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Author Topic: Ruptured Patellar Tendon Surgery  (Read 1425790 times)

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Offline Nigel

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Re: Ruptured Patellar Tendon Surgery
« Reply #105 on: June 02, 2004, 11:18:03 PM »
Justin - bad luck with the knee.

I don't think MRI is very common for this kind of thing - certainly not on NHS anyway! I've not had MRI for mine, either in France where they operated or on return to UK. Anyone on the thread have an MRI??

The best "Haynes Guide"  8) to patellar tendon repair I've come across is the one on http://www.emedicine.com/orthoped/topic246.htm
which is referred to by others in earlier posts.

Go easy with the repaired leg as you don't want to risk a full rupture and tendons take a long time to heal.

Let us all know how you get on!

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

Offline kdhfrank

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Re: Ruptured Patellar Tendon Surgery
« Reply #106 on: June 03, 2004, 03:16:49 AM »
hey mates

following my patellar tendon rupture (thanks to that jerk O/S that did it to me) my new O/S ordered an ultrasound (done by a physician not a tech)...it was easy to see where the rupture was and how far my quad had receded up the leg..(i managed to watch while the tears of despair were running down my cheeks)...i then had an MRI...this may have had more to do with the scar tissue but I am not sure...I do remember being extremely uncomfortable for it and got an additional dose of demerol IV on top of the epidural in my back...i would think that an MRI would be better in Justin's case as it does layer slices and the ultrasound may not be able to penetrate the sheath to see the repair. if the tendon was fully ruptured the repair would probably have been done differently...wire vs. suture...due to the unelastic quality of the tendon itself...(no flexibility...no elasticity) and the need for healing of tendon before active ROM...i question whether a MD on a cruise ship would even be qualified to do this kind of repair as it is extremely uncommon. (yes...it is very rare but  there seems to be a run of us lately)...so again i would have this looked at by a very experienced O/S who has taken care of this type of injury....i thought you guys would find this interesting...most patellar tendon ruptures occur in the male 35yrs. plus, somewhat out of shape recreational athlete...often occurs playing basketball and overdoin..."showing off?" (just kidding) weekend warrior!...should have been drinking a beer and watching the game instead of playing it!...and i know i am not in this group as i am female, 35+ and in incredible shape!!!!...and damnit ENG...you should demand a CPM from your O/S...they are covered by ins...OR SIGN A MEDICAL RELEASE AND GO SEE SOMEONE ELSE!...you are in the U.S. and your insurance certainly has DME coverage!!! i want to see you get better on time...not later.  a CPM will help with passive ROM and flexion which it sounds like you may be having problems with....and in reality this injury can take up to 18 months to repair...heal. do you guys think we could write a book and start charging these O/S for advice???? 2 weeks and counting...and yes, i am scared.
love, auntie 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!

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #107 on: June 03, 2004, 06:59:23 AM »
Auntie Kim, you're the bomb ;D and you hit it right on the head when you described the out of shape, weekend warrior type who is most suceptible to this particular injury.  Thanks to Tony or Nigel for posting the website of the particulars of the injury as they have shown me more of the why it happened to me :-[  I do need to do whatever has to be done in order to get better in a timely fashion as my occupation depends on it.  I still haven't gone back to work and I couldn't if I wanted to.  That's what I'll use to get my outdated OS to agree to more treatment.  I have been doing my exercises and have increased the setting on my brace to 40 degrees lately and I do notice more confidence in the knee and less swelling and no pain just stiffness when I try to take it beyond the setting w/o the brace.  Sorry for the poor chap who got injured during his honeymoon, hope it didn't cramp yur style too much ;D, I can't believe that the ship's doc was able to patch you up so quickly like that, good for him if it turns out alright!  This thread continues to amaze me and keep me on my rehab 8)  Frats, 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 #108 on: June 03, 2004, 10:52:42 PM »
Hey Kim - what's all this about "should be drinking beer instead of playing"? Let me tell you, our kind of Weekend Warrior drinks beer, THEN plays.  :P At our age we need the muscle relaxant effect.

And what about that Justin, what exactly should he have been sticking to, instead of playing football??  ???
Left patellar tendon break and repair with wire loop mid-Mar '04.
Full recovery, signed off by OS in September.

Offline kdhfrank

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Re: Ruptured Patellar Tendon Surgery
« Reply #109 on: June 04, 2004, 04:29:23 AM »
mates

i can think of a lot of other ways of rolling around in the sand on my honeymoon that dont include a football...and probably burns more calories!!!! sounds like our beer swigging weekend warriors are getting a little antsy in front of the t.v.!  ;D...

cheers

kim

ps
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!

Offline EngKnee

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Re: Ruptured Patellar Tendon Surgery
« Reply #110 on: June 04, 2004, 07:23:54 AM »
 :-[Ok guys, I admit I was completely sober when I did my knee but I'm not going to say what I did in the sand on my honeymoon ;D, I can't even remember being married it's been so long ago..... ::) Kimmy I love it when you talk dirty :P  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 Fisnik

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Re: Ruptured Patellar Tendon Surgery
« Reply #111 on: June 05, 2004, 01:16:12 AM »
Hey everyone,

Long time no see. Been very busy working these days, and haven't been writing since there was nothing to tell, really. I was stuck in the heavy cylinder cast unable to flex the knee at all and, apart from having stitches removed about 2wks post-op. The only exiting thing was getting used to the crutches and being able to sit on the toilet seat. And oh, I turned 31 yesterday.  ;D

Today, however, 4 weeks post-op to the day, was much more eventful:
For starters, I went out  after a month of house prison and noone could convince me to come back home. The first 5 hours of the day were spent queuing at the hospital (hospitals in Kosovo, by the way, are in awful state and they resemble Timbuktu rail stations in Indiana Jones movies), waiting to see my OS, which I finally did. He decided to remove the cast and put an adjustable brace, which was very relieving, especially since he had said earlier that I should be keeping the cast for 8 weeks.

Had an ultrasound, which, according to him, looked quite good and the tendon appears to be healing slowly, but surely.

He reccomended a CPM machine, which is unobtainable in Kosovo, so I need to urgently arrange one from abroad, so I can start flexing that knee - perfect timing for this kind of exercise while watching Euro 2004 soccer championship. Any other ideas than Ebay? Much easier for me to obtain one in Europe, so if any of you knows where I could get hold of one, gimme a shout, please.

He also set my brace to 20 degrees and told me to keep that setting while walking around in crutches, so the knee bends a tiny bit, which for me is really a big improvement, considerin that initially he wanted me completely immobile for 8 weeks.

Had also a chance to ask loads of questions, and I actually impressed him with the knowledge I had gained about this specific injury. Also gave him about 50 pages of printouts I got from the web, in case he hasn't read any of them.  ;)

Doctors here can be very nasty if you appear to be telling them what to do, but he was quite grateful. I kept asking him why haven't I started flexing the knee while everyone else started doing that in week one post-op. He stated that he didn't want to take any chances because of: a) The rarity of this injury, b) My unusual body size and weight, c) The wires they have in Kosovo are of poor quality and seem to snap easier, hence the reason he put two of them inside my leg (not dissolvable, of course - wouldn't be surprised if he'd said they're made of wool or something) and d) He was worried I might do something against his instructions (yes, I look a bit rebellious and arrogant, but sincerely I'm not - must be my appearance). He simply thought that the first month is very critical and he didn't want any complications, so he played the safe card.

Bottom line is, I am very happy to have gotten rid of that heavy cast - feel like a bird wearing the brace. I'm also happy to be bending the knee a bit (yeah, I know, 20 deg is nothing, but it's a start). I'm happy about the fact that I can put quite some weight on the injured leg and don't seem to feel any pain, and that is a good sign, right?

Content with this morning's outcome, I decided to spend the rest of the day roaming the streets of Prishtina, which was very relaxing, especially while visiting my favourite coffee places. Glad to see friends again, particularly those who didn't have a clue about my injury and looked in disbelief at my crutches. Had some comments about my weight (loss), which was very encouraging, too. Most thought I'd gone back to London or something.

Overall, although a day late, today's day was a perfect birthday gift.

I think I wrote a bit more than I intended. Well, can't be bothered to edit stuff out. Too tired from the busy day, so I think I'm off to bed earlier tonight.

Have a good one, all!
Fisnik

P.S. I truly identify myself as a lame Weekend Warrior who thought he could actually fly and ended up immobilised for god-knows-how-long.
« Last Edit: June 05, 2004, 01:24:05 AM by Fisnik »
Ruptured Patellar Tendon while playing basketball on 07 May '04.
Open surgery to repair immediately.
Two wires because of large body frame (2m tall 130 kg)
Completely immobilised for 6 weeks.

Offline biged

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Re: Ruptured Patellar Tendon Surgery
« Reply #112 on: June 05, 2004, 03:28:40 AM »
Hey guys and gals :)
My name is Ed and I ruptured both my patella tendons in both knees.  I am 6 weeks out now and just wanted to intro myself.  I am so excited to be able to talk with people that have gone through the same pain and trama I have. I live in Charlotte NC (and of course the weather is beautiful up here on Lake Norman where I live so the cabin fever is driving me nuts)

Offline kdhfrank

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Re: Ruptured Patellar Tendon Surgery
« Reply #113 on: June 05, 2004, 04:43:10 AM »
big ed

i would say congratulations on joining our club but i dont want you to throw your cane at me...in this thread you should be able to: know that you are not alone...but close to it. we are all going mad from being house bound and attached to our laptops and computers. we all think...but might not admit it...its kind of nice not working. most of us are out of shape weekend warriors (except for myself of course). we know more about our injury then our orthopedic surgeons. we could probably write a book and become wealthy... at least in euros. we smile and we cry. we just wish we could sit on the toilet like the old days. we support each other and chuckle at our various ingenious ways of figuring out how to do something without our legs. we dream about someday kicking a football (soccerball) or dribbling the ball down the court without crumbling into a sack on the ground...(except me of course). we give each other the strength to meet each day head first...and pass on the tips on how we did it. we are all united in our cause (to get our quads out of the jelly stage) even though our countries are not. and we pray that a fire alarm wont go off so that we dont have to run down 4 flights from our flat. we wish the mailman would have sympathy on us and bring our mail to the door. we wish we  could potty train our dogs...or at least teach them to use the litter box. we have all become comrades and probably all have the same scar. we all know that some day we will be the same as before even though we dont always hear that from our doctors. we would not be friends if we had not found knee guru. welcome. and may your recovery be faster then the rest of us!!! fat chance against me though!

cheers

kim from atlanta (and the only girl/woman here) and a nurse practitioner to boot.
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!

Offline Fisnik

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Re: Ruptured Patellar Tendon Surgery
« Reply #114 on: June 05, 2004, 05:43:41 AM »
Auntie Kim,

You definetely are an inspiration to us lesser mortals (read: weekend warriors). Although your last post didn't exactly answer the question I keep asking myself all the time (Will I have trouble because I spent the 4 post-op weeks without bending the knee at all?), it at least managed to cease my violent shaking (I AM dead scared) and stopped me from being on the verge of crying.

In case you're wondering, Ed, it was me who wrote a very happy-go-lucky post a few hours ago when I felt really happy about bending my knee a couple of degrees. Now, after reading a bit more about CPM use (which, incidentally, is inexistent in my country), I come to realise that my OS should have made me use one weeks ago and nearly started crying from worry of how it will affect my rehab in the future. These mood swings seem to one of the most common things we have here, and I'm glad I have a chance to share this with someone.

Has any of you guys (and our muse, Kim) gone through what I have? 4 weeks post-op without flexing the knee AT ALL? How will this affect my ROM and should I lose all  hope of getting my leg back to the previous state of should I still fight?

Gimme some hope, pals, as the articles I'm reading about this surely don't. My mood resembles that of my wife during her last pregnancy - one minute I'm the happiest guy in the world, the next I'm crying like a baby, not to mention hours of anxiety, laughter and fear in between. And the diet I'm applying in order to lose weight (and be fit just like I used to more than a decade ago) makes me crave for even weirder things than she did during her nine months.

At times, I see roasted chckens everywhere I look...hundreds of them! Chocolate with mayonaisse? Damn, I would kill for one of those! I think I'll just nibble on a carrot instead and shut up.

Fis
« Last Edit: June 05, 2004, 05:44:49 AM by Fisnik »
Ruptured Patellar Tendon while playing basketball on 07 May '04.
Open surgery to repair immediately.
Two wires because of large body frame (2m tall 130 kg)
Completely immobilised for 6 weeks.

Offline Nigel

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Re: Ruptured Patellar Tendon Surgery
« Reply #115 on: June 05, 2004, 04:26:40 PM »
Fis, can I chip in a comment on this CPM machine thing? I'm sure they're brilliant and several people on KG speak very highly of them. But if you can't get hold of one, that doesn't mean you can't work on getting ROM. I was never offered a CPM machine, the physio just got me to do my own passive flexing several times a day.

Basically, you just need to move the knee joint without using the muscles. There are lots of ways to do that. The best way I found (at my PT's suggestion) was to sit on a high-ish chair with my bad leg resting on my son's skateboard. Then, use my good good to rock the skateboard back and forward gently, causing the bad knee to bend and straighten. I sat in front of the TV in the evenings and did that.

Also, I was back at work from early on post-op. I used to take off my leg brace while I was sitting down at the desk, with my bad foot planted on the floor, and rock slide my castored office chair backwards and forwards with my good leg.

I think these things, although they were low-tech, contributed to my good experience in getting ROM back quite quickly.

Provided you don't put any active tension on the muscles, I think you can safely work at your own speed to build up ROM passively. At first you'll only be able to get a few degrees of bend, but you should progress steadily.

Hope it works for you.

Best, Nigel



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

Offline Nigel

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Re: Ruptured Patellar Tendon Surgery
« Reply #116 on: June 05, 2004, 04:49:28 PM »
Fis - BTW, forgot to mention...I think your 4 weeks without flexing will be no big problem. Plenty of people go 12 wks+ in a full cast. Anyway, actually you ARE flexing now - to 20 degrees in your new brace. Obviously if you can start doing passive ROM exercises before too long (with CPM machine or without) it will help you get full ROM back quicker. But try to relax meanwhile and don't sweat it.

If you'll excuse me for saying it, the mood swings problem sound like a crash-diet issue, not a knee issue!! Don't starve yourself or you're bound to end up feeling miserable.

Talking about overcoming an injury, we watched the drama-docu film "Touching the Void" (on DVD) last night. It's the one about the two climbers who got in trouble on a 20,000 ft mountain in Peru. One broke his leg (badly - shaft of femur straight through the knee joint, YUGGHH) near the top, his partner tried to lower him down in stages but then had to cut the rope. Won't say any more, or I'll spoil the story. An amazing study in human endurance and sheer bloody-mindedness, and well worth watching if you get a chance.

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

Offline Omaha

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Re: Ruptured Patellar Tendon Surgery
« Reply #117 on: June 05, 2004, 06:06:44 PM »
Hello, I have been following this board now for a couple days and decided I should contribute.

I completly ruptured my patella tendon on May 4th playing basketball.  Surgery was on May 7th.  I am 6 foot 5 inches so the OS used 2 wire loops for support.  If the wires need to be removed the OS says a small incision will be made on the outside of my leg and he will just pull them out.

I woke up in post-op with a hinged brace and polarcare ice unit on.  Surgery was at 11:00 and I was on my way home at 5:00.

Week 1  -  A lot of pain.  Polarcare ice unit ran almost non-stop for the 1st few days.  Pain was all but gone by the end of week 1 and I stoped taking meds.  I will return to work on Monday.

Week 2  -  Visited the OS.  He said all went well and set the brace to 30 degrees.  Started Physical Therapy.  Very passive exercises up to 60 degree ROM.  Instructed to leave brace at 30 degrees for weightbearing and 60 degrees when doing passive ROM.  I could not reach 60 degees.

Week 3 - More of the same untill I visited the OS.  He was much more aggressive.  Changed the weight bearing to 60 degrees and the passive ROM to 90 degrees.  Started to attempt strait leg lifts and lower leg lifts.  Quad is mush and I could not do either one.

Week 4 - PT "encouraged" the ROM to 90 degrees.  He was assisting the the leg lifts at the beginning of the week, but I can now do both unassisted.  It is truly amazing how fast the improvements can come.  I have not been able to reach 90 degree ROM on my own.

Mood  -  Rollercoaster ride.  One day you can't believe how pathetic you are for not being able to lift your leg and the next day the improvement comes along to pull you out of the funk.

My next goal - I need to work on the quads so I can get the OS to let me stop using those bleeping crutches.

I have appreciated reading everyones experiences.          
                                                                  John
Ruptured Patellar Tendon right leg 4 May '04 while playing basketball
Surgery to repair 7 May '04, two wire loops for support

Offline Fisnik

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Re: Ruptured Patellar Tendon Surgery
« Reply #118 on: June 05, 2004, 06:06:53 PM »
Nigel,

You could be right about the diet and mood swings, but if I ate as much as used to and kept still like I do now, the bed would probably break by now.

Not only do I have to be careful not to gain weight, but I'm actually trying hard to lose some in order to make the rehab easier, and I am succeding. I think I can cope with mood swings provided that a lighter, stronger (and hopefully handsomer) version of me comes out of this injury.  ;D

Come to think of it, my worst moments are actually during late nights, deprived of dinner. Once upon the time, pizza delivery used to be a perfet cure.
Ruptured Patellar Tendon while playing basketball on 07 May '04.
Open surgery to repair immediately.
Two wires because of large body frame (2m tall 130 kg)
Completely immobilised for 6 weeks.

Offline Fisnik

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Re: Ruptured Patellar Tendon Surgery
« Reply #119 on: June 05, 2004, 06:21:11 PM »
Wow, John (Omaha)!

We seem to have so much in common! I am 6ft 6in and I also have two wires, I also ruptured my tendon playing basketball and we had surgery the same day!!!

The difference is that my OS is much more conservative than yours and I live in a country where CPM machines are nonexistent. You seem to be improving extremely fast!!!

I'm curious, how heavy are you and how old (if you don't mind sharing this with us)?

Fis
« Last Edit: June 05, 2004, 06:21:48 PM by Fisnik »
Ruptured Patellar Tendon while playing basketball on 07 May '04.
Open surgery to repair immediately.
Two wires because of large body frame (2m tall 130 kg)
Completely immobilised for 6 weeks.