collapsed.  Took 3 firefighters to get me into the ambulance.

I'm doing a pretty serious hike tmr, 3200 ft gain to a chain of alpine lakes.  I am truly blessed to have this degree of mobility again.

[Johanna]

Hello RPTers...waves...I'm back with the latest...

Before I begin, I am sending a hang in there message to you, tidileboss.  I hope you found Norene's advice useful and contacted your OS about any potential signs of infection.  And madvillian, I surely appreciated reading your updating post.  I found it very encouraging to read of your return to some decent level of mobility.

In previous posts, I've mentioned that I had to have my wire removed.  That occurred this last Thursday, about 3 months post op.  Before I share about that, I thought I'd mention my latest battle with my insurer.  You know they ought to be cautious about igniting the wrath of a retiree.  Especially one who has to sit around the house waiting on a recovery before resuming pleasurable activities.  This recent round occurred when some insurance clerk (who seems incompetent, overworked or both) decided in her wisdom to cancel my home services because I seem to be able to get to my doctors' appointments (which are 160 mile round trips - with the assistance of kind folks who drive me there) and that there were no home assistance agencies where I live (she decided reading my record was an inordinate waste of her time, because I've had a number of visits both after the tendon graft and before that my knee replacement.)  Grant you, the visits have been erratic due to their interference with denying authorizations.  I have wondered if they are motivated to stall services to wear down an expectation of benefit delivery.  At any rate, I researched the appeal process and faxed off a protest letter.  In it, I mentioned that there were few chairs I could sit in just yet, and fewer toilets high enough for me too.  That seemed to be persuasive.  The appeal was expedited, and I won it.  Of course, my PT was suspended for two weeks again in the interim.  I've been on the phone so frequently with a nurse case manager that this last time she chuckled and exclaimed that she's ready to put me on speed dial.

OK...on with the wire removal experience.  Ah yes, it was quite the experience before hand.  I was required to have someone accompany me because I had to undergo sedation for this and they wouldn't even allow me to use a taxi to get home (not that that was an option for me living so very far away).  Anyway, I solicited the help of a great friend who came out the night before to go with me.  Thank goodness.  I set the alarm for 3 am and never heard it.  EEK.  She woke me up about 4:30.  As quickly as I'm able to move these days, I had to shower and get ready ASAP.  We left about 5 am to complete an 80 mile drive one way to arrive there by 6.  Well that didn't happen.  I was late about 20 minutes and my surgery was scheduled for 7.  If that weren't enough of an issue, I had to use the facilities.  And yes, one of my main concerns came to fruition.  OMG.  They ushered me into a 'handicap' bathroom (no stalls).  I took a look and gulped.  It had the side rail, but the toilet was very low.  I locked the door and hoped for the best.  Well the best didn't happen!  Uh Huh.  I couldn't get up from it.  Thank goodness I keep my cell handy.  I had to call the front desk with it (I had called earlier to let them know I was running low.)  And, they had to unlock the bathroom door and come help me.  Should I be glad for the distraction?  There is no doubt I would have injured myself in a major way trying to get up on my own. 

Finally, I had the procedure (this was done at an out patient surgical center).  Woke up with my knee in an ace bandage.  I found out that I'm to keep it on until I see my OS this Thursday for him to remove the stitches.  It looks like he made the incision right near my knee cap.  I also learned that I'd not resume PT until after I see him.  I'm back to sponge baths until then, oh joy.  The good news is that I am not in pain with it, and I can still bend my knee.  I did sleep the first night in the brace again.  Last night, I decided to remove the brace and that worked without incident. 

I do hope I will make even better progress shortly...at least be able to get up from a seated position with greater ease.  Perhaps my OS will have me take some steps sans brace at this visit.  That will be something...a first since I started wearing a brace last winter, after I was diagnosed with the rupture prior to the graft. I'll post an update Thursday evening. 

At least there was some 'entertainment' over the last two weeks with the election insanity here, across the pond.  If you are inclined to pray, I think the US is in need of prayers.  Good grief, already.  Okey Dokey everyone...sending mobility health wishes to you all.

~ Johanna ~