Ruptured Patellar Tendon Surgery

[MinorSetback]

DJ... Congrats on getting back on the bike and getting your full range of motion back. Like yourself, I was the same exact way.. 2 weeks ago i started riding the stationary bike, I never thought I would get it across.. Then the second PT session, I went around completely.. Yes it was somewhat of a quick pain, but it did feel good to finally be able to accomplish that.. Now when i go to PT, I ride for about 5 min. with no problem. I just had My ROM yesterday and I'm about 115 degrees. You are lucky you had the CPM machine.. I had asked for it, but my doc and Phyisio said it was not neccessary.... I was really bummed about that.. but it looks like it worked out though so far. Let me ask you something, does the top of your kneecap hurt at all when you bend it? Not a lot of pain, but a short pain when you do heal slides? I get a little pain when I do them..
As for swelling, my knee is still a little swollen at times. I was told its normal because of the exercises.. I cant wait for that to go down..

Minor Setback.  I was on the bike for the first time this week and I could only rock back and forth and it was very painful in the quads/top of the knee.  During the next session my PT manipulated scar tissue and got the kneecap moving a bit more so I was able to actually peddle on the bike which felt like a huge accomplishment.  I'm up to 90 degrees with the CPM which I have to send back this Monday and I'm bummed out about that.  I can sit know with a bent leg and move about without my brace. 

I'm a very skinny guy 6'1" 155lbs so I don't have alot of weight bearing down on the knee which helps I think.  I'm sort of amazed at how rapidly things progress since I've started bending and exercises.  Two weeks ago my knee and lower leg were extremely swollen.  Now no swelling except for the knee and I can sit in a chair almost normally which has made work a lot easier. 

[steesh]

Hi All,
That is me 4 weeks post surgery. Eventually found out tendon repaired with 3 screws into patella and sutured back together. Mobilising ok with crutches. Trying my best to not weight bear but no pain still. Had brace moved to 30 degrees then 60 and appt on Monday. Knee stiff but managing the 60. Due to see Os in a fortnight to get 90 and physion to begin. Cant wait to start so feel like i am doing something to get better.

Main problem is the boredom. Bizarrely started buying star wars figures on ebay. Not spending money going out and holiday for june cancelled. Hopefully get away towards end if year.

Steesh

[John42]

Hi Steesh



PATIENCE  - Don`t push it


JohnK/ Manchester UK

[steesh]

Hey John,

Doing my best to take it easy. It is a weird injury. Feel like I could be doing more. Realise need to let it heal. Had a long discussion with OS. He is actually an old friend from uni. Have seen three different surgeons now. The consesus seems to be to get the knee bending in the first 6 weeks but to protect it by not weight bearing and no physio.

Have been told a few times that doctors are the worst patients and they are probably right! Seem to have had it easier than many others with little pain and being able to get around on crutches ok. No complications so far and keeping fingers crossed! Never thought Iwould be so keen to get back to work. Difficult being idle.

Steesh

[CSM4thCAV2014]

Well, this is my one year update as today marks the anniversary of my unfortunate bilateral PTR. From what I observed, I don’t think we had another bilat PTR on this board since mine unless I missed it. First of all, as I’ve said before, a double is somewhat different as far as PT and recovery time. I hear folks talking about walking, driving, starting PT and going back to work even in just a few weeks after the injury…that is amazing to me. Anyway, even as far as doubles go, and without many others to compare to, I feel that mine has been a very difficult and tough recovery. Right now, I cannot run, I cannot jump, knees buckle under me w/o warning at times and steps are extremely difficult. Early on, I was told by my OS that this is a yearlong injury, so obviously, I’m a bit disappointed with where I’m at now that I’m at the 1 yr point.

To summarize my journey over the last 12 months goes as follows and I apologize in advance to the marathon length of this post but I wanted to list some milestones and prominent issues. I suffered double rupture on May 2nd 2011 while running…did not trip, step in a pothole or anything, just running. Surgery was performed within 18 hours of the incident. I was placed in plaster full leg casts for two weeks until staples were to be removed and then a hard fiberglass cast on each leg for 6 more weeks w/no weight bearing at all. Was confined to either a wheelchair w/leg extensions or a trapeze equipped hospital bed for the first 8 weeks. I opted for a bed pan in lieu of making the journey to transfer in and out of the bed to potty seat. Fitted with immobilizers after cast removal and began PT at 10 weeks. My first steps were made with the assistance of a walker. ROM at first PT session was around 25-30 and straight leg lifts came relatively easy as I had been doing those all the while I was in the heavy casts. I reached 90 ROM around 12-13 weeks mark and steadily improved all the way to mid 130’s on both knees by the 4 month mark. My OS did not use a wire. At 5 month mark, I switched PT’s so as to join a facility with a pool. As soon as my ROM started coming back I developed a uncomfortable popping in both knees-worse on the left. It became apparent my kneecaps were positioned way too high (patella alta). I began PT on my own in Feb and still utilize the pool for water therapy which has been a huge help.

The things that have helped me, in no particular order are: ice, tempurpedic knee pillow, stationary bike, total gym(leg squats), water therapy, patella manipulation, ibuprofen, heating pads, muscle rub, a patella tracking brace, a great boss who let me come back to work early and work at the desk, and finally a very supportive, loving wife and daughter.
The kneecap popping has gotten worse with time and has limited my aggressiveness when it comes to PT. I had a “clean-up” scope surgery done at the 6 month point and in Mar I received the rooster beak fluid injection…neither helped much. I switched OS’s in October. His prognosis are that the kneecaps are too high and this is what is causing most of my problems with recovery. Currently, I’d estimate I have 40% overall knee function and strength. I had one dislocation last month which corrected itself on its own while I was enroute to the hospital…very, very painful event to say the least. Last week when I went to follow-up with my OS, he had called upon another knee specialist to examine my knee. When he had me cycle my left knee from flexion to extension, he looked startled and simply said “something’s in there”. I assume he meant something that shouldn’t be in there. My OS thinks we should do a TKR on the left knee right away and the other specialist agreed. A lot of that thinking comes from the fact that even before my injury; I had a long history of scopes for both patella roughness, meniscus tears and reduced joint space in the medial compartment. I can’t help wondering if the OS knows I’d need the TKR soon anyway w/o PTR injury and maybe he’s just hoping that will greatly help or perhaps eliminate the patella alta problem as well. From everything I’ve read, I don’t see where a TKR procedure changes patella height. So I’m going to hold off on that surgery just yet and may make a trip down to Vanderbilt for yet another opinion. Once again, the challenge is finding a OS that not only has done some double PTR’s but is considered a guru at it.

That would be my single most important advice I would give anyone who has suffered this terrible injury…if at all possible, be very selective as to who does your surgery. Especially on a double as there isn’t a “good knee” to compare proper patella height to and you could end up with the problem I have. If you get someone who has done a few and knows what they are doing, it will position you a lot better for a complete and quicker recovery. I wish the best to all and again sorry for the long post.

JC

[tonestone]

Today marks my 10th Month post op and things are going very well .  I am almost back to normal, very little swelling and really not much for me to complain about (knock on wood and I say so far).  I am back to playing softball and I stated that I would be cutting back but that lasted a whole week after the season started, I already played about 25 games to date and the season started in April.  I am happy with my progress, running at full speed (I ask my friends how I look running and the tell me you haven’t lost a step and running looks very smooth – getting  a lot of compliments on my come back/progress - I say progress because I am not done.  Keep on keeping on!!!). 

** I still go to the gym 2 or 3 times a week or on my off days because the quad is about 90 to 95% and it is now part of my routine.

To all the new member’s things will get better and it comes with time, as we all know it’s a long road to recovery.  Patience is the key!!!  Listen to your OS, PT and most importantly YOURSELF it’s your knee.  Keeping a positive attitude is the only way to get by this, remember every person is different so don't gauge your progress against others use what they have done to assist you in knowing that you too will get there with time. 

Good luck and take care

[sir95]

Well done on your recovery.  I snapped my patella tendon nearly 10 months ago and had a box wire for 4 months.  My problem was that I did the injury near a major training hospital in London but was referred to my local hospital for after care.  I struggled to get physio and was left in a brace for too long and now my leg will not bend.  I have had 3 operations and having a fourth.  I would just like to advise people the same as others listen to your body and make sure you get PT as soon as possible.  I have been off work and found this really tough so good luck to all of you going through this.

Steve

[Zlou58]

Well dudes!!!!  I just was on the down hill of my first torn patella tendon until a fall last night. I ruptured both patella and have surgery Tuesday!  I'm 29 and in alright shape but terrified of going though this BS again.  Any thoughts or advice to help on first few days are more than welcome.


Lou

[John42]

Hi Lou

Our thoughts are with you - very few patients rupture both tendons together - you are in for a very long haul - but all being well, patience will be rewarded.

Best Wishes

JohnK/ Manchester UK

[Goat456]

Hi,
   let me start by saying I'm new to this site but I really appreciate all the personal advice and sense of community here. I'm 18 and about to graduate high school. back on the 28th of march I was in weights class at school doing the norm for me... doing a set of 3 reps on deadlift at 285lb (I'm 5'1", female and 155 pounds). I love weights and usually can go up to 300lb (or could). However, that day sadly changed my life. On the last repitition I heard the normal sound of the patellar tendon loosening up but then I heard a strange pop. what was strange to me was that I felt normal for a full 15 minutes after this happened, but then there was the slow onset of nearly unbearable pain. I went to the doctor and was immediatley refferred to an OR and sent in for xrays and an MRI. What really irritates me the most about this injury is that both reports came out clean. When I finally went in for the appointment to see my OR, she said the reports looked good. As soon as she put my knee's at 90 degrees hanging over the table, and I kid you not, she told me "you've ruptured your tendon, I'm scheduling you in for surgery tomorrow." I had surgery on April 12th and spent the next week, spring break, recovering. So it's been nearly a month since surgery and I just feel hopeless about ever being able to lift or run or wrestle ever again. Has anyone ever had post-op depression like that? and what should I be doing to heal up well? My OR said absolutely no weight bearing for 3 months...

[sir95]

Hi welcome to the board

I am in hospital just have had my fourth operation.  I was also 3 months non weight bearing, however what I would advise is to start seeing a physio as soon as possible.  They can start manipulating your knee cap so that it does not heal incorrectly as leaving a leg out straight does you no favours.  I know this from personal experience.  I had three operations and  10 months later I luckily found a physio who knew what my problem was.  I had been left too long and everything healed incorrectly.  It has been 10 months of hell but as I am sitting here from having a tendon release and scar tissue removed I am already at 120 Rom when  encore I was only 45 Rom.  I have a lot to thank my physio for and he used to work with the England Rugby 7's and British Athletics Team.  Godd luck with it all but please seek physio as soon as possible.  Yes you will get very low days but keep positive and you can still work your upper part of your body so work on that. 

[Republic]

Goat456--

I think we've all had that feeling one time or another.  The fact is, it's a slow process. I was an avid runner & cyclist before I tore my patellar tendon. With the way my knee felt, the prospect of running seemed pretty dim in my mind. Eventually... and once I got my ROM back, I could think about running.  I can do about 2-3 miles and I do 40-60 mile rides at this point (I had surgery Dec 8th).  I just recently started doing leg exercises at the gym -- leg press, hamstring curls, very light squats, and lunges.  I can deadlift, but I'm very cautious with that as well (as I am with everything)... so I'm only doing about 105 at this point (laughable - especially compared to what I used to be able to do). But I'd rather be able to something as opposed to getting hurt again. There were many times I was downright frustrated and annoyed beyond comprehension -- especially since I went from being so active to so sedentary. I still kept up with upper body lifting since my Dr said I could full-weigh bear 3 days after surgery, I just couldn't bend it until week 6.

Getting ROM back is crucial, as everyone here will tell you, and going slow is even more important. You're young (I'm 29), so that's in your favor as well. Ask questions, read everything you can, and bounce your PT program off of people here if something doesn't seem right. Mine was very conservative and very steady.  Don't feel the need to rush anything, you want to make certain its healed correctly so you don't have problems later on. It will heal, you will run again, and you will lift weights again. My doc said the tendon will probably take a year to fully get back to its strength pre-injury.

The key is not worrying about your progress compared to others.   It's hard not to let your mind wander & worry, but once you start PT, you'll start seeing progress and that proverbial light at the end of the tunnel. You'll get there!

As everyone says around here -- keep asking questions!
-Adam

[redcoat82]

Yesterday was 11 weeks post op for me. I am pleased with my progress, although still find it hard to believe it is such a long haul.

I have been in PT for 4 weeks, and have essentially achieved full ROM and am making good progress on strength. I am walking without a limp most of the time and can go upstairss without much of a worry. Downstairs is still a challenge, and I have semi regular wobbles.

I am planning on getting out on my bike this weekend, question for the cyclists, how long did it take before you were comfortable clipping in?

I would agree with the advice on the board about taking control of your rehab, based on comments on this board I made sure my therapist had extensive RPT experience (I am his 3rd this year), and I have been very satisfied with the program.

Good luck to all,

Paul

[John42]

Hi Paul

To reach full ROM within 11 weeks is very good news, however just take it easy, as you don`t want to rerupture your knee - Doubtful that the tendon is 100% healed, so take care.


JohnK/ Manchester UK

[redcoat82]

Hi John,

I completely agree with taking it easy, my strength is just no starting to come back in the VMO, and my OS thinks it will be 2-4 weeks before I am out of the danger zone.

Interestingly, my "complete" ROM is just under 140 as I didn't get full ROM  back on my left knee when I ruptured the patella tendon 19 years ago, my therapist also feels that I didn't ever recover full strength in the left quad and used my right to compensate for the past 20 years. As I am starting strengthening I am doing both quads as if I did a bilateral, so that I am able to get equal strength into both legs as  I now won't have a "good" one to fall back on. Once again illustrates the importance of having a good therapist, my rehab from the previous injury left me less than 100% in both ROM and strength.

Paul