Ruptured Patellar Tendon Surgery

[ih8bigots]

Hey everybody,

I'm a long time reader of this thread, and I have found it extremely helpful from the initial diagnosis, through the surgery, and through the recovery and rehab processes.  It is nice to have patient perspectives to spell the odd papers or research studies that seem to gravitate towards extremely successful surgeries with terrific recoveries to preinjury conditions.  Anyway, this is my first post. 

A little background info:

28 year old male
Complete rupture on right knee November 2009
Repair about 14-20 days later
Gait normal, back to preinjury physical activities
Still experiencing high riding kneecap on injured leg
Unable to obtain full active terminal knee extension

I was wondering if the posters with patella alta are experiencing extensor lag.  Even though I am pain free, and my knee is mostly functional, it bothers me how much less I can actively extend my right knee vs my left (hard to say for sure, but I would guess 15 degrees less).  I was led to believe that it was just weak VMO, but now I wonder if I've simply reached a limit with the current length of the tendon and position of the patella.

Any input would be appreciated.

John L

[John42]

Hi John

In response to your post, would advise that over the past years, very few RPT patients will gain their preinjury ROM.  I understand from my Consultant, that in most cases, during the operation, there is some shortening of the tendon is required regardless of hose much PT you might have done.

My Consultant also stated, that what ever ROM is reached at twelve months, is the final ROM and anything over 115 is livable.

I ended up with 118ROM, and can do most normal things, but admit that I cannot run after a bus, nor find it a bind climbing stairs or uphill on a road.

So, in conclusion, listen to your knee, and take extra care on wet road etc.

Best wishes

JohnK/ Manchester UK

[bballkingofnba]

Hi John L,

I am in the same boat as you where I am missing a few degrees of extension (not near 15 tho about 3 or 4). I have spoken to my doctor about this in great detail and he said he has seen patients with a high riding kneecap who have full ROM as their uninjured leg. What causes this defecit is initial poor physical therapy in the beginning. Restoring knee extension passively is goal#1 after knee surgery and for some reason my PT failed to understand that. Instead he worked aggresively on my flexion and for extension he had me try to do short arc quads but after repair by the time u can do a normal short arc quad from 20 to zero degrees its too late to achieve extension if you already havent done so. It is important to find out what is causing your lack of extension as a patella alta usually doesnt cause an extension defecit, but a patella baja almost always does. I would see a doctor and they can usually just go in with a scope and clean out scar tissue which brings that extension back. It is a very minor surgery and patients go back to activities in a couple of weeks. And tho john is right the tendon is shorter when the repair is done since the ends are cleaned out, over time it stretches as flexion is gained and it may even become longer than the other tendon as in our cases since we have patella altas. Hope this helped!

[Humpy]

Good Evening all

I haven't posted on here for a long time so I thought I would send a update

It was a year ago today I ruptured the patellar tendon in both knees by tripping over a tree root!!!
I have had two lots of surgery 1 to carry out the repairs and the 2nd to remove the tension wires, Today I am nearly back to normal I am able to run cycle swim pretty much where I was all within a year not sure if I was lucky or just healed quickly, My only real issue is a constant crunching in my right knee mainly when descending stairs I've been told there is no cartilage left in the knee and I am due to see a specialist to regrow my own and have it inserted back in, more surgery.

Not sure if your still around but there was a guy on here named Tiger who had the same surgery at the same hospital in Redhill by the same surgeon it would be good to see how your doing if your still around on here.

All the best fellow RPT sufferers

[mxbigd17]

Hey everyone, time for my 10 week post op update. I went to PT yesterday and did some strength and stretching exercises. An at the end she put a ice/compression machine on my entire leg, the name of the machine was called "The Game Changer". It was awesome, after 20 mins of use my leg swelling was down so much and my knee pain was gone and I could walk normal for about 30 mins. Then the knee swelled up to its now "normal" size and reality kicked back in. PT measured my knee at 83 degrees, ROM is coming but it's coming slowly.

John K, I went out 2 weeks ago and purchased a floor cycle like you recommend for this injury and it is great. I could not get a full revolution at first, but now a couple weeks later I can. It's not a thing of beauty to watch right now, but I'm doing it. Like you say, it's the small accomplishments that matter with this injury. I do therapy everyday on my own, not just during PT sessions and on Sunday I did therapy ALL day and I was so happy. Only to wake up yesterday to a badly swollen knee, and in pain. It felt like I took two steps back, ROM was at barely 35 degrees. I was feeling down to say the least, but I went to my PT session and got thru it. And the ice /compression machine at the end, like I said was AWESOME. Can you send me the information you have sent other people about rehab. I would really like to read thru it. What is your opinion of 83 degrees at the 10 week mark?

Thanks to everyone who has responded on my earlier post. It def helps to read positive reply's as I find myself getting depressed from time to time. I know it will get better, at least that's what I've been reading about on this forum.

[boing]

Juls,

Sorry it took me so long to reply your post. I have to admit that I am jealous about your scar. It looks so "beautiful" comparing to mine .

Kneeds,

I was officially released by doctor yesterday, exactly 14 weeks since injury.
A little background of myself: 29 yrs old male; fully ruptured patellar tendon and slightly damaged cartilage while playing basketabll on 4/28/13; outpatient surgery on 5/9/13; followed 4 weeks in immobilizer; began PT at 6/11/2013; gained my full ROM back at 7/02/13; accomplished slow jog 5 miles on 8/03/13; medical released at 8/05/13.
My recovery may seem a little speedy and aggresive to some others on here. We all are different, different ages, different injuries, different conditions, different medical providers... Hence we might end up having different timelines and routes. But I believe that we all have the same goal: defeat the injury and get the pre-injury life back. Like many others have said many time here, please keep your hopes high, the knee will come back. Sincere thanks to John K, Ben, Clint, BBall, Juls, and many other friends... here on Kneeguru for forming such a comfortable and informative community.
Take care everyone, wish you the best and I can't wait to read more success stories soon. 

[John42]

Hi mxbigd17

Delighted to hear of your progress.

Also delighted that you have invested in a floor cycle - A mini exercise bike which costs in the region of £30/$45.

A new thread has been set up for RPT/RQT patients - have a look at it - go back to the Bulletin board,
click on Ruptured Patellar Tendon/Ruptured Quadricep Tendon - then look on the right hand side the button which takes you to a new web page.

This is specific to the Ruptured Tendons, and there are a series of entries to documents which have been compiled over the years - all good and helpful stuff.

JohnK/ Manchester UK

[fishy]

Week 10 after surgery.  I have reviewed most of the pages and have a better understanding of my injuries.  MY STORY:  May 24th, after three grueling days of moving boxes into garage prepping for a move...and LAST trip with a box I stumbled and fell down two steps to the concrete floor landing on BOTH knees....went to ER and doc thought just a bad sprain.  Two days later after a light work out I was walking towards my car and both knees ruptured and I fell screaming to the pavement.  Operated on May 27, right leg partial tear, left leg full rupture.  Both legs in braces for 8 weeks, the last two weeks have been amazing without braces.  ROM left 120 and right 120+.  I am a 66 yo male, 5'10", and have worked out most of my life and ran 60+ marathons (10k, 1/2marathon & full marathons). I have taken a statin (cholesterol medication) for 14 years and my doc reports that statin family of drugs can destroy muscle...and I must say I have tried most of the statin family of drugs trying to minimize the muscle pains during runs and workouts.
Today:  quads have atrophied and leg pains (especially at night).  I can't stand up without using my arms, stairs (down is the worst).  I walk usually unassisted.  Thanks to all who have posted before me and I promise I will post regularly to keep the ball rolling.  And like everyone else who has said it before me.... take it slow and keep your spirits up....

[Onedertwin]

Hi I've been following this post since I ruptured my patellar tendon on June 22, 2013 in Kansas City while playing in a flag football game. A member of the opposing team obviously was too dumb to remember it was flag football because he tackled me and I fell back on my leg. I looked at my thigh and saw a lump (my knee cap) and an indentation in my knee (where the knee cap was happily living) and completely panicked. I was taken to the hospital and diagnosed with a ruptured patellar tendon. I had surgery 4 days later (was was supposed be two days later but swelling prevented it).

I just had my six week follow up and my doc told me that I should start putting weight on it and trying to walk around my apartment in the brace and without crutches. I'm terrified of trying to walk. I still cannot drive though. The mental aspect of this injury has been just as traumatic as the physical injury itself. Today has been the first day that I felt like I've gotten some somewhat good news. Thanks for all of your posts about your injury. I start PT this week (which I felt was too long to start). I will continue to update you all on my progress.

[fishy]

Hi I've been following this post since I ruptured my patellar tendon on June 22, 2013 in Kansas City while playing in a flag football game. A member of the opposing team obviously was too dumb to remember it was flag football because he tackled me and I fell back on my leg. I looked at my thigh and saw a lump (my knee cap) and an indentation in my knee (where the knee cap was happily living) and completely panicked. I was taken to the hospital and diagnosed with a ruptured patellar tendon. I had surgery 4 days later (was was supposed be two days later but swelling prevented it).

I just had my six week follow up and my doc told me that I should start putting weight on it and trying to walk around my apartment in the brace and without crutches. I'm terrified of trying to walk. I still cannot drive though. The mental aspect of this injury has been just as traumatic as the physical injury itself. Today has been the first day that I felt like I've gotten some somewhat good news. Thanks for all of your posts about your injury. I start PT this week (which I felt was too long to start). I will continue to update you all on my progress.

I recommend you read the posting on this subject and you will be amazed at how similar we all are when it comes to fear....fear of falling, of reinjury, pain, ROM, etc..  I am not that far ahead of you in recovery and I have had all the same feelings....the up side is huge though....when you remove your braces there is additional blood flow/circulation, and then work outs are easier.  Be kind to yourself, and I assure you that your recovery will go much smoother.... I will continue to post and will be very interested in your next posts...

[John42]

Hi Onedertwin

Welcome to the RPT thread - You have sustained a very serious injury with a long rehab - suggest that you read some of the previous posts on this this thread - click on the Quadriceps & Patellar Tendon rupture button on the right had side of this page - this will lead you to a thread on which there is a set of documents which I have compiled over the years - this will give you a good insight of your injury and the rehab process.

ASK questions - listen to your knee - keep posting

Take care
JohnK/ Manchester UK

[John42]

https://www.facebook.com/QuadricepsPatellarTendonRupture


Hi Folks

This is the new page constructed with documents, which I have compiled over the years.

KneeGuru have also added a couple of documents as well, just click on the various links.

Hope everybody makes good use of this information

JohnK/ Manchester UK

[bballkingofnba]

Boing, I am guessing the tad bit of the patella alta you have doesnt bother you in terms of running?

[copper44]

Hello.  I ruptured my patellar tendon on July 31, 2013 during a fall at the office.  I have had knee tendonitis for most of my adult life, but nothing as acute as this.  I saw the surgeon the next day on August 1st, but I still do not have a surgery date because his office has yet to submit pre-certification paperwork (he's been in surgery and hasn't dictated notes yet!).  Because of this delay and the fact that he's already booked, it looks like I may not get under the knife for another 2 weeks which will be a total of 3 weeks after my rupture.  Is that too long?  I really like my surgeon despite his less than stellar administrative skills, but I am seriously considering going to another doctor.  Is it worth it?  I have seen a lot of references about getting surgery quickly to keep the tendon from shortening and to keep the tendon from developing scar tissue and I am wondering what quickly really is.  Does surgery 3 weeks post injury put me at risk of not having a successful surgery?  I love to run and I would be devastated if a surgery delay kept me from my goal of being able to return to running 3-4 miles 3 times a week. 

Thanks to all who have posted before me.  This site has been a wealth of information and a big comfort during a very scary situation.

[John42]

Hi Copper44

Welcome to this exclusive club - you have sustained a very rare and serious injury to your knee.  Yes three weeks is a very long time following your injury, and suggest that you press for immediate surgery.

A long rehab is awaiting you and suggest that you read some of the previous posts on this thread.

I have compiled together with KneeGuru a series of documents over the last few years.  They cover a RPT/RQT injury.

If you click on the attached link, and click on the various links, you will learn a great deal about your injury and the rehab process.


https://www.facebook.com/QuadricepsPatellarTendonRupture

Read with care and keep posting

Where do you live?

JohnK/ Manchester UK